HomeMy WebLinkAboutHistoric Chem InventoryFORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
one page per material per building or area
❑ADD [—]DELETE REVISE
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) HANSON AGGREGATES
CHEMICAL LOCATION M<
CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES NO
FACILITY ID #
FA0002505
MAP#
GRIDH
(Agency use only)
H. CHEMICAL INFORMATION
CHEMICAL. NAME S O L O M O N COLORS
I RARE S[:CRIS h ❑ No Yes
If Subject to EPCRA, refer to instructions
COMMON NAME SOLOMON COLORS
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
HAZARDOUS MATERIAL TYPE ❑ a. PURE ❑x b. MIXTURE ❑ c. WASTE
RADIOACTIVE ❑ Yes ❑ No
CURIES
(Check one item only)
PHYSICAL STATE. SULIU ®b. LIQUID GAS
❑ a ❑
L� LARGEST CONTAINER A 00.0
(Check one item only)
FED HAZARD CATEGORIES ❑ a. FIRE ❑ b. REACTIVE ❑ c. PRESSURE RELEASE ❑ d. ACUTE HEALTH ❑ e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE CODE
3000.0
1 4400.0
UNITS* ❑X a GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d TONS
DAYS ON SITE: 365.0
(Check one itein only) *If EHS, amount must be in pounds,
S FORAGE IM a ABOVE GROUND TANK e. PLASTIC/NONMETALLIC DRUM 0 t. FIBER DRUM 0 in. GLASS BOTTLE
CONTAINER ❑ h. UNDERGROUND TANK ❑ f. CAN ❑j. BAG ❑ n. PLASTIC BOTTLE ❑ q. RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ❑ o. TOTE BIN ❑ r OTHER
❑ d. STEEL DRUM ❑ h. SILO ❑ I. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE ❑x a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
STORAGE TEMPERATURE 0 a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC
I
IRON (III) OXIDE
❑ Yes ❑ No
2
❑ Yes ❑ No
3
❑ Yes ❑ No
4
❑ Yes ❑ No
5
❑ Yes ❑ No
I more blmledws coin ponen is are present al penter than V4. bt ,,,iglu if non-eareinogemc, or tl.l % by weight it carcinogenic, olfarh odditionot sheets or paper cnpturiag Ihr required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If P:PCRA Please SI,n Here
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
one page per material per building or area)
[]ADD []DELETE ItE:V IS 1'
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA— Doing Business As) HANSON AGGREGATES
CHEMICAL LOCATIOP CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
FA0002505
MAP#
GRID#
(Agency use only)
H. CHEMICAL INFORMATION
CHEMICAL NAME
Da rawe I d C
TRADE SECRET ❑ Yes 0 No
If Subject to EPCRA, refer to instructions
COMMON NAME Daraweld C
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete i£required by CUPA)
Carcinogen (CARC), Toxic (Tox)
HAZARDOUS MATERIAL TYPE [3.. PURE ❑' b. MIXTURE ❑ c WASTE
(Check one item only)
RADIOACTIVE ❑ Yes ❑ No
CURIES
PHYSICAL STATE
❑ a. SOLID ❑' b. LIQUID ❑ c. GAS
LARGEST CONTAINER
0.023
(Chook one item only)
FED HAZARD CATEGORIES
(Check all that apply) ❑ a. FIRE ❑ b. REACTIVE ❑ c PRESSURE RELEASE ®d ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE. CODE
3.0
1 5.0
UNITS* • a. GALLONS b. CUBIC FEET
Q Q ❑ c POUNDS ❑ d. TONS
DAYS ON SITE-
0
(Check
(Check one item only) *If EHS, amount must be in pounds.
STORAGE a. ABOVE GROUND TANK E3 e PLASTICINON METALLIC DRUM C3 i. FIBER DRUM m. GLASS BOTTLE
CONTAINER ❑ b. UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n- PLASTIC BOTTLE ❑ q. RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g- CARBOY ❑ k. BOX ❑ o. TOTE BIN r OTHER
❑ d. STEEL DRUM ❑ h. SILO [11. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE 0 a. AMBIENT ❑ b. ABOVE AMBIENT [3c. BELOW AMBIENT
STORAGE TEMPERATURE 0 a AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC
%WT
HAZARDOUS COMPONENT For mixture or waste only
EHS
CAS #
5.0
2-methylpentane-2,4-diol
❑ Yes ® No
107-41-5
2
1.0
vinyl acetate
❑ Yes ®No
108-05-4
3
❑ Yes ❑ No
4
❑ Yes ❑ No
S
❑ Yes ❑ No
If more haubrdous components are prevent at greater than I % by weight if non -carcinogenic, or 0.1 % by weight if carcinogenic, attach additional %herbs of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA. Please Si n Here
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
:orareja
CHEMICAL INVENTORY
one page per material er huildin
❑ADD []DELETE REVISI?
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA— Doing Business As) HANSON AGGREGATES
CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
FA0002505
MAP#
7
GRID#
(Agency use only)
H. CHEMICAL INFORMATION
CHEMICAL NAME
Da i I I
TRADE SECRET ❑ Yes 0 No
raf
If Subject to EPCRA, refer to instructions
COMMON NAME Darafill
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE I I \ /. \ R 1) CLASSES (Complete if required by CUPA)
Carcinogen (CARC), Sensitizer (Sens), Toxic (Tox)
HAZARDOUS MATERIAL TYPE
❑ a. PURE M b MIXTURE 0 c WASTE
RADIOACTIVE []Yes❑ No
CURIES
(Check one item only)
PHYSICAL STATE
13 a. SOLID 0 b. LIQUID c GAS
LARGEST CONTAINER 0.094
(Check one item only)
FED HAZARD CATEGORIES ® a. FIRE ❑ b REACTIVE ❑ c. PRESSURE RELEASE ® d. ACUTE HEALTH ® e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL. WASTE AMOUNT
STATE WASTE CODE
3.0
1 5.0
UNITS* @ a. GALLONS Q b CUBIC FEET ❑ c POUNDS ❑ d. TONS
DAYS ON SITE:
(Check one item only) *If EHS, amount must be in pounds.
STORAGE L3 a. ABOVE. GROUND TANK 0 e. PLASTIC/NONMETALLIC DRUM i. FIBER DRUM ❑ in GLASS BOTTLE
CONTAINER ❑ b. UNDERGROUND TANK ❑ I. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ q. RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ❑ o. TOTE BIN r. OTHER
❑ d. STEEL DRUM ❑ It. SILO [11. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE ED.. AMBIENT ❑ b ABOVE AMBIENT [1c. BELOW AMBIENT
STORAGE TEMPERATURE Q a. AMBIENT ❑ b ABOVE AMBIENT ❑ c BELOW AMB[ENT 0 d. CRYOGENIC
CAS
68603-42-9
1 100.0
Coconut fatty acid diethanolamide
❑ Yes ® No
2 5.0
Diethanolamine
❑ Yes ® No
111-42-2
3
❑ Yes ❑ No
d
❑ Yes ❑ No
❑ Yes ❑ No
If more hazardous components are present at greater than 1 :4 by weight if oon•careinogenic. or 0.1 % by weight if cartinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA Please Si n Here
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
(one page per material per building or area
❑ADD ❑DELETE ❑REVISE
1. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) HANSON AGGREGATES
CHEMICAL LOCATION Mi SE CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY 1D #
FA0002505
MAP#
GRID#
(Agency use only)
H. CHEMICAL INFORMATION
CHEMICAL NAME P O LARS ET
TRADE Sf:CRE'P Yos No
If Subject to EPCRA, refer to instructions
COMMON NAME POLARSET
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
HAZARDOUS MATERIAL TYPE ❑ a. PURE 0 In. MIXTURE ❑ e. WASTE
RADIOACTIVE ❑ Yes ❑ No
CURIES
(Check one item only)
PI [YSICAL STATE
❑ a. SOLID 0 b LIQUID ❑ c. GAS
LARGEST CONTAINER 5�0.0
(Check one item only)
FED HAZARD CATEGORIES ❑ a FIRE ❑ b. REACTIVE ❑ c. PRESSURE RELEASE ❑x d. ACUTE HEALTH ❑x e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE CODE
1300.0
1 1800.0
UNITS* ❑X a. GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d. TONS
:1
DAYS ON SITE:
365O
(Check one item only) -if EHS, amount must be in pounds
.
STORAGE a. ABOVE GROUND TANK e. Pf.ASTICMONMCTAI.LIC DRUM i. FIBER DRUM m. GLASS BOTTLE
CONTAINER ❑ b. UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE [3 q. RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ❑ o. TOTE BIN 13 r. OTHER
❑ d. STEEL DRUM ❑ In. SILO ❑ I. CYLINDER ❑a p. TANK WAGON
STORAGE PRESSURE ❑x a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
STORAGE TEMPERATURE El a. AMBIENT ❑ b ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC
u
'or It 1\ tl l or waste only)
FrIs
eft N
1 10.0
CALCIUM BROMIDE
❑ Yes ❑ No
007789-41-5
z 25.0
CALCIUM NITRATE
❑ Yes ❑ No
010124-37-5
3 25.0
CALCIUM NITRITE
❑ Yes ❑ No
013780-06-8
4 10.0
DIETHYLENE GLYCOL
❑ Yes ❑ No
000111-46-6
5 10.0
METHYLDIETHANOLAMINE
❑ Yes ❑ No
000105-59-9
If more h utardous components are present at greater titan 1 % by weight it notrcarcinogenic, or 0.1 % by weigh) ircareinogenic. auach additional sheet of paper capturing the rrquired information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
Ir EPCRA Plea. a Si n Ilere
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
(one page r material r buildingor area
❑ADD ❑DELETE REVISE
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA— Doing Business As) HANSON AGGREGATES
CHEMICAL LOCATION �, ; H
CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
FA0002505
MAP#
GRID#
(Agency use only)
II. CHEMICAL INFORMATION
CHEMICAL NAME
LIQUID HAMMER
TRADE SECRET Yes ❑ No
instructions
If Subject to EPCRA, refer to
COMMONNAME LIQUID HAMMER
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
HAZARDOUS MATERIAL TYPE ❑ a- PURE 0 b. MIXTURE ❑ c. WASTE
RADIOACTIVE ❑ Yes []No
CURIES
(Check one item only)
PH Y SICAL STATE
❑ a. SOLID 0 b, LIQUID ❑ c, GAS
LARGEST CONTAINER � y � / y
L v
(Check one item only)
.
FED HAZARD CATEGORIES
El a FIRE ❑ b. REACTIVE [I c. PRESSURE RELEASE 0 d. ACUTE HEALTH 0 e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE CODE
200.0
1 250.0
UNITS* ❑X a. GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d. TONS
DAYS ON SITE:
365.0
(Check one item only) *If EHS, amount must be in pounds.
STORAGE a. ABOVE GROUND TANK E3 e. PLASTIC/NONMETALLIC DRUT-70 i. FIBER DRUM 0 in. GLASS BOTTLE
CONTAINER ❑ b, UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ q. RAIL CAR
0 c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k, BOX ® o. TOTE BIN ❑ r, OTHER
0 d, STEEL DRUM ❑ h. SILO ❑ 1, CYLINDER 0 p, TANK WAGON
STORAGE PRESSURE 0 a, AMBIENT ❑ b ABOVE AMBIENT ❑ c. BELOW AMBIENT
STORAGE TEMPERATURE 0 a. AMBIENT ❑ b ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC
%WT
HAZARDOUS COMPONENT (For mixture or waste only)
EHS
CAS #
1
❑ Yes ❑ No
2
❑ Yes ❑ No
3
❑ Yes ❑ No
4
❑ Yes ❑ No
❑ Yes ❑ No
If more hazardous components are present at greater than 1% by weight if non -carcinogenic, or 0.1% by weight ircarcinogenic, attach additional shreb of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA Please Sin Here
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
(one page ur mnirrial rr buildin or arra
❑ADD [—]DELETE ❑Rt'.V ISE
I. FACILITY INFORMATION
I111SINF•.SS NAME. (Same as FACILITY NAME or DBA —Doing Business As) HANSON AGGREGATES
-
CHEMICAL LOCATION ,SH
CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
(Agency use only)
FA0002505
MAPH
GRID#
II. CHEMICAL INFORMATION
CHEMICAL NAME CAR WASH 2000
I RADI SECRET ❑ Yes ❑ No
If Subject to EPCRA, refer to instructions
COMMON NAME CAR WASH 2O00
EHS* ❑Yes []No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
HAZARDOUS MATERIAL TYPE ❑ a. PURE I] b. MIXTURE ❑ c. WASTE
(Check one item only)
RADIOACTIVE ❑ Yes []No
CURIES
PHYSICALSTATE ❑ a SOLID h LIQUID ❑ c. GAS
(Check one item only)
LARGEST CONTAINFR 250.0
FED HAZARD CATEGORIES ❑ a. FIRE ❑ b. REACTIVE ❑ c, PRESSURE RELEASE ❑ d. ACUTE HEALTH ❑x e. CHRONIC HEALTH
(Check all that apply)
AVERAGE: DAILY AMOUNT
200.0
MAXIMUM DAILY AMOUNT
250.0
ANNUAL WASTE AMOUNT
STATE WASTE CODE
UNITS* 0a. GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d. TONS
(Check one item only) *If EHS, amount must be in pounds.
DAYS ON SITE:
STORAGE LEI a. ABOVE GROUND TANK E3 e. PLASTICINONML•'TALLIC DRUM i. FIBER DRUM ❑ to GLASS BOTTLE
CONTAINER ❑ b, UNDERGROUND TANK ❑ F. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ q RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g CARBOY ❑ k. BOX ❑ o. TOTE BIN ❑ r. OTHER
❑ d STEEL DRUM ❑ h SILO ❑ l CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE I@ a AMBIENT ❑ b ABOVE AMBIENT ❑ c BELOW AMBIENT
STORAGE TEMPERATURE a AMBIENT ❑ b ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC
W(]-or
nux ure or w, s i!
1
O HAZARDOUS COMPONENTS AT 1% OR GREATEI
[]Yes ❑ No
2
❑ Yes ❑ No
3
❑ Yes ❑ No
d
❑ Yes ❑ No
i
❑Yes ❑ No
If more hasmdoua camponeutr are In —at to treater thou 1 % by weiYbt it non•curcinoltenic, or 0.1% by x65:111 if tarctnogellir, anaclr additionnt bco, or paper copnving Um required inforanttion.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA, Please Si ,tt Herc
I Mass
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
one Rare per material cr buildin or area
®ADD []DELETE []REVISE 200
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA— Doing Business As) 3
Hanson Aggregates
CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202
❑ YES ® NO
1 MAP# (optional) 203 GRIDII (optional) 204
FACILITY ID #
2 D-7
1
II. CHEMICAL INFORMATION
CHEMICAL NAME 205
TRADE SECRET 0 Yes 10 No tut,
Crete -Off Concrete Dissolver
If Subject to EPCRA, refer to instructions
208
EHS' El Yes ElNo
COMMON NAME 207
CAS# 209
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210
211
HAZARDOUS MATERIAL TYPE ❑ a. PURE ® b. MIXTURE [:1c. WASTE
212
RADIOACTIVE ❑ Yes ® No
211
CURIES
(Check one item only)
214
PHYSICAL STATE
❑ a. SOLID ®b. LIQUID ❑ c. GAS
215
LARGEST CONTAINER 250
(Check one item only)
216
FED HAZARD f'ATFCTTnRTFS ❑ a. FIRE ❑ b. REACTIVE ❑ c. PRESSURE RELEASE ® d. ACUTE HEALTH ® e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT 217
MAXIMUM DAILY AMOUNT 219
ANNUAL WASTE AMOUNT 219
STATE WASTE CODE 22U
200 1
250—
1
UNITS" ® a. GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d. TONS 221
DAYS ON SITE: 222
(Check one item only) "If EHS, amount must be in pounds.
365
STORAGE L1 a. ABOVE GROUND TANK e. PLASTICINONMETALLIC DRUM i. FIBER DRUM m. GLASS BOTTLE 223
CONTAINER ❑ b. UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ r. OTHER
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ® o. TOTE BIN ❑ q. RAIL CAR
❑ d. STEEL DRUM ❑ h. SILO ❑ 1. CYLINDER ❑ p. TANK WAGON
224
STORAGE PRESSURE ® a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
STORAGE TEMPERATURE ® a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC 225
%WT
HAZARDOUS COMPONENT (For mixture or waste only)
EHS
CAS #
1 10-30
Organic Acid Proprietary
❑ Yes ❑ No
230
231
232
233
2
❑ Yes ❑ No
234
235
236
237
3
❑ Yes ❑ No
238
239
240
241
4
❑ Yes ❑ No
242
243
244
245
5
❑ Yes ❑ No
If more hazardous components are present at greater than 1 % by weight if non -carcinogenic, or 0.1 % by weight If carcinogenic, attach additional shetis or paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246
If EPCRA Please Sign Here
C:\Documents and Settings\coverIMMy Documents\LC's Temp File.,_16_CC\San Luis Obispo\CI1PA\F1MBP\2012\Inventory\Crete-Off f_)issolver -
Add.DOC 24-Feb-12
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
]area
one a e per material per building
®ADD []DELETE []REVISE 200
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3
Hanson Aggregates
CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202
❑ YES ® NO
t
(optional) 20371GRID# (optional) 204
FACILITY ID # 7�
3 H-7
II. CHEMICAL INFORMATION
CHEMICAL NAME 205
TRADE SECRET Yes Ll No 206
DCI-S
If Subject to EPCRA, refer to instructions
COMMON NAME 207
208
EHS* ❑Yes []No
CAS# 209
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete irrequired by CUPA) 210
211
HAZARDOUS MATERIAL TYPE
❑ a. PURE ®b. MIXTURE ❑ c. WASTE
212
RADIOACTIVE El Yes ®No
213
CURIES
(Check one item only)
214
PHYSICAL STATE [:)a SOLID ® b. LIQUID ❑ c. GAS
(Check one item only)
215
LARGEST CONTAINER 55
716
FED HAZARD CATEGORIES ❑ a. FIRE ❑ b. REACTIVE ❑ c PRESSURE RELEASE ® d. ACUTE HEALTH ® e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT 217
MAXIMUM DAILY AMOUNT 21 s
ANNUAL WASTE AMOUNT 219
STATE WASTE CODE 220
40
55
221
UNITS* ®a. GALLONS ❑ b. CUBIC FEET ❑ c. POUNDS ❑ d TONS
1 DAYS ON SITE: 222
(Check one item only) *If EHS, amount must be in pounds.
STORAGE a. ABOVE GROUND TANK e. PLASTICNONMETALLIC DRUM i. FIBER DRUM n m. GLASS BOTTLE 223
CONTAINER ❑ b. UNDERGROUND TANK ❑ f. CAN ❑ j BAG ❑ n. PLASTIC BOTTLE ❑ r. OTHER
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ❑ o. TOTE BIN ❑ q. RAIL CAR
❑ d. STEEL DRUM ❑ h. SILO ❑ I. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE ® a AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT 224
STORAGE TEMPERATURE ® a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c, BELOW AMBIENT ❑ d. CRYOGENIC 225
%WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
226
227
228
229
1 1-10
Calcium Nitrate
❑ Yes ❑ No
010124-37-5
230
231
232
233
2 25-50
Calcium Nitrite
❑ Yes ❑ No
013780-06-8
234
235
236
237
3
❑ Yes ❑ No
238
239
240
241
4
❑ Yes ❑ No
242
243
244
245
5
❑ Yes ❑ No
1f more hazardous components are present at greater than 1 % by weight if oon•carcinogenie, or 0.1% by wtight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246
C:\Documents and Settings\coverlw\IVIy Documents\LCD's Ternp file-_116__i:C;\San Luis 01)ispo\t;(1PA\I-iMBP\2012\Inventory\DCI-S.L)i-tC. 24-Feb-12
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
(one page per material per building or area)
❑ADD ®DELETE ❑REVISE 200
Page of
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business A s)
Hanson Aggregates
CHEMICAL TOCATION
FACILITY ID #
II.
CHEMICAL NAME
COMMON NAME
Tech -Off
CAS#
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
zol CHEMICAL LOCATION CONFIDENTIAL zo
EPCRA
❑ YES ®NO
MAP# (optional) 203 GRID# (optional) 20,11
1 D-7
CHEMICAL INFORMATION
205 TRADE SECRET ❑ Yes ® No 206
If SubJect to EPCRA, refer to instructions
207
Zoe
EHS*
❑ Yes ❑ No
209
*If EHS is "Yes", all amounts below must be in lbs.
HAZARDOUS MATERIAL TYPE 211
(Check one item only) ❑ a. PURE ® b. MIXTURE ❑ c. WASTE RADIOACTIVE ❑ Yes ❑ No
PHYSICAL STATE 214
(Check one item only) ❑ a. SOLID ® b. LIQUID ❑ c. GAS
LARGEST CONTAINER 500
FED HAZARD CATEGORIES
(Check all that apply) ❑ a. FIRE ❑ b. REACTIVE ❑ c. PRESSURE RELEASE ® d. ACUTE HEALTH
AVERAGE DAILY AMOUNT 27500
IMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT
400
UNITS* ® GALLO
210
212 213
CURIES
215
216
® e. CHRONIC HEALTH
1 I STATE WASTE CODE 220
a. NS ❑ b. CUBIC FEET ❑ c. POUNDS
(Check one item only) *If
❑ d. TONS
221
DAYS ON SITE:
ZZ
STORAGE ®a. ABOVE GROUND TANK
EHS, amount must be in pounds
365
CONTAINER ❑ b. UNDERGROUND TANK
e. PLASTIC/NONMETALLIC DRUM
❑ f. CAN
i. FIBER DRUM
❑ GLASS BOTTLE
22;
❑ c. TANK INSIDE BUILDING
❑ g• CARBOY
❑ J• BAG
❑ BOX
❑ n. PLASTIC BOTTLE
❑ r. OTHER
❑ d. STEEL DRUM
❑ h. SILO
1.
❑ I. CYLINDER
o.
❑ o. TOTE BIN
❑ p. TANK WAGON
❑ q, RAIL CAR
STORAGE PRESSURE ® a. AMBIENT
❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
224
STORAGE TEMPERATURE ® a. AMBIENT
❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
❑ d. CRYOGENIC
225
226
1 90-100 31 % Hydrochloric Acid
i 230
3 234
4 238
5 242
If more hazardous components are present at greater than I% by weight if m
ADDITIONAL LOCALLY COLLECTED INFORMATION
.,. oaorc WHY) CI1b CAS #
227 El Yes
Yes El No 7647-01-0 229
231 232
El Yes ❑ No v3
235 236
❑ Yes ❑ No 237
239 240
El Yes ❑ No zel
243 244
El Yes ❑ No 245
or O.1 % by weight if cardnagenic, attach additional sheets of paper capturing the required informallon.
246
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