1998, 05-06 Haz Mat Inventory StatementCRITICAL AND RjDOUS MATERIALS INVENTORY STATEMENT SUMMARY
NAME: ADD'R�ESS:_I t 1 t 1 �1�I Lard l sr
PERMIT #: Date:
CRITICAL MATERIAL USER: Y N SPRINKLER: Y N CONTAINMENT AREAS: Y N
DOUBLE CONTAINMENT: REQUIRED: GAL. PROVIDED: GAL.
Physical Hazard
Material
Class
IN STORAGE
USE: OPEN
USE: CLOSED
TOTAL ALLOWED
AMOUNT OVER
CRIT. MAT
1.1 Combustible liquids
If
111-A
III -B
1.2 Combustible fiber
1.3 Cryogenic,
flammable or oxidizing
2.1 Explosive
3.1 Flammable solid
3.2 Flammable gas
(gaseous) (liquefied)
3.3 Flammable liquid
i -A
I -B
I -C
Combination I -A, I -B, I -C
4.1 Organic peroxide,
unciassifed detonatabie
4.2 Organic peroxide
i
l l
ill
IV
V
4.3 Oxidizer
4
3 �e
2
1
4.4 Oxidizer as
(gaseous) (liquefied)
�fL
�+
5.1 P ro horic!✓j
6.1 Unstable reactive
4,
r
3
2
1
7.1 Water reactive
3
2
1
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