Ordinance No. 19593 - Laserfiche WebLink

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b. Location of emergency equipment. c. Identify the general purpose of other areas within the facility. d. Location of all tanks. 4. Provide the following on the map or in a map key or legend: a. The requested permit quantity for each storage facility by hazard class . b. A list of hazardous materials fvr each storage facility includ- ing chemical name, common or trade name, and hazard class. Hazard Class is defined in Article 80, Division II.~ c. A list of waste hazardous materials for each storage facility identified as wastes hex: "waste" ail}, Include the hazard class. d. List the contents and capacity limit of all tanks at each facility and indicate whether they are above or below ground. e. List separately any radioactive, cryogens, and compressed gases. f. If you are claiming any hazardous materials to be trade secrets, you must provide that information in a called manner ~tagether with a keys SECTIaN II: HAZARDOUS MATERIALS INVENTQRY STATEMENT HMIS Although the HMIS is apart of the Hazardous Materials Management P1 an, it may be a separate document. Reportings to the State Fire Marshal's office via the "Hazardous Substance Employer Survey" will satisfy the HMIS requirement in part. Supplemental information will be obtained by Fire Service personnel at such time that the facility is physically inspected. HAZARDOUS MATERIALS INVENTORY STATEMENT (HMIs) (Public Document) A. Note: Complete a separate form for each facility. 1. Page o f 2. SIC Code~s~ that apply to location: 3. Date farm completed: 4. Employer name: Dun & Bradstreet No. 5. Company name: 6. Facility address: City: Business phone: State: County: Zip: 7. Facility ID Number has indicated on storage locator maps: B. Information in addition to that provided on the state Fire Marshal's "Hazardous Substance Employer Survey". YES N0 1. Do you stare or use any carcino ens? Ordinax~.ce -~ 7 9