008 - Hazardous Material Inventory Report (EPCRA).pdf

Contractor Hazardous Material Inventory Log Instructions (EPCRA)

Chemical Description:

• Material Name - List the brand or generic name of the chemical material.

• Manufacturer - List the name of the manufacturer of the product.

• Constituents of Concern - List the constituents (ingredients) as listed on the Safety Data Sheet (SDS).

• CAS # - List the Chemical Abstract Service (CAS) Number for each Constituent of Concern listed. This information is found on the SDS. If no CAS number is listed, state “N/L”.

• % - List the concentration of each Constituent of Concern listed. This information is found on the SDS.

If the concentration is not listed, state “N/L”.

• Product Weight - List the weight of material contained in one container of the product. This information is normally listed on the SDS or can be determined from the density or specific gravity of the product listed on the SDS.

• In addition, check all the boxes that apply to this chemical:

o Pure or Mix - choose only one.

o Solid, Liquid or Gas - choose only one.

o Extremely Hazardous Substance (EHS), Ozone Depleting Substance (ODS), SARA TITLE III

Chemical (SARA III), Air Toxic Chemical (AIR TOX) or Carcinogen

• (CARC) - based on the information provided by the material’s SDS. Choose all that apply.

o HM exempt - per EPCRA section 312 and based upon user knowledge, choose this box if the material would normally be exempt from reporting for hazardous material storage.

o Tri exempt - per EPCRA section 313 and based upon user knowledge, choose this box if the material would normally be exempt from reporting for the Toxic Release Inventory (TRI).

Physical and Chemical Hazards:

• For each material listed, check all the physical and health hazard boxes that apply. These hazard categories are defined in 40 CFR 370.2.

• Fire Hazard - flammable, combustible liquid, pyrophoric, oxidizer.

• Sudden Release of Pressure - explosive, compressed gas.

• Reactive - unstable reactive, organic peroxide, water reactive.

• Immediate (acute) Health Hazard - highly toxic, toxic, irritant, sensitizer, corrosive.

• Delayed (chronic) Health Hazard - carcinogens, mutagens, other long-term health hazards.

Storage Description: Storage Code:

• List the appropriate storage type, pressure and temperature condition codes for the material based upon the codes listed below. List the storage type in the first box, the applicable pressure code in the second box and the applicable temperature code in the third box. More than one storage code may apply if material is stored in different types of containers.

Storage Type:

A - Above Ground Storage Tank F Can L Cylinder B - Below Ground Storage Tank G Carboy M Glass Bottle or Drum C - Tank Inside Building I Fiber Drum N Plastic Bottle or Drum D - Steel Drum J Bag R Other E - Plastic/Non-metallic Drum K Box

Pressure and Temperature Conditions:

1 - Ambient Pressure 4 Ambient Temperature 2 - Greater than Ambient Pressure 5 Greater than Ambient Temperature 3 - Less than Ambient Pressure 6 Less than Ambient Temperature but not Cryogenic 7 - Cryogenic Conditions

Contractor Hazardous Material Inventory Log (EPCRA)

Inventory in Pounds:

• Maximum Amount - List the maximum amount of a material that was on-hand (stored) at any one time.

Amount must be recorded in pounds.

• Average Amount - List the average amount of a material that was on-hand during the reporting period.

Amount must be recorded in pounds.

• Days on Site - List the number of days during the reporting period each material was on-site. If the material was present for the whole year, record as 365.

Amount Used in Pounds:

• List the amount of each material used during the reporting period. Amount must be recorded in pounds.

Amount used is the best estimate based on the contractor material tracking system.