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STATETIERII PACKET2012
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STATETIERII PACKET2012
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ATTACHMENT 5 <br />MAXIMUM AMOUNTS <br />For each hazardous chemical, estimate the greatest amount in pounds present at your facility on any single day during the reporting <br />period. <br />Find the appropriate range value code under Reporting Ranges. <br />Enter this range value code as the maximum amount. <br />AVERAGE DAILY AMOUNT <br />For each hazardous chemical, estimate the average weight in pounds that was present at your facility during the year. <br />To do this, total all daily weights and divide by the number of days the chemical was present on the site. <br />Find the appropriate range value under Reporting Ranges. <br />Enter this range value as the Average Daily Amount. <br />NUMBER OF DAYS ON-SITE <br />Enter the number of days that the hazardous chemical was found on-site. <br />STORAGE CODES AND LOCATIONS <br />List all non -confidential chemical locations in this column along with storage types/conditions associated with each location. You may <br />list several locations for a particular chemical. Each column of boxes indicates a type of storage container (for example: an <br />underground storage tank at ambient pressure and temperature (B 14) or a compressed gas cylinder at ambient temperature (L24)) and <br />the corresponding line represents a location for that container. <br />STORAGE CODES <br />Indicate the code for the container types and the pressure and temperature conditions for that storage container. <br />STORAGE LOCATIONS <br />Provide a brief description of the precise location of the chemical so that, emergency responders can locate the area easily. These <br />descriptions must correspond to the site plan that you provide. <br />CERTIFICATION <br />The owner, operator or the officially designated representative of the owner or operator must certify that all infoi„iation included in the <br />HCIF submission is true, accurate and complete. On the first page of the report enter your full name and official title. Sign your name <br />and enter the current date. Also, enter the total number of pages included in the Confidential and Non -confidential information sheets <br />as well as all attachments. An original signature is required on at least the first page of the submission. Submissions to the HSERC, <br />LEPC and Fire department must each contain an original signature on at least the first page. Subsequent pages must contain either an <br />original signature, a photocopy of the original signature or a signature stamp. Each page must contain the date on which the original <br />signature was affixed to the first page of the submission and the total number of pages in the submission. <br />
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