Hazardous Substance Filing Notice, Fire Department, undated

NYC-WTC_000169017 Revised | 3,94 . portant: Read all instructions before completing form Reporting period: From January | to December 51,2600 Page 5 of 8 pages NEW YORK CITY Right-to-Know FACILITY INVENTORY FORM TIER TWO BOND MMI! ANY g x Name Alone Sairy Barwey Hordes WAC Steet “7 wetinp TeAnpa cCEste® City New Yoke State {7 Zipt4 (0048-1196 ‘Velephone (ZL2 ) 787-7oo0 County SIC Dun & Brad. : 5 § NameSaconow Jmure Gata ly Phone (2 (2) 7#3-?€6c¢ Mail Address — SAHE Code E200 Number lol | (lela) Lele sts] sf Name fduaz) f- CAMPBELL Title PRoPEtr4 MAGA Ge (2 Name [fo ©. Megias_ TitleASs 7. Peecicta MAaaGEd . For Official Use Only: 1D# | Date Received: SIMU? Day Phone (2 ¢2.)'762-)"23 24-hr phone (4/7) 7% © -3¥67 Chemical Description Physical and Health Hazards Check all that apply Inventory Storage Codes and Locations (Non-Confidential) j i Storage Locations S TOTO. 0 NICKEL CADMIUM BATIE RIE 4% CADMUM OKiDE (1206190) (s)peormay jo (soureny Check all that apply: { ] Pure [Mix LA Solid [ ] Liquid [ ] Gas[{ ] EHS fA Fire Sudden Release Of Pressure 28% PITACHUM Hy daors De (210087 Reactivity ¥ cactiv [7 lnmediate (acute) [Y Delayed(chronic) Max Amount (code) El vg. Amount (code) lols No. of Day's Present =x Check box if infonnation submitted is identical to last year ~ S#a Foot {J Pure [| ] Mix [ | Solid [ ] Liquid [ ] Gas[ ] EHS CAS Trade CET T TT) 1) secret (s)peormsy jo (sjoweny Cheek all that apply: (] Fire Sudden Release Of Pressure [| Reactivity [| Immediate (acute) [| Delayed(chronic) Max Amount (code) Ce vg. Amount (code) d No. of Days Present Check box if information submitted is identical to last year L S TTTELLUICU Oo, a (s)yeotway jo (sjawreny Check all that apply: { ] Pure [ ] Mix [ ] Solid [ ] Liquid [ ] Gas[ ] EHS [| Fire Sudden Release OF Pressure [_] Reactivity [] Imunediate (acute) [| Delayed(chronic) 4 Max Amount (code) ce vg. Amount (code) : No. of Days Present Check box if information ‘2 submitted is identical to last year UO r Certification (Read and sign after completing all sections) I vertify under penalty of law that I have personally examined and am familiar with the information submitted in pages one through , and that based on my inquiry of those individuals responsible for obtaining the information, | believe that the submitted information is true, accurate and complete. JOke HAR KSoN EC eST Vick PRES \DELT. OPTIONAL I have attached a site plan : L Name and official title of owner/operator OR owner/operator’s authorized representative Signature Date signed “| ‘ 23 NYC 9/11 Public Portal Document