Hazardous Substance Filing Notice, Fire Department, undated

NYC 9/11 Public Portal Document

Revised I !, .. . .,pattern!• Read till insirucliuns before euntpleting Ion?: Reporting period: I ro►n January I to Decembers+ 1A0 1'•t6e or r page.) NF11 YORK Name S bcptwii 3H'41eAR#y Hor.Dr' , IAJC 3 NameS,ewrw u JFrtrts ' t('' 412 E y Phone Z ' s 3 -7i o t. r z~1 CITY Right-to-Know Slrcct -- '7 Leg. -b tRAAE CB u C2 Mail Address_ _ _4 tiC- FACILITY ('ity ,U i'ogt- State JJi Zip+4 /00,Y9 _ i l96 INVENTORY Z - I 'ele phone Z► Z Name .42f 7 CAxP3Ft I I ) je2-70eoO County Title FORM SIC Dun & Brad, a Day Phone (2 11 ) 783-rZ3 24-hr phone;._ Tl 11*R f WO C ode I I I ( Jf INumber IoIt 1 Ft I 131 1 I t S Name TTo O. MESi4c TitleA , T. {r %ti ry N~1un6 I'm' Official Use Unit: 1D!! c° Day Phone z t o )1?.4 -~ fz 3 24-hr phone; PII Dale Received: .-•---~---------- Physical and Storage Codes and Locations Health (Non -Confidential) Chemical Description Hazards Inventory Storage Locations Cheek all that npp/s 1. A> r — 7 1 m❑ trade a❑ Fi+c P1 i I 0 3 Check box Secret if 1=BO,l) 11 i Do % 1~(EfH A V et Sudden Rclease May Antoun! (curie) 7 _ t,4 L Q_ ( _ p v ❑ Of Pressure information 'L[21CNt.aFLue;zO (7r-69-4) submitted •L ❑ Reactivity O isidrntical At . Amount (code) to last year z

Check till that rry►plt'•' I Fare I I Mix I I Solid (ti.iquid [ ] Gas [ J EI IS ❑ Immediate (,+cute)

Detayed(chmnic) 6i f No. o Do s Present ::: _____________________________________________________

CAS — Trade ( x ❑ Secret ❑ ❑ Fi1e if Sudden Release Mar Amount (code) S r y 7 t !4 FO 0 2 1= RE O r 1 12 ' 10 0 % M -r y A►J Z ❑ Of Pressure information o^ submitted JJC LORODt FLU0 RO 7 r-'71- A) o r isidrntical [" Reactivity sg. Amount (code) to last year hnmediate (acute) 7U LJ Check all Nun rrpplt': 3i ii (+liPure I .I Mix -I Solid [Liquid [ I Gas [ I EHS Dclayed(cltunic) No. ofDcn's Present C' A S (( III Trade ❑ ❑ L_L_L1 ]~ m ❑ Secret Fire Max Amount (code) l 4 if BM3C WAstt 10 % P r_Teo L e u r1 Sudden Release of Pressure 7 fN r~ information S_ L+iFOuAT~ (bt7P~-13+r-2 Oa/e submitted

a, 4 o_y cEuE 6~_____ -- F_ Q Sbo3-r_-c Reactivity 11 vg. i mount is identical to last year (code) hmnedinte (acute) Cl c ck all /11(11 app/v.- Dctaycid(chmnte) Li i i ( ( Pure (v~Mix ( ( Solid (✓Liquid [ ] Gas [ I EFTS ❑ No. of Du Prese► i C.'rrri/icu►i«n (Read and sign altar completing all seelions) I certily wider penalty of law that 1 have personally examined and ant OPTIONAL familiar with the information submitted in pages one through _, and that un my inquiry ol'those individuals responsible for obtaining the information, based I have attached a I believe that the submitted infonnation is true, accurate and complete. site plan JOt iJ MA-2t~sOu Ft~sT ~tcC PREst .D Ca ; ❑ Nan e and official title of owner/operator OR owner/operator's authorized representative Signature Date signed 23

NYC-WTC 000169014