Hazardous Materials Report Form, 7 World Trade Center, n.d.

NYC 9/11 Public Portal Document

Instructions for Hazardous Material Listing

Identifying Symbol: This area identifies different classes of hazardous material. Most material will fall within one of these classes. If a particular material falls within two or more classes, it should be listed in each applicable class. Two additional boxes are provided for material that does not fall within any class. These boxes may also be used if addi­ tional space is needed to further identify previously listed categories. Amounts to be reported are shown in Table 1 below.

NOTE: SHIPPING AND PACKAGING LABELS MAY BE OF ASSISTANCE IN IDENTIFYING THE CLASS OF MATERIAL.

Hazardous Material Description and Proper Shipping Name

This area is reserved for the description and name of any hazardous material within a given class. If there is more than one material within a certain class, at a given location, then the most prevalent or most common should be used (indicate "most common").

Total Amount

List the total amount of reportable material within the given class. If the amounts vary from day to day, then the average amount should be listed.

Identifying Hazardous Material Description Total Symbol and Proper Shipping Name Amount Ethyl Chloride_______________ 60 qals. (most common) flammable. \ LIQUID/

Special Considerations/Remarks

This area is reserved for the policyholder and the fire chief for making any notes or comments tray feel are pertinent. Several examples are listed below:

' 1. Building has a sprinkler system, 2. Adjacent building is a school. 3. Guard dogs are on the premises from 6:00 p.m, to 6:00 a.m. 4. Hazardous material amounts may vary greatly from day to day. 5, Poor water supply. 6. Access to the building is poor. 7. Flammable liquid is stored in the same building as oxidizer.

Table 1

Amounts to be Reported

1. Explosives and Blasting Agents - any amount 8. Oxidizer - over 50 pounds 2. Poison Gas - any amount 9. Organic Peroxide - over 10 pounds 3. Poison and Irritant - any amount 10. Combustible Liquid - over 25 gallc-'s inside a 4, Flammable Liquid - over 5 gallons inside a building building and over 60 gal­ and over 10 gallons outside a lons outside a building building 11. Radioactive Material - any amount 5. Flammable Solid - any amount 12. Corrosive Material - over 55 gallons 6. Flammable Gas - over 2,000 cubic feet at normal 13. Dangerous When Wet Material - any amount temperature 14. Etiologic Material - any amount 7. Nonflammable Gas - over 6,000 cubic feet at normal temperature

(OVER)

F100965-001 (4/82) New York State Department of State, Office of Fire Prevention and Control

NYC-WTC_000169146