HomeMy WebLinkAbout420 John Fitch Boulevard - Tier II Repor Page f pages
Form Approved OMB No.2050-0072
Facility Identification Owner/Operator Name
Name Propane Gas Service Name Inergy Propane LLC Phone 86 528-1030
Tier Two Street 420 John Fitch Blvd Mail Address 240 Route 10 West Whippany, NJ 07 81
EMERGENCY City South Windsor County Hartford State CT Zip, 06074
AND Emergency Contact
HAZARDOUS NAILS code 454310 Dun&Brad Number 05-433-1868
CHEMICAL Name John Love Title CSC h gr
INVENTORY Phone (860)528-1030 24 Hr.Phone 315 25-6294
FOR ID#
Specific OFFICIAL Name Dan Greene Title opera ions Mgr
Information USE Date Received Phone (860)528-1030 24 Hr.Phone 860 73-1068
by Chemical ONLY
Important: Read all instructions before completing form Reporting Period:From January t to December 31,2012 [ 1 Check if information below is identical t4 the:information,sqbn litted last year.
Physical E 2 Storage Codes and Locations R
Chemical Description and Health Inventory w (Non-Confidenti )
Hazards 0 a o
(check all that apply) Storage Locations
Trade
CAS 0000 74 98 6 secret [4] Fire Max.Daily A 2 4 420 John Fitch Blvd
Chem.Name Propane [4] Sudden Release 0 5 Amount(code) „
of Pressure
Check all ] [ [4] [4] ] [] Reactivity 4 Avg.Daily Amount ,
that apply Pure Mix Solid Liquid Gas EHS [4] Immediate(acute) (code)
EHS Name [] Delayed(chronic) F-3--T 6 1 4 1 No,of Days []
On-site(days)
Trade
CAS secret [] Fire Max.Daily
Chem.Name [] Sudden Release [Amount(code).._..
of Pressure
Check all ] [ [] [] [] [] Reactivity Avg.Daily Amount
that apply Pure Mix Solid Liquid Gas EHS [] Immediate(acute) code
EHS Name [] Delayed(chronic) _. No.of Days_ []
On-site(days)
Trade
CAS Secret [] Fire Max,Dail
Chem.Name [] Sudden Release I I :]Amount(code)
of Pressure
Check all [] [] [ [] ] [] Reactivity II Avg,Daily Amount.
that apply Pure Mix Solid Liquid Gas EHS [] Immediate(acute) _ code
EHS Name [] Delayed(chronic) No..-of Days []
... ._.. ...
On-site(days)
Certification (Read and sign after completing all sections) Optional Attachments
I certify under penalty of law that I have personally examined and am familiar with the' eti n submitted in pages one through 1 and that based [] I have attached a site plan
on my inquiry of those individuals responsible for obtaining the information,I be' e that the s . d information i, s�,and complete. [] I have attached a list of site:coordinateabbreviations
John Love 2/20/13 [] 1 have attached a description of dikes and other
Name and official title of ownerloperator OR owner/operator's Date signed safeguards measures
authorized representative
Page pages
Form Approved WB No.2050.0072
Facility Identification Owner/Operator Name
Name Arrow Gas Name Inergy Propane LLC Phone 86 528-1030
Tier Two Street 195 Commerce Way Mail Address 240 Route 10 West Whippany, J07EI81
EMERGENCY City South Windsor County Hartford State CT Zip 06074
AND Emergency Contact
HAZARDOUS NAILS Code 454310 Dun&Brad Number 05-433-1868
CHEMICAL Name John Love Title CSC IV gr
INVENTORY Phone (860)528-1030 24 Hr.Phone 315 25-6294
FOR ID#
Specific OFFICIAL Name Dan Greene Title Operal ons Mgr
Information USE r Date Received Phone (860)528-1030 24 Hr.Phone 860 73-1068
by Chendcal ONLY
Important: Read all instructions before completing form Reporting Period:From January 1 to December 31,2012 [ ] Check if information below is identical to the information subff itted last year.
Physical >v Storage Codes and Locations a
Chemical Description and Health Inventory is y 1 (Non-Confidential) w
Hazards ` 41` o.
(check all that apply) v t� a i" O
Storage Locations
Trade
CAS 0000 74 98 6 Secret [4] Fire Max.Daily A 2 1 _4 195 Commerce Way
Chem.Name Propane [4] Sudden Release 0 5 Amount(code)
of Pressure
Check all (] [j 4] [4] [] [] Reactivity 0 4 Avg.Daily Amount
that apply Pure Mix Solid Liquid Gas EHS [4] Immediate(acute) (code)
EHS Name [] Delayed(chronic) 1 3 1 6 1 5 1 No.of Days []
On-site(days)
Trade
CAS secret [] Fire Max.Daily
Chem.Name [] Sudden Release Amount(code)
of Pressure
Check all [] [] [] [] [] [] [] Reactivity Avg.Daily Amount
that apply Pure Mix Solid Liquid Gas EHS [] Immediate(acute) code
EHS Name [] Delayed(chronic) No.of Days []
On-site(days)
Trade
CAS Secret [] Fire Max.Daily
Chem.Name [] Sudden Release Amount(code)
of Pressure
Check all [] [] [] ] [] I] [] Reactivity F___T_]Avg.Daily Amount
that apply Pure Mix Solid Liquid Gas EHS [] Immediate(acute) code
EHS Name [] Delayed(chronic) No.of Days []
On-site(days)
Certification (Read and sign after completing all sections) Optional Attachments
I certify under penalty of law that I have personally examined and am familiar with the infgauatiR submitted in pages one through 1 and that based [] I have attached a site plan
on my inquiry of those individuals responsible for obtaining the information,I b ' that the ed information is true,accurate,and complete. [] I have attached a list of site coordinate abbreviations
John Love 2/20/13 [] 1 have attached a description of dikes and other
Name and official tide of owner/operator OR owner/operators Sign a Date signed safeguards measures
authorized representative