Document 2J18z4RyaQrLmLkaeejyEoBrr

(Important: Type or print: rea^jnstructtons_before_completing form.) Form Approved OMB No.: 2070-0093 Approval Expires ;- 01/91 Papi 1 of 5 a-EPA U.S. Environmental Protection Agency TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM Section 313 of the Emergency Planning and Community Rlght-to-Know Act of 1986. also known as Title HI of the Superfund Amendments and Reauthorlzatlon Act EPA FORM R PART 1. FACILITY IDENTIFICATION INFORMATION (This space for your optional use.) Public reporting burden tor thli coltactIon of Information la astlmatad to vary from 30 to 34 houri par taasonaa, with an average of 32 houri par Including time tor reviewing inatructloni, Marching existing data sources, gathering and maintaining the data neaoed, and completing and reviewing the collection of Information. Send oomments regarding this burden estimate or any other aspect of this collection of information, including suggestions tor reducing this burden, to Chief, information Policy Branch (PM-223). US EPA, 401 M St., SW. Washington. D.C. 20480 Attn: TRI Burden and to the Office of Information and Regulatory Affairs. Office of Management and Budget PapenworK Reduction Protect (2070-0093), 1.1 Are you claiming tne cnemical idantity on page 3 trada secret? 1. 1 1 Yes (Answer question 1.2: XL J No (Do not answer 1.2: Attach aubstantiation forms. 1 Go to Question 1.3.) 1.2 If " Yes" m 1. t, Is tht copy: [ ] Sanitized [ ]l Insanitlzed 1.3 Raooning Year 19 89.. 2. CCERTIFICATION (Read and sign after completing aH sections.) 1 hare! certify that I nave reviewed the attached documents and that, to the bett of my knowledge and belief, the submitted information la true and comp!ete and that tha amount# and values in this reoort are accurate baaed on reasonable estimates using data available to the preoarers of this reoort. Name and official title of owner/operator or senior management otticiai T. G. Signature Brown. Works Manager. UJ0 PPG Industries. Lake Charles. Date signed 6 La. 3. FACILITY IDENTIFICATION Facility or EstaPliahment Name PPG Indus trips. I nr.. WHERE TO SEND COMPLETED FORMS: 1. U.S. ENVIRONMENTAL PROTECTION AGENCY Street Addreas Columbia Southern Road 3.1 City Westlake State LA County Zip Code 70559 P.O. BOX 70266 WASHINGTON. DC 20024-0266 ATTN: TOXIC CHEMICAL RELEASE INVENTORY 2. APPROPRIATE STATE OFFICE (Sh instructions Appendix E) This report contains Information for (Chech one): 3.2 * [X ] An entire facility b. [ ] Part of a facility. Technical Contact 3.3 Andy F. P1a u c h p ? 3.4 Public Contact SIC Code (4 digit) 3.5 a.2812 c. 2815 c. 28 6 9 Latitude 3.6 Degrees Minutes Seconds 30 13 27 Dun & Bradstreet Numoer(s) 3.7 a. 00-808-6 505 EPA Identification Numoer(s) (RCRA I.D. No.) 3.8 ..LAD 00 808 `g06_______ NPDES Permit Numoer(s) 3.9 LA___0000751 Receiving Streams or Water Bodies (enter one name per box) a.Calcasieu River d. NA Degrees 92 nUlA Telephone Number (include area cede) (318) 491-4184 Telephone Number (include area code) \ J. / -4 ^ X e. Longitude Minute* 15 f Seoonds SC >. NA b. Bavou B:Inds 3.10 ..Bayou Verdine NA Underground Inaction Well Code (UtC) Idontltlcatlon Numper(s) 3.1 .NA 4. PARENT COMPANY INFORMATION Nemo of Parent Company 4.1 PPG Industries.__Lux. Parant Company's Dun A Braoatreat 4.2 00-134-4803 EPA Form 9350-1 (1-89) Revised--Do not use previous versions.  (Important: Type or print; read instructions before completing form.) rn. O LHA REPA FORM PART 11. OFF-SITE LOCATIONS TO WHICH TOXIC CHEMICALS ARE TRANSFERRED IN WASTES 1. PUBLICLY OWNED TREATMENT WORKS (POTWs) 1.1 POTW name NA Street AUdreat 1.2 POTW name Street Addreaa City County City State Zip State (This space for your optional use.) Page 2 of S County Zip 2. OTHER OFF-SITE LOCATIONS (DO NOT REPORT LOCATIONS TO WHICH WASTES ARE SENT ONLY FOR RECYCLING OR REUSE). 2.1 Off-site location name NA EPA Identification Number (RCRA 10. No.) 2.2 Off-site location name EPA identification Numper (RCRA ID. No.) Street Adore** Street Addreaa City County City County State Zip State Zip la location under control of reporting facility or parent company? [ ]v*a [ ] No la location under control of reporting facility or parent company? [ ] Yea [ ] No 2.3 Off-slte location name 2.4 Off-slte looatlon name EPA Identification Number (RCRA IQ. No.) ERA Identification Numper (RCRA ID. No.) Street Addreaa Street Address City County City County State Zip State Zip la location under control of reporting facility or parent company? 2.5 Off-slte location name [ ] Yea [ ] No is location under control of reporting facility or parent company? 2.6 Off-slte location name [ ] Yes [ ] No ERA Identification Number (RCRA ID. No.) EPA Identification Number (RCRA ID. No.) Street Addreaa Street Address City County City County State Zip State Zip IS location unoer control of reporting facility or parent company? [ ] Yea [ ] No N Check It audition*! page* of Part It are attached. How many? Is location under control of reporting facility or parent company? [ ] Yea t ] No EPA Form 9350-1 (1-89) Revised--Do not use previous versions.  (Important: Type or print; read instructions before completing form.) 4 EDA TW CrM EPA F0RM ^ part III. CHEMICAL-SPECIFIC INFORMATION Page 3 of 5 (This space for your optional use.) 1. CHEMICAL IDENTITY(Do not complete this section if you complete Section 2.) 1.1 [Reserved] 75-25-2 )1.2 CAS Number (Enter the number exactly as it appears on the 313 list. Enter NA if reporting a chemical category. Chemical or Chemical Category Nam (Enter the name exactly at it appear* on the 313 )list. 1.3 Bromoform (Tribromomethane) Generic Chemical Nam (Complete only if Part l. Section 1.1 is checked "Yet." Generic name mutt be structurally descriptive-1 1.4 MIXTURE COMPONENT IDENTITY (Do not complste this section if you complete Section 1.) 2. )Generic Chemical Name Provided by Supplier (Limit the name to a maximum of 70 characters (e.g.. numbers, letters, spaces, punctuation), 3. ACTIVITIES AND USES OF THE CHEMICAL AT THE FACILITY (Check all that applv. I Manufacture the chemical: 3.1 r Y] a. 1 A J Produce If produce or import: f I For on-site c.l J use/processing f d-L 1 For sale/ J distribution b. [ ] Import e.[ x] As a byproduct f. [ ] As an impurity Prccesa the 3.2 chemical: 3.3 Otherwise use the chemical: [ a'* d.[ [ al 1 As a reactant JAfi * reactant ] Repackaging only 1 As a chemical -I processing aid h f 1 As a formulation b,L J component [1 b.l J As a manufacturing aid [ 1 As an article c.L J component ri c.L J Ancillary or other use CALENDAR YEAR 5. RELEASES OF THE CHEMICAL TO THE ENVIRONMENT ON-SITE A. Total Release (Ibs/yr) You may report releasee of less than 1.000 lbs. by checking ranges under A.1. (Do not use both A.1 and A.2) A.1 Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate 5.1 Fugitive or non-point air emissions 5.1a [][][] NA 5.2 Stack or point air emissions 5.2a [][][] NA 5.3 Dcsttirnsecaahmmars*genosrr wwtoailtareerrchbenoivHdiniiengsa 5_*3,.1 --a. (Enter letter code from Part I Section 3.10 tor itream(i) in the box provided-) 05 .3.2 5.3.3 0 5.3.1a [][][] 5.3.2a [][][] 5.3.3a [][][] NA 8400 200 5.4 Underground Injection 5.5 Releases to land 5.5.1 On-alte landfill 5.4a [][][] 5.5.1a [][][] NA NA 5.5.2 Land treatment/application terming 5.5.3 Surface impoundment 5.5.4 Other disposal [ ]5.5.2a . [ ][ ] 5.5.3a [][][] 5.5.4a [][][] NA NA NA [ ] (Check If additional Information Is provided on Part IV-Supplemental Information.) B. Basis of Estimate (enter code)! 5.1b O t.2 b 5.3.1b O 5.3.2b 0 C % From Stormwater 5.3.1c NA 5.3.2c NA 5.3.3b M 5.4b 5.5.1b I I 5.5.2b 5.5 3b 1 I 5.5.4b EPA Form 9350-1(1-89) Revised--Do not use previous versions. SL 022454  (Important: Type or print; read instructions before completing form.) 'tCDA EPA FORMR PART III. CHEMICAL-SPECIFIC INFORMATION (continued) Page 4 of 5 (This space for your optional use.) 6. TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS You may report transfers of less than 1,000 lbs. by checking ranges under A.1. (Do not use both A.1 and A.2) A. Total Transfers (ibs/yr) A.1 Reporting Ranges 0 1-400 500-499 A.2 Enter Estimate B. Basis of Estimate (enter code) Discharge to POTW _____ 6.1.1 (enter location number 1 from Part ll, Section t.) I .I1 'll___ | [ 3[ 3[ 3 NA LZ36.1.1b Other otf-*ite location .____ ,-- _ , 6.2.1 (enter location number | from Part ll, Section a.) I ,| `M l___| [][][] NA 6.2.1b 0 Other oft-site location ----, ... (enter location number 2 II 6.2.2 from Part ll. Section 2.) 1 1 1____| [ 11 11 i n6.2.2b 1___1 Other off-site location , --. ----- (enter location number (-ill 6.2.3 from Part II. Section 2.) | z | |___ 13 13 13 6.2.3b 1|--___11 [ ] (Check if additional information Is provided on Part IV-Supplemental Information.) C.Type of Treatment/ Disposal (enter code) ___ 6.2.1c M |J 6.2.2c |M| | ] 6.2.3c M | 1 7. WASTE TREATMENT METHODS AND EFFICIENCY A. General Wastestream (enter code) S. Treatment Method (enter code) C. Range of Influent Concentration (enter code) M. 7.1b 7.2a 7.2b 7.2c 7.3a 7.3b 7.4a 7,4b 7.3c 7.4c 7.5a 7.5b 7.6a 7.6b 7.5c 7.6c 7.7a 7.7b 7.8a 7.8b 7.9a 7.9b 7.7c 7.8c 7.9c 7.10a 7.10b 7.10c D. Sequential Treatment? (check if applicable) 7.Id l 1 7.2d [ 3 7.3d [ 3 7,4d [ 3 7.5d 7.6d 7,7d [3 [3 [1 7.8d [ 1 7.9d [ 3 t 17.10d E. Treatment Efficiency Estimate 7.1e 7.2e 7.3e 7.4e 7.5e 7.6e 7.7e 7.Be 7.9e 7. lOe % % % % % % % [ ] (Check If additional information Is provided on Part IV-Supplemental Information.) F. Based on Operating Data? Yes No 7.If [ 3 [ ] 7.2f [ 3 [ 3 7,3f [ 3 [ 3 7.4f [ 3 [ 3 7S' [ 1 [ 1 , B' l ] ( 1 7.7f [313 7.8f [ 3 [ 1 7.9f [ 1 [ 3 3 1[7.10f [ 8. OPTIONAL INFORMATION ON WASTE MINIMIZATION (Indicate actions taken to reduce the amount of the chemical being released from the facility. See the instructions for coded items and an explanation of what information to include.) A. Type of Modification (enter code) B. Quantity of the Chemical In Wastes Prior to Treatment or Disposal C. Index Reason for Action (enter code) Current reporting year (Ibs/yr) Prior year (Ibs/yr) l Or percent ! change M NA % EPA Form 9350-1 (1-89) Revised - Do not use previous versions. SL 022A55  (Important: Type or print; read instructions before completing form.) EPA REPA FORM PART IV. SUPPLEMENTAL INFORMATION Use this section if you need additional space for answers to questions in Part III. Number the lines used sequentially from lines in prior sections (e.g.. 5.3.4. 6.1.2. 7.11) Page 5 of 5 ADDITIONAL INFORMATION ON RELEASES OF THE CHEMICAL TO THE ENVIRONMENT ON-SITE (Part III, Section 5.3) You may report releases of less than 1.000 lbs. by checking ranges under A.i. (Do not use both A.i and A.2) A. Total Release (Ibs/yr) A.i Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate 5.3 Discharges to ,--. receiving streams or waterbodies I 5.3------ l__l 5.3____ a [][][] B. Basis of Estimate (enter code in box provided) C.% From Stormwater 5.3_____b|_n__ 1 5.3_____ c (Enter letter coOe from Part l |j Section 3.10 tor stream(a) men [][][]the box orovioed.) ----------------- 5.3____ a 5.3.____bl 1 5.3.____ c 5.3____a [][][] 5.3.____bQ 5.3. ADDITIONAL INFORMATION ON TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS (Part III, Section 6)_______________ ____ You may report transfers of less than 1.000 lbs. by checking ranges under A.i. (Do not use both A.I and A.2) A.Total Transfers (Ibs/yrl A.i Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate B. Basis of Estimate (enter code in box provided) C. Type of Treatment/ Disposal Discharge to POTW ., (enter location number 6.1 _______from Part A, Section [][][] 6.1.____ b n Other otf-tlt* location n Tenter location nuummbbeeir ----------from Part II, Si tion 2 Other off-aite location 6,2. (enter location number ..so---- from Part ll. Section 2 [][][] [][][] 5.2.____ b [^] 5.2.____ b S 6.2.i 6.2.' 6.2. Other oft-elte location (enter location number . from Part ll, Section 2 MMM 6.2 ADDITIONAL INFORMATION ON WASTE TREATMENT METHODS AND EFFICIENCY (Part III A. General Wastestream (enter code in box provided) B. Treatment Method (enter code in box provided) C. Range of Influent Concentration (enter code) D. Sequential Treatment? (check if applicable) E. Treatment Efficiency Estimate Section 71 F. Based on Operating Data? Yes No 7.______a 7- "Mil 7. c 7. d[ ] 7. e %7 f[ ][ ] 7. a Q 7. b | | | | 7. = Q 7. d[ ] 7. e % 7_____ f[ ][ ] 7. a Q 7- b | | | | 7. c 7. d[ ] 7. e %7 [ ][ ] 7---* 7. 7. a Q 7,, b L| 1 1 b| | M 7'----- " 7. . 7. 7. d[ ] d[ ) 7, e 7._____ e 7 'MM %7 f[ ][ 1 7. . Q 7. b || | | 7. c 7. d[ ] 7. e %7 fl ][ ] 7--`D 7' 7------- 7- " ru i b n 11 7. c Q 7. a[ ] 7. e % 7 'MM 7- c 7. d[ ] 7. e % 7 'MM 7-------a Q 7. b n 1 1 7. c 7. d [ ] 7._____ e %7 f [L 1J [L ]J EPA Form 9350-1(1-89) Revised--Do not use previous versions. SL 022456