Document ZOm4Vo09ooMVNov83vpZnrz0

CertainTeed Corporation Pipe & Plastics Group PO. Box 253 Sulphur, LA 70663 (318) 882-1441 CertainTeed El September 8. 1988 Ms. Meredith N. Scheck Assistant Director The Vinyl Institute Wayne Interchange Plaza 155 Route 46 West Wayne, NJ 07470 II Dear Ms. Scheck: As requested in your letter of August 31, 1988, please note the attached copies of our SARA Section 313 forms. If further assistance is needed concerning this matter, please contact me. Sincerely, x"7 J't I '-'w8 Bruce J. Brroocck a Technical Supervisor Attachments pc: C. A. Gellner, Plant Manager 01-91-0283 CTL016303 (Important: Type or print; read instructions before completing form.) Approval Expires 01/91 Pag# 1 of S oEFA U.S. Environmental Protection Agency TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM EPA FORM Section 313, Title III of The Superfund Amendments and Reauthorization Act of 1986 R (This space for EPA um only ) PART I. FACILITY IDENTIFICATION INFORMATION 1. 1 Does this report contain trad* secret Information? 1. 1 | V* (Answer 1.2) | xl ^* (Do not aniwtr 1 2) 1.2 t* this a sanitised copy? Y NO 1.3 Reporting Y*ar 1987 2. CERTIFICATION (Read and sign alter completing all sections.) I hereby certify that I have reviewed the attached documents and that, to the best of my knowledge and belief, the submitted information is true and complete and that the amounts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report. Nut** and official tit!* of owner/operator or senior management official C. A. GELLNER, PLANT MANAGER Signature Oat* signed 11 Sty 3. FACILITY IDENTIFICATION Facility or Establishment Name CERTAINTEED CORPORATION Street Address PETE MANENA ROAD 3.1 City County This report contains Information for: (check on*) a | Xl ^ *nllr# covered facility. 3.2 jj | | Part of a covered facility. SULPHUR CALCASIEU State L_ LOUISIANA Technical Contact 3.3 BRUCE J. BROCKA Zip Code 7 i Qi6 i 6) 4 mo i 2i sn Telephone Number (Include area code) (318 882 -1441 Public Contact 3.4 C. A. GELLNER T*l*phon* Number (Include area cod*) (318 882 -1441 a. SIC Code 3.3 6 N/A 2| 8, 2| 1 __ L_ i Latitude 3.6 Deg. Min. Sec. e. 111 Longitude Deg Min. Sec. Where to send completed forms: I 3l o |1 i 3 1 3 .0 i9 i 31 1 (7 1 SiO Dun A Bradstreet Numbe*(s) 3.7 * N/A ____ I I ~ I I I I - I I I I b. I 1- I II 1. 3.8 EPA identification Number (RCRA I.O. No.) L i A i DiO i L i 0 i 3i 31 2 |0 i 2 i S b. J___L N/A ii i i i i NPOES Permit Number(s) 3.9 N/A i___i U S. Environmental Protection Agency P O. Bo* 70266 Washington. DC 23024-0266 Attn: To*lc Chemical Petes*# Inventory Li AiOiO i AH I 01 2i 5 Name of Receiving $tr*am(s) or Watar Body(t) J__ I I I__ L 1-1..-L * BAYOU O' INDE 3.10 b. N/A c. Underground Injection Well Code (IAC) Identification No. 3.11 _!___ I___ I I N/Al I I l I I *4. PARENT COMPANY INFORMATION Name of Parent Company CERTAINTEED CORPORATION__ P, 0. ROX RAn Parent Company * Dun & BradJtreet No. 4.2 0 I 01 - 12 nisi - I 81 ? 16 I s. EPA Form 9350-1 (1-88) VALLEY FORGE. PA 19482 CTL016304 (Important: Type or print; read instructions before completing form.) REPA FORM PART II. OFF-SITE LOCATIONS TO WHICH TOXIC CHEMICALS ARE TRANSFERRED IN WASTES " 1. PUBLICLY OWNED TREATMENT WORKS (POTW) Facility Nam# N/A Street Addreta City County State Zip 1 111 H1 11 2. OTHER OFF-SITE LOCATIONS - Number these locations sequentially on this and any additional page of this form you use. | ] Other off-site location EPA Identification Number (RCRA O. No.) Facility Name Street Addratt N/A I I II1111111 City County Stata Zip 1 1 1 1 l-l 1 1 1 l location under control of reporting facility or parent company? | [ j j k| | Other off-site location Ye* No ^ EPA Identification Number (RCRA O. No.) 1 1 111111111 Facility Name Street Addre** N/A City County State Zip 1 III l-l 1 l 'ocatlon under control of reporting facility or parent company? | [ | j | [ Other off-site location Yes No II EPA Identification Number (RCRA O. No.) Facility Name Street Addreei N/A |j |III11111 City County State Zip 41| 1 1 1 1 l-l 1 It location under control of reporting facility or parent company? | | [ "j Ye* Ns 1 1- | | Check if additional page* of Part 1 are attached. CTL016305 > EPA Form 9350-1(1-88) (Importqnt: Type or prim; read instructions before completing form.) REPA FORM PART III. CHEMICAL SPECIFIC INFORMATION Pg J of 5 1. CHEMICAL IDENTITY 1.1 | | Trade Secret (Provide a generic name in 1.4 below. Attach substantiation form to this submission.) 1.2 CAS # 0 00 07 5 | "| 0 11 | -| It) (Use leading leros if CAS number does not fill space provided.) Chemical or Chemical Category Name 1.3 VINYL CHLORIDE Generic Chemical Name (Complete only If 1.1 It checked.) 1.4 MIXTURE COMPONENT IDENTITY (Do not complete this section if you have completed Section 1.) 2. G#n#fIc Chemical Name Provided by Supplier (Limit the name to a maximum of 70 characters (e.fl.. numbers, letters, spaces, punctuation)). 3. ACTIVITIES AND USES OF THE CHEMICAL AT THE FACILITY (Check afl that apply.) 3.1 Manufacture: a.0 Produce b. 0 Import e D use/k\lng d- distribution e` A * byproduct f.Q As an lmptxlty 3.2 Process: a. fx] As a reactant 1J d. | | Repackaging only b r~| As a formulation 1___1 component c ("1 As an article 1--1 component 3 Otherwise Used: ____ a.| | procassff aid b. (0 As a manufacturing aid c.[ | Anclary or other use 4. MAXIMUM AMOUNT OF THE CHEMICAL ON SITE AT ANY TIME DURING THE CALENDAR YEAR | 0| 6 | (enter code) 5. RELEASES OF THE CHEMICAL TO THE ENVIRONMENT A. Total Release You may report releases of less than 1.000 lbs. by checking ranges under A.1. A.1 Reporting Ranges 0 1-400 SOO-OOO 5.1 Fugitive or non-point air emissions S.la 5.2 Stack or point air emissions 5.2a 5.3 Discharges to water (Enter latter code from Pert 1 Section 3.10 tor ttreama(a).) 5.3.1 |a | |----| 5.3.2 |__ | 5.3.1a 5.3.2a 5.3.3 Q 5.3.3a 5.4 Underground Injection 5.4a 5.5 Relea ses to larid 5.5.1 (enter code) 1 5.S.2 (enter code) ,,, | (enter code) 5.5.1a 5.5.2a 5.5.3a | | (Check If additional Information la provided on Part (V-Supfjlemental Information.) EPA Form 9350-1(1-88) A.2 Enter Estimate 26.000 15,000 1.5 N/A N/A N/A N/A N/A N/A B. Basis of Estimate (enter code) 5.1b 0 5.2b 0 5.3.1b [M] C. % From Stormwater 5.3.1c 5.3.2b 0 5.3.2c 5.3.3b 0 5.3.3c 5.4b 0 5.5.1b 0 5.5.2b 0 5.5.3b 0 f* CTL016306 _ l. r r\ i vr^ti i i, m ^wt.u.ucuy 1. TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS You may report tran*f#r of {! (Kart 1.000 tb. by c^*c*ng rano+t undtr A. 1. A.Total Tran*fer* (e/yr) A.1 Reporting Range* o i-4*e soo-tee A.2 Enter Ertknate B. Bail* of Estimate (enter code) $.1 Olac^arg* to POTW N/A 8.1b 0 Other off-lte location i----1 6.2 [Enter block numtw from Part 1. Section 2.) 1----* N/A 8.2b 0 6.3 Ojfw obfifo-cilitanulomcbaetiron r") from Part 1, Section 2.) J N/A S.3b 6.4 Other off-kite location i--| (Enter block rumtw 11 from Part 1, Section 2.) '---- N/A 8.4b Q | ] (Check If additions Information I* provided on Part (V-Supplemerrtal Information) 40l} C. Typ* of Trtatmont/ OttDOtftJ fontor codol 8.2c 8.3c 8.4c 7. WASTE TREATMENT METHODS AND EFFICIENCY A. General Wastestream (enter code) B. Treatment Method (enter code) 07.1a 7.1b F7 1 C. Range of D. Sequential Influent Traatment? Concentration (check If ____ (enter codel _____ applicable)___ 7.1c 7.Id E. Treatment Efficiency Estimate 7.ie 99.99% 7.2a 7.2b 7.3a 7.3b 7.2c 7.2d 7.2e 7.3c 7.3d 7.3# % % 7.4a 7.4b 7.4c 7.4d 7.4e % 7.5a 7.5b 7.5c 7.5d 7.5# % 7.6a 7.6b 7.6c 7.6d 7.8# % 7.7a 7.7b 7.7o 7.7d 7.7# % 7.8a 7.8b 7.8c 7.8d 7.8# % 7.9a 7.9b 7.9c 7.9d 7.9# % 7.10a 7.11a 7.10b 7.11b 7.10c 7.11c 7.10d 7.lid 7.10# 7.11# % % 7.12a 7.12b 7.12c 7.12d 7.12# % 7.13a 7.13b 7.13c 7.13d 7.13# % 7.14a 7.14b 7.14c 7.14d 7.14# % (Check If additional Information Is provided on Part IV-Supplemental Information.) F Based on Operating Data? Yea No 7.If 7.2f 7.3f 7.4f 7.5f 7.6f 7.7f 7.8f 7.9f 7. lOf 7.Ilf 7.12f 7.13f 7.14f . OPTIONAL INFORMATION ON WASTE MINIMIZATION (Indicate action* taken to reduce the amount of the chemical befog roleaaed from the faclty. See the Instruction* for coded Item* and an explanation of what Information to Include.) ____________________________________________ A. Type of modification (enter code) B. Quantity of the chemical h the wastestream prior to treatment/dUpoeal C. Index 0. Reason for action (enter code) m Current reporting year (foa/yr) Prior year (fea/yr) | Or percent i change ( 1' on CTL016307 m EPA Form 9350-1(1-88) (Important: Type or print; read instructions before completing form.) REPA FORM PART IV. SUPPLEMENTAL INFORMATION Us* this section If you need additional spac* for answers to questions In Parts I and III. Number or letter this Information sequentlalty from prior sections (*.g.. D.E, F, or 5.54, 5.55). Pag* 5 of 5 ADDITIONAL INFORMATION ON FACILITY IDENTIFICATION (Part 1 - Section 3) ___ Stc Cod* ___ 3.5 ___ I11 111 III Dun Ik. Brd*tr*t Numb*r|i) 3.7 ____ 1__ LlJ__ 1__ L 1 - 1 J Li 1 1-1 1 1 1-1 1 1 1 EPA Identlficitlon Numbar(i| RCRA ID. No.) 3.8 1 111 1 111111 1 111 1 11 1 1 1 1 NPDES Permit Number() 3.9 1 111 1 111 Nm of Receiving Strem() or Weter Body() 1 111 1 111 3.10 -- ADDITIONAL INFORMATION ON RELEASES TO LAND ( Part III - Section 5.5) Releases to Land A. Total Release (tos/yr) A.1 Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate 5.5 (enter code) 5.5____ a .5 5.5____ (enter code) (enter code) 5.5____ a 5.5____ a B. Basis of Estimate (enter code) 5.5____ b Q 5.5____ b 5.5------ b Q ADDITIONAL INFORMATION ON OFF-SITE TRANSFER ( Part III - Section S) A.Total Transfer* (tos/yr) A.1 Reporting Range* 0 1-499 500-999 A.2 Enter Estimate ------ 6. _ S. Dlsch*rg* to POTW Other ofl-elte location (Enter block number from Pert 1, Section 2.) Other of1-lte location (Enter block number from Part 1. Section 2.) 6.____ a ii l--l I| 11 L--l 8.___ a 6.___ a B. Basis of C. Type of Treatment/ Estimate Disposal (enter code) (enter code) --b 6.___b O 6.___b n 6. c. 6.___ c. ADDITIONAL INFORMATION ON WASTE TREATMENT (Part III - Section 7) A. General Wastestream (enter code) B. Treatment Method (enter code) C. Range of Influent Concentration (enter code) D. Sequential Treatment? (check If applicable) 1 7h E. Treatment Efficiency Estimate F. Based on Operating Data? Ye* No 7.___e 7.___ f % 1 "1 NN 7. b 7.___ d mi 7-- % _L___ b__ 7.___c (ZH 7.___ d ?._ % O 1 *n n 1J 7. b 7. d 1 1 ?._ 7.___f % 7. b 7.___ c CU 7.___ d 7.___ 1 % 1 EPA Form 9350-1(1-88) CTL016308 'j L L n n 1 r-' rs. (Important: Type or print; read instructions before completing form.) Approval Expires- 01/91 Page t of 5 6EFA U.S. Environmental Protection Agency TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM EPA FORM Section 313, Title III of The Superfund Amendments and Reauthorization Act of 1986 R (ThJi space lor EPA usa onfy.) PART I. FACILITY IDENTIFICATION INFORMATION 1.1 Does this report contain trad# sacral information? 1. | ) Yes (Answer 1 2) f~x| No (Do not answer 1.2) 1.2 I* thl a sanJtlred copy? Q Y,, NO 1.3 Reporting Yaar 1987 2. CERTIFICATION (Read and sign after completing all sections.) I hereby certify that I have reviewed the attached documents and that, to the best of my knowledge and belief, the submitted information is true and complete and that the amounts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report. Nam* and official title of owner/opera I or or sank* man adamant official C. A. GELLNER, PLANT MANAGER Shatura Date signed 3. FACILITY IDENTIFICATION Facility or Establishment Name CERTAINTEED CORPORATION Street Address PETE MANENA R0A0 3.1 City County This report contains Information for: (check one) * 1 X] ^ ntlre covered facility. 3.2 ^ | | Part of a covered facility. SULPHUR State CALCASIEU Zip Code 1 3.3 3.4 3.5 3.6 3.7 3.8 3.9 LOUISIANA Technical Contact 7 1 016 1 6) f*l-IOI 21 S 13 Telephone Number (include are* code) BRUCE J. BR0CKA Public Contact (318 882 - 1^1 Telephone Number (include */** code) C. A. GELLNER a. SIC Coda b- N/A 2) 8 | 2| 1 111 Latitude Deg. Min. Sec C. Ill__ longitude Dag. Min. Sac. (318 882 - 1 1 Whora to send completed forms: ____ i 3. 0M i 313 iQ i9 i 311 i7 l StO Dun A Bradstreet Numc*'(i) N/A .LI-1 1 L 1 - 1 J__ L 1 1-1 iVal-i EPA Identification Number (RCRA l.O. No.) b. * L iA i D 10 i At 0 I 3t T12 tO i 2tS N/A i lt i ttt NP06S Permit Numbr(i) b. N/A _L j--A| 0 [0 i A | 1 | Ol 21 S Nam* of Receiving Str*am(i) or Water 8ody(s) a. BAYOU 01 INDE I1 I 111 I___I U S. Environment*! Protection Agency P O. Box 70266 Washington, OC 20024-0266 Attn: Toxic Chemical Raleas# inventory 3.10 N/A 3.11 Underground Injection Wall Coda (UC) Identification No. II I I N/Al I I I I I . PARENT COMPANY INFORMATION Name of Parent Company CERTAINTEED CORPORATION P 0 ROY RAO Parent Company's Dun 6 Bradstreet No. 0 1 01 - 12 1 31 51 - 1 81 7 16 1 S EPA Form 9350-1 (1-88) VALLEY FORGE. PA 19'>82 CTL016309 (Impo'tQrit: Typt.or print; read instructions before completing form.) REPA FORM PART II. OFF-SITE LOCATIONS TO WHICH TOXIC CHEMICALS ARE TRANSFERRED IN WASTES 1. PUBLICLY OWNED TREATMENT WORKS (POTYQ Facility Nam* N/A Street Addrett City County Slat* Zip 1 1 1 1 l-l 1 1 1 2. OTHER OFF-SITE LOCATIONS - Number these locations sequentially on this and any additional page of this form you use. | ] Other off-site location EPA Identification Number (RCRA O. No.) Facility Nam* Street Addrett N/A 1 1 1 1 1f11111 City County State Zip 1 111 I'll I* location under control ot reporting facility or parent company? | [ | [ 1 1... I Other off-sit* location Yee No W EPA Identification Number (RCRA D. No.) Facility Name Street Addreti N/A 1 1111 1 1 - L-l 1 1 City Cotnty State Zip ___ 1____1___ 1___ l-l 1 It location under control of reporting facility or parent oompany? Yea No [ | Other off-site location 1 1_ EPA Identification Number (RCRA O. No.) Facility Name Street Addrett N/A 1 1 1 1 1 1111 1 1 City COLTrty State Zip . 1 J-LJ l-l i 1. L j | Chock >t additional paget of Part I ar attached. EPA Form 9350-1(1-88) Ym No CTL016310 (Important: Type or print; read instructions before completing form.)_____________________ REPA FORM PART III. CHEMICAL SPECIFIC INFORMATION page 3 of 5 ' 1. CHEMICAL IDENTITY 1.1 | | Trade Secret (Provide a generic name in 1.4 below. Attach substantiation form to this submission.) 1.2 CAS # 00 76 ^ 7 | -| 0 | 1 | -| 0 j (Use leading zeros if CAS number does not fill space provided.) Chemical or Chemical Category Name 1.3 HYDROCHLORIC ACID )Generic Chemical Mama (Complata only If 1.1 Is checked. 1.4 MIXTURE COMPONENT IDENTITY (Do not complete this section if you have completed 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 apply.) 3.1 Manufacture: a.| X| Produce b. | ] Import e'CD ute/proceselng d- distribution * 0 A* a byproduct f. A. an Impurity 3.2 Process: a. 1 Ias a reactant 1--1 d. | | Repackaging only y Otherwise Used: .| 1 prncassfrlg^iH b. 1 1 As a formulation 1--1 component b. | | As a manufacturing aid c | 1 As an article 1--1 component c.| | Ancillary or other use W4. MAXIMUM AMOUNT OF THE CHEMICAL ON SITE AT ANY TIME DURINQ THE CALENDAR YEAR [ p| 1 1 (enter code) S. RELEASES OF THE CHEMICAL TO THE ENVIRONMENT You may report releases of less than 1.000 lbs. by checking ranges under A.1. A. Total Release (Ibs/yr) A.1 Reporting Ranges o i-ree soo-eee 5.1 Fugitive or non-point air emissions 5.1a A.2 Enter Estimate N/A B. Basis of Estimate (enter code) 5.1b Q 5.2 Stack or point air emissions 5.2a 5.3 Discharges to water (Enter letter code from Part 1 Section 3.10 lor strem*().) 5.3.1 | | i--i 5.3.2 LJ 5.3.1a 5.3.2a 3.800 N/A N/A 5.2b Q 5.3.1b Q 5.3.2b Q C. % From Stormwater 5.3.1c S.3.2c 5.3.3 5.3.3a 5.4 Underground Injection 5.5 Releases to land cc ^ 1 (enter code) 5.4a 5.5.1a N/A N/A N/A 5.3.3b Q 5.4b Q 5.5.1b Q 5.3.3c S.5.2 || (enter code) 5.5.2a 5.5.3 (enter code) 5.5.3a (Check If additional Information la provided on Part IV-Supplemental Information.) N/A 5.5.2b Q 5.5.3b Q _______ H1A_________ CTL016311 EPA Form 9350-1(1-88) tPA i-OKM I i.ran Hi ^comuiueoj . TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS oYfou m *(yHarenp1o,r0t 0t0ranlb1rbsy checking rtno unPor A. 1. A.Total Transfers (bs/yr) A. 1 Reporting Ranges o t-ase 5oo-eee A.2 Enter Estimate 8. Basis of Estimate (enter code) 6.1 Dlscharoe to POTW EDN/A .1b Other off-ilte location |----- 1 6.2 (Enter block number 11 from Part 1, Section 2.) l--l EDN/A 6.2b 6.3 Q(EJnhteerrobflfo-ckltenulomcbaetiron 1----- 1| from Part 1. Section 2.) 1------1 6.4 Othor (Entor obflfo-ctkitsnutomebaetrton i--1 from Part 1. Section 2.) 1-- N/A N/A .3b .4b Q | | (Check If additional Information Is provided on Part IV-Supplemental Information) Pag* ioli C. Typo of Treatment/ DitpotaJ fontor cod#) 6.2c 6.3c 6.4c 7. WASTE TREATMENT METHODS AND EFFICIENCY A. General Wastestream (enter code) B. Treatment Method (enter code) C. Range of D. Sequential Influent Treatment? Concentration (check If _____(enter code) _____ applcable)___ 7.1a 7.1b A0k 7.1c 7.Id E. Treatment Efficiency Estimate 7.ie 99 % 7.2a 7.3a fw~l 7.2b 7.3b C1 1 7.2c 7.2d 7-2* 7.3c 7.3d 7.3e 101 % % 7.4a 7.4b 7.4c 7.4d 7.4e % 7.5a 7.5b 7.5c 7.5d 7.5e % 7.6a 7.6b 7.6c 7.6d 7.6e % 7.7a 7.7b 7.7c 7.7d 7.7e % 7.8a 7.8b 7.6c 7.8d 7.8e % 7.9a 7.9b 7.9c 7.9d 7.9e % 7.10a 7.11a 7.10b 7.11b 7.10c 7.11c 7.10d 7.lid 7.10e 7.lie % % 7.12a 7.12b 7.12c 7.12d 7.12e % 7.13a 7.13b 7.13c 7.13d 7.13e % 7.14a 7.14b 7.14c 7.14d 7.14e % (Check If additional Information la provided on Part IV-Supptemental Information.) F. Based on Operating Data? Yes No G37.If 7.2f 7.3f 7.4f 7.5f 7.6f 7.7f 7.8f 7.9f 7.10f 7.Ilf 7.12f 7.13f 7.14f 8. OPTIONAL INFORMATION ON WASTE MINIMIZATION (Indicate action* taken to reduce the amount of the chemical behg released from the facBty. See the Instruction* for coded Items and an explanation of what Information to Include.) A. Type of modification (enter code) B. Quantity of the chemical In the wastestream prior to treatment/dlspoeal C. Index D. Reaeon for action (enter code) 1m Current reporting year (bs/yr) Prior year (bs/yr) | Or percent | enange , 11 %% nn m EPA Form 9350-1(1-88) CTL016312 (Important: Type or print; read instructions before completing form.) REPA FORM PART IV. SUPPLEMENTAL INFORMATION Us* this section If you need additional spac* for answers to questions In Parts I and III. Number or letter this Information sequentially from prior sections (e.g., D.E, F. or 5.54. 5.55). Pag* 5 of 5 ADDITIONAL INFORMATION ON FACILITY IDENTIFICATION (Part 1 - Section 3) ----- SIC Cods ----3.5 ----- 1 1 1111 Dun & Bnd*tr##t Number(t) III, 3.7 ZLj___i -1 i i i -1 i i i EPA identification Number (a) HCRA I.D. No.) 3.8 1 111 1 111111 NiPOCS Permit Numb#r(s) 3.9 1 _____i___ i___i i i i i i_____________ Name of Recalving Stream(s) or Water Body(i) 3.10 1 - 111 1 ~ 1 1 1 1 1 111 1 1111 1 1 1 1 1 1 1 1 1 1_____________ ADDITIONAL INFORMATION ON RELEASES TO LAND ( Part III - Section 5.5) Releases to Land A. Total Release (bs/yr) A. 1 Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate 5.5____ (enter code) 5.5____ a .5 5.5____ (enter code) (enter code) 5.5____ a 5.5____ a B. Basis of Estimate (enter code) 5.5____b Q 5.5____ b Q 5.5____ b Q ADDITIONAL INFORMATION ON OFF-SITE TRANSFER ( Part III - Section <) A.Total Transfers (Ibs/yr) A. 1 Reporting Range* 0 1-499 500-999 A.2 Enter Estimate ------ 6. 6. ------- Olacharge to POTW Oth#r off-sit# location (Ent#r block numbtr from Part 1, Section 2.) Other off-alt* location (Enter block number from Part 1, Section 2.) 6.___ a i I 1--1 r-1 1 1----- 1 6.___ a 6.___ a B. Basle of C. Type of Treatment/ Estimate Disposal (enter code) (enter code) 6._b EZ6.___b 6.___b CU 6. c. 6.___ c. ADDITIONAL INFORMATION ON WASTE TREATMENT (Part III - Section 7) A. General Wastestream (enter code) B. Treatment Method (enter code) C. Rang* of Influent Concentration (enter code) D. Sequential Treatment? (check If applicable) 7. b 7.___ d E. Treatment Efficiency Estimate F. Based on Operating Data? Yes No 7.___ e 7.___ f % "4l n LL nn ! n! ! -------- u 1 ooo 1 r-' 7. b 7.___ d 7._* 7.___ f % J k_. 7. b 7. b 7. b 7-_* 1 J EZ7.___ c EZ7.___ d 7-__* ?._ 7.___ 1 % % 7._ 7.___ 1 % EH EZ ' m 1 N EPA Form 9350-1(1-88) CTL016313 (Important: Type or print; read instructions before completing form.) Approval Expires 01/91 Page 1 of 5 EFA U.S. Environmental Protection Agency TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM Section 313, Title III of The Superfund Amendments and Reauthorization Act of 1986 EPA FORM R (This spec* (or EPA us* only.) PART I. FACILITY IDENTIFICATION INFORMATION 1 1 Doe* this report contain trade secret Information? 1. [ 1 Ves (Answer 1.2) | xl No (Do not answer 1 2) 1.2 Is this a sanitized copy? (_J Ves |_J No 1.3 Reporting Year 1987 2. CERTIFICATION (Read and sign after completing all sections.) 1 hereby certify that I have reviewed the attached documents and that, to the best of my Inowledge and belief, the submitted information is true and complete and that the amounts and values in this report are accurate based on reasonable estimates using data available to the preparers of this report. Nam* and official tit!* ol owner/operator or senior management official C. A. GELLNER, PLANT MANAGER Signature Date signed (oK-7/r^ 3. FACILITY IDENTIFICATION Facility or Establishment Name CERTAINTEED CORPORATION Street Address PETE MANENA ROAD 3.1 City County This report contains Information for: (check one) a 1 Xl ^ covered facility. 3.2 ^ | | Part of a covered facility. |) 3.3 3.4 3.5 3.6 3.7 3.8 3.9 SULPHUR State CALCASIEU Zip Code LOUISIANA Technical Contact 7 1 0 16 1 6l 1*1-10 1 21 SIR Telephone Number (Include area code) BRUCE J. BR0CKA Public Contact C. A. GELLNER a. SIC Code b- N/A 2) 8| 2i 1 111 Latitude Deg. Min. Sec. C. 1 1___ 1__ Longitude Deg. Min. Sec. ___l. 3-1 011 i 313 10 i S i 31 1 17 1 Si 0 Dun & Bradstreet Numbe'(s) N/A _J__ LJ__ I I 1 - I b. I___L.- IIIL EPA Identification Number (RCRAI.D. No.) * L i A i 0 |0 i 4i0 i 3i 3i 2 iQ i 2t5 N/A tii i iii NPOES Permit Number (s) * Ll AiOiO l <i|1 1 Ol 2l5 Name of Receiving Stream(s) or Water Body(s) N/A J__ L I I J__ I__ L a. BAYOU D1I NOE (318 882 - 11*41 Telephone Number (Include area code) (318 882 -1ii*1 I___I Where to send completed lorms: U S. Environmental Protection Agency P O. Box 70266 Washington, DC 20024-0266 Attn: Toxic Chemical Release inventory 3.10 N/A Underground injection Well Code (UlC) identification No. 3.n i i i i VAi i i i i i 1_____ a. PARENT COMPANY INFORMATION Neme of Parent Company CERTAINTEED CORPORATION Parent Company's Dun & Bradstreet No. P. D 0 101-12 I 31 5 1 - I 81 2 16 I S EPA Form 9350-1 (1-88) ROY RAn VALLEY FORGE. PA 19*tS2 CTL016314 (Important: Type or print; read instructions before completing form.) REPA FORM PART II. OFF-SITE LOCATIONS TO WHICH TOXIC CHEMICALS ARE TRANSFERRED IN WASTES Pay 2 of 5 1. PUBLICLY OWNED TREATMENT WORKS (POTW) Facility Nam* N/A Street Address City County Slat* zip < III 1-11 II 2. OTHER OFF-SITE LOCATIONS - Number these locations sequentially on this and any additional page of this form you use. | | Other off-site location EPA Identification Number (RCRA ID. No.) Facility Name Street Address N/A 111 1 1 .................................. City County State Zip 1 III l-l 1 j |It location under control of reporting facility or parent company? | ] Ye* No 1 | Other off-site location 1 EPA Identification Number (RCRA O. No.) Facility Name Street Addrett N/A 111 1 1 1 1 1 1 II 11 City County State Zip J___ 1 1 1___ l-l It location under control of reporting facility or parent company? | | | 1___1 | | | Other off-site location Ye* No 1 EPA identification Number (RCRA O. No.) Facility Name Street Addrett N/A 1 1 1 1 1 1 1 1 1 1 L_ City County State Zip 1 III l-l 1 It location under control of reporting facility or parent company? | | | | Yet No II H I Check if additional page* of Part 1 are attached. EPA Form 9350-1(1-88) CTL016315 (Important-: Type or print; read instructions before completing form.)_____________________ REPA FORM PART III. CHEMICAL SPECIFIC INFORMATION Pag# 3 of 5 ^ 1. CHEMICAL IDENTITY 1.1 | | Trade Secret (Provide a generic name in 1.4 below. Attach substantiation form to this submission.) 1.2 CAS# 00 766 k 3 3 | "| 9 1 (Use leading zeros if CAS number does not fill space provided.) Chemical or Chemical Category Name 1.3 SULPHURIC ACID Generic Chemical Name (Complete only If 1.1 Is checked.) 1.4 MIXTURE COMPONENT IDENTITY (Do not complete this section If you have completed 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 apply.) 3.1 Manufacture: a.| | Produce b. | | Import < For on-sit# use/processing d 1 1 For sale/ '1--1 distribution e. [ | As a byproduct As an Impurity 3.2 Process: a. | ] As a reactant b 1 1 As a formulation ' 1--1 component - At an article component d. | | Repackaging only 3 Otherwise Used: I y| As a chemical * L_ii processing aid b. | | As a manufacturing aid - Ancillary or other use MAXIMUM AMOUNT OF THE CHEMICAL ON SITE AT ANY TIME DURING THE CALENDAR YEAR | 0| ^ | (enter code) 1 5. RELEASES OF THE CHEMICAL TO THE ENVIRONMENT A. Total Release llbs/yr) You may report releases of less than 1,000 lbs. by checking ranges under A.1. A.1 Reporting Ranges o t-<ee 50o-eoo S.1 Fugitive or non-point air emissions 5.1a 5.2 Stack or point air emissions 5.2a 5.3 Discharges to water (Ent#r letter cod# from Part 1 Section 3.10 for *tram*().) 5.3.1 | | i----- 1 5.3.2 |__ 1 5.3.1a 5.3.2a A.2 Entsr Estimate N/A N/A H/A B. Basis of Estimate (enter code) 5.1b O 5.2b Q 5.3.1b Q 5.3.2b Q C. % From Stormwater 5.3.1c 5.3.2c 5.3.3 5.3.3a 5.3.3b Q 5.3.3c 5.4 Underground Injection 5.4a 5.5 Releases to larid ... 1" (#nt#r cod#) 5.5.2 1 (#nt#r cod#) 5.5.1a 5.5.2a B 5.5.3 (#nt#r cod#) 5.5.3a (Ch*ck If additional Information Is provided on Part IV-Supplemental Information.) N/A 5.4b Q N/A 5.5.1b Q N/A 5.5.2b Q 5.5.3b Q N/A______ -- CTT.n leu. EPA Form 9350-1(1-88) EPA FORM n.Pan Hi (Continued/ . TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS You may report tr&ntfart rang#t urx3#r A.V. A.Total Transfer* (b/yr) A. 1 Reporting Range* 0 1-4*9 500-909 A.2 Enter Ettlmat* B. Ba*i* of Ettlmate (enter code) 8.1 6.2 6.3 6.4 Dltcharp* to POTW Otlw off-tlle location (Enter block number from Part 1. Section 2.) Ojher otf-lte location (Enter block number from Part 1, Section 2.) Other ofl-tlto location (Snt#f block number from Part 1, Section 2.) N/A 6.1b N/A 6.2b N/A 6.3b N/A 6.4b [ | (Check If additional Information It provided on Part IV-Supplemental Information) Pag* 4 of S C. Type of Treatment/ Disposal (enter code) 6.2c 6.3c 6.4c 7. WASTE TREATMENT METHODS AND EFFICIENCY A. General Wastestream (enter code) B. Treatment Method (enter code) 7.1a 7.1b C. Range of D. Sequential Influent Treatment? Concentration (check If _____(enter code) _____ applicable)___ 7.1c 7.Id E. Treatment Efficiency Ettlmate 7.V* % 7.2a 7.2b 7.3a 7.3b 7.2c 7.2d 7.2* 7.3c 7.3d 7.3* % % 7.4a 7.4b 7.5a 7.5b 7.4c 7.4d 7.4* 7.5c 7.5d 7.5* % % 7.6a 7.6b 7.6c 7.6d 7.6* % 7.7a 7.7b 7.8a 7.8b 7.7c 7.7d 7.7* 7.8c 7.6d 7.8* % % 7.9a 7.9b 7.9c 7.9d 7.9* % 7.10a 7.11a 7.10b 7.11b 7.10c 7.11c 7.10d 7.lid 7.10* 7.11* % % 7.12a 7.12b 7.12c 7.12d 7.12* % 7.13a 7.13b 7.13c 7.13d 7.13* % 7.14a 7.14b 7.14c 7.14d 7.14* % (Check If additional Information la provided on Part IV-Supplemental Information.) F Based on Operating Data? Yes No 7.If 7.2f 7.3f 7.4f 7.5f 7.6f 7.71 7.61 7.91 7.10f 7.Ilf 7.12f 7.13f 7.14# 8. OPTIONAL INFORMATION ON WASTE MINIMIZATION (Indicate actions taken to reduce th* amount of the chemical being released from the facBty. See the Inetructlon* for coded Items and an explanation of what Information to Include.) A. Type of modification (enter code) B. Quantity of the chemical In the wastestream prior to treatment/dlsposal C. Index D. Reason for action (enter code) Current reporting year (bs/yr) Prior year (fes/yr) | Or percent i change ( 11 %% nn m EPA Form 9350-1(1-88) CTL016317 (Important: Type or print; read instructions before completing form.) REPA FORM PART IV. SUPPLEMENTAL INFORMATION Use this section If you need additional space for answers to questions In Parts I and III. Number or letter this Information sequentially from prior sections (e.g., D.E. F, or 5.54, 5.55). Page 5 of S (TW tpec* tor EPA um onty.) ADDITIONAL INFORMATION ON FACILITY IDENTIFICATION (Part 1 - Section 3) 3.5 3.7 3.8 3.9 ----- SIC Cod*_____ ____ _J___11III Dun & BradstrMt Number(*) III i i -1 i i i -1 i i i EPA identification Number(a) RCRA I.D No.) 1 111 t 11111 1 NPOES Permit Number(s) i i -1 i i i -1 i i i i iii i iiii i i ______ i____ i i i i i____i____i_________________ Name of Receiving Stream(s) or Water Body(s) 3.10 i iii i iii ADDITIONAL INFORMATION ON RELEASES TO LAND ( Part III - Section 5.5) Releases to Land A. Total Release (Ibs/yr) A. 1 Reporting Ranges 0 1-496 500-999 A.2 Enter Estimate 5.5____ (*nt*r cod*) 5.5____ a 5 5.5____ (*nt*r cod*) (enter code) 5.5____ a 5.5____ a B. Basis of Estimate (enter code) 5.5____ b Q 5.5____ b EH 5.5------ b Q ADDITIONAL INFORMATION ON OFF-SITE TRANSFER ( Part III - Section ) A.Total Transfers (Ibs/yr) A. 1 Reporting Ranges 0 1-499 500-999 A.2 Enter Estimate ------- 6. ,, 6. ----- Discharge to POTW Other off-sit* locstlon (Ent*r block number from Psrt 1, Section 2.) Other ort-lte location (Enter block number from Part 1. Section 2.) 6.___ a i---- 1 l--l 1-----1 1-----1 6.___ a 6.___ a B. Basis of C. Type of Treatment/ Estimate Disposal (enter code) (enter code) _ 6.___b EH EH6.___ b 6. c. 6.___ c. | ADDITIONAL INFORMATION ON WASTE TREATMENT (Part III - Section 7) A. General Wastestream (enter code) B. Treatment Method (enter code) C. Range of Influent Concentration (enter code) D. Sequential Treatment? (check If applicable) EH7.___ a 7.___ b EH7.___c 7.___ d 7. b EH EU7.___c 7.___ d E. Treatment Efficiency Estimate F. Based on Operating Data? __________ YfiJ____Na_ 7.___ e % ._t % 1L at 7. b 7.___ d _f % 7. b EH ED7.___c 7. d 7- 7._. % 7. b EH EH7.___c 7.___ d 7__ _J ' % EPA Form 9350-1(1-88) CTL016318 u o J .!, r*! (Important: Type or print; read instructions btfort completing form.) Approval E*p<r#$- 01/91 Pag 1 of S o-EFA U S. Environmental Protection Agency TOXIC CHEMICAL RELEASE INVENTORY REPORTING FORM Section 313, Title III of The Superfund Amendments and Reauthorization Act of 1986 EPA FORM R (This space for EPA ute ortfy J PART I. FACILITY IDENTIFICATION INFORMATION 1 1 Does this report contain trad* secret information? 1. | | Vaa (Answer 1.2) | J([ No (Do not answer 1 2) 1.2 b this a sanitised copy? Q Y" NO 1.3 Reporting Vaar 1987 2. CERTIFICATION (Read and sign after completing all sections.) I hereby certify that I have reviewed the attached documents and that, to the best of my knowledge and belief, the submitted information is true and complete and that the amounts and values In this repon are accurate based on reasonable estimates using data available to the preparers of this report. Nam* and official tit!# of ewmr/operator or senior management official C. A. GELLNER, PLANT MANAGER Signature Date signed 3. FACILITY IDENTIFICATION Facility of Establishment Name CERTAINTEED CORPORATION Street Address PETE MANENA ROAD 3.1 City County This report contains Information for: (check one) a | X| An entire covered facility, 3.2 b | | Part of a covered facility. SULPHUR State CALCASIEU Zip Code | LOUISIANA Technical Contact 3.3 BRUCE J. BR0CKA Public Contact 3.4 C. A. GELLNER 7 1 0 16 1 6l 1*1-10 1 21 sn Telephone Number (Include area code) (318 882 -lWl Telephone Number (Include arta code) (318 882 -11*1*1 a. SIC Code 35 b N/A 2| 8 I 2i 1 111 | Latitude C. ___1___1__ longitude 3.6 Deg. Min. Sec. Deg. Min. Sec. _l..3i o 11 i 313 iQ - 13 l 31 117 1 SiO. Oun i Bradstreet Numbe'(a) 3.7 * N/A ____ I 1-1 I I I - I J__ L JYV I I-I I J__ L 3.8 EPA Identification Number (RCflA 1.0. No.) b. * L t A I Dip I 4|0 I 3* 3i 2 iQ i 2iS I N/^A I1 till NPOES Permit Number(t) 3.9 b- N/A l 1 A) 0)0 | Li 1 i 0i 2l5 ____ I____I___ I--I-- i_l__ I__ L Name of Receiving Straam(s) or Water Body(s) J__ L Whore to send completed forms: U S. Environmental Protection Agency P.O. Boa 70266 Washington. DC 20024-0266 Atln: Tonic Chemical Release Inventory * b. 3.10 BAYOU D ' I NDE N/A Underground Injection Well Code (DC) Identification No. 3.11 II I |N/AI I I I I I 4._ PARENT COMPANY INFORMATION Name of Parent Company CERTAINTEED CORPORATION P. 0 4.2 Parent Company's Oun & Bradstreet No 0 I 01-12 nm -I 81216 1 A EPA Form 9350-1 (1-88) ROY RAd VALLEY FORGE. PA 19^82 CTL016319 (Important. Typ? or print; read instructions before completing form.) REPA FORM PART II. OFF-SITE LOCATIONS TO WHICH TOXIC CHEMICALS ARE TRANSFERRED IN WASTES Pag* 2 of S 1. PUBLICLY OWNED TREATMENT WORKS IPOTW1 Facility Ntm# N/A Street Addrett City County State Zip ......................... -Mil 2. OTHER OFF-SITE LOCATIONS - Number the** location* sequentially on thla and any additional page of thla form you uae. [ ] Other off-site location EPA Identification Number (RCRA O. No.) 1 1 111111111 Facility Nam* StrMt Addrett N/A City County State Zip 1 1 1 1 l-l 1 1 1 |It location under control of reporting facility or parent ocmpany? | | | | | Other off-alte location Ye* No [ EPA Identification Number (RCRA O. No.) 1 1 11 1111 111 Facility Name StrMt Addreaa N/A City County State Zip 1 1 1 1 l-l 1 orIt location under control of reporting facility parent oompany? | [ j | Yea No | | Other off-alte location 11 EPA identification Number (RCRA O. No.) Facility Nama StrMt Addrett N/A (|1I1 11 1 111 City County State Zip 1 III l-l 1 |It location under control of reporting facility or parent company? | | j k Yet No 11- | | Check If additional paget of Part 1 are attached. EPA Form 9350-1(1-88) CTL016320 (Important.' Type or print; read instructions before completing form.)_____________________ REPA FORM PART III. CHEMICAL SPECIFIC INFORMATION Page 3 of 5 1. CHEMICAL IDENTITY 1.1 [ | Trade Secret (Provide a generic name in 1.4 below. Altacb subjtantialion form to this submission.) 1.2 CAS# 0 0 1 3 1 01 --1 7 | 3 |-[""Tj (Use leading zeros If CAS number does nol fill spice provided.) Ch#mical or Chemical Category Name 1.3 SODIUM HYDROXIDE (SOLUTION) Generic Chemical Name (Complete only If 1.1 la checked.) 1.4 MIXTURE COMPONENT IDENTITY (Do not complete this section if you have completed 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 (Cheek all that apply.) 3.1 Manufacture: a.Q Product b. Q Import e/elng d- dlstrtoutlon e. Q] A* a byproduct f. Q A. an Impurity 3.2 Pro....: d. | | Repackaging onfy ` Otherwise Used: a.[ ]p^ocessIng^aJd ___ b. CD A* * rn*ntrf*ctuf1nfl aid c-CZ3 AnclBarY f other use MAXIMUM AMOUNT OF THE CHEMICAL ON SITE AT ANY TIME DURING THE CALENDAR YEAR | 0 14 1 (enter code) 5. RELEASES OF THE CHEMICAL TO THE ENVIRONMENT You may report releases of less than 1,000 lbs. by checking ranges under A.1. A. Total Release (tos/yr) A.1 Reporting Ranges o i-4se soo-eee 5.1 Fugitive or non-point air emissions 5.1a A.2 Enter Estimate N/A 5.2 Stack or point air emissions 5.2a N/A 5.3 Discharges to water 5.3.1 [ a| Section 3.10 for straama(s).) j--i 5.3.2 LJ 5.3.1a 5.3.2a 5.3.3 5.3.3a A, 200 N/A N/A 5.4 Underground Injection 5.4a 5.5 Relea ses to larid 5.5.1 IT (enter code) 5.5.2 (enter code| 5.5.1a 5.5.2a A 5.5.3 (enter code) 5.5.3a | [ (Check If additional Information It provided on Part (V-Suppfemental Information.) N/A N/A N/A N/A EPA Form 9350-1(1-88) B. Basis of Estimate (enter code) 5.1b 5.3.1b Q 5.3.2b Q] 5.3.3b Q ** 5.5.1b CD C. % From Stormwater 5.3.1c 5.3.2c 5.3.3c 5.5.2b Q 5.5.3b Q CTL016321 EPA FORM ft. Part 111 (Continued; 6. TRANSFERS OF THE CHEMICAL IN WASTE TO OFF-SITE LOCATIONS You may r#port transfer* of l#s (Kan 1.000 lb by checking rang unoor A.1. A.Total Transfers (bs/yr) A.1 Reporting Ranges 0 1-490 500-000 A.2 Enter Estimate B. Basis of Estimate (enter code) 6.1 Discharge to POTW Other off-lit* location i----i 6.2 (Enter block number 1 from Part 1, Section 2.) 1----- 1 6.3 OJher off-alta location [Enter block number from Part 1, Section 2.) t~~1( 11 - 6.4 Other off-alta location i--| (Enter block number from Part 1, Section 2.) 1--1 N/A N/A N/A N/A 6.1b 6.2b 6.3b 6.4b | | (Check If additional Information Is provided on Part IV-Supplemental Information) O D O Q Pag* 4 of 5 C. Typ of Trgatmgnt/ Dttpo4f (*nt#r cod) 6.2c 6.3c 6.4c 7. WASTE TREATMENT METHODS AND EFFICIENCY A. Genera] Wastestream (enter code) B. Treatment Method (enter code) 07.1a 7.1b 7.2a 7.2b C1 1 C. Range of Influent Concentration __ fenter code! 7.1c 7.2c D. Sequential Treatment? (check If aoodcablel 7.Id 7.2d E. Treatment Efficiency Estimate 7-i* 7.2e 99% % 7.3a 7.3b 7.3c 7.3d 7.3e % 7.4a 7.4b 7.4c 7.4d 7.4e % 7.5a 7.5b 7.5c 7.5d 7.5e % 7.6a 7.6b 7.6c 7.6d 7.6e % 7.7a 7.7b 7.7o 7.7d 7.7e % 7.8a 7.8b 7.6c 7.6d 7.8e % 7.9a 7.9b 7.9c 7.9d 7.9e % 7.10a 7.10b 7.11a 7.11b 7.10c 7.11c 7.10d 7.lid 7.10e 7.lie % % 7.12a 7.12b 7.12c 7.12d 7.12e % 7.13a 7.13b 7.13c 7.13d 7.13e % 7.14a 7.14b 7.14c 7.14d 7.14e % (Check If addKIonal Information Is provided on Part IV-Supplemental Information.) F Based on Operating Data? Yes No 7.If 7.2f 7.3f 7.4f 7.5f 7.6f 7.7f 7.8f 7.9f 7. lOf 7.Ilf 7.12f 7.13f 7.14f #. OPTIONAL INFORMATION ON WASTE MINIMIZATION (Indicate actions taken to reduce the amount of the chemical being released from the facRty. See the Instructions for coded Kerns and an explanation of what Information to Include.) A. Type of modification (enter code) B. Quantity of the chemical In the wastestream prior to treatment/dUposai C. Index D. Reason for action (enter code) Current reporting year (bs/yr) Prior year (be/yr) ( Or percent | change ( 11 %* nn m EPA Form 9350-1(1-88) CTL016322 (Important: Type or print; read instructions before completing form.) REPA FORM PART IV. SUPPLEMENTAL INFORMATION Use this section If you need additional space for answers to questions In Parts I and III. Number or letter this Information sequentially from prior sections (e.g., O.E, F, or 5.54, 5.55). Page S of S ADDITIONAL INFORMATION ON FACILITY IDENTIFICATION (Part 1 - Section 3) ----- SIC Code ----3.5 ----- 1 1 1111 Dun A SradstrMt Numbr(ij 'll, 3.7 i i -1 i i i -1 j i i ' EPA Identification Nlumber() RCRA I.O. No.) 3.* 1 111 1 111111 NPOES Permit Number() 3.9 1 1 - 1 1 1 1 - 1 11 1 1 111 11111 1 1 _____1___ 1-J- 1___ 1 1 1 1_____________ Name ot Receiving Stream(i) or Water Body(t) .........................Ill 3.10 ADDITIONAL INFORMATION ON RELEASES TO LAND ( Pert III - Section 8.5) Releases to Land A. Total Release (bs/yr) A.1 Reporting Ranges 0 1-409 500-999 A.2 Enter Estimate 5.5____ (enter code) 5.5____ a .5 5.5____ (enter code) (enter code) 5.5____ a 5.5____ a B. Basis of Estimate (enter code) 5.5____b Q S.5____ b O 5.5____b Q ADDITIONAL INFORMATION ON OFF-SITE TRANSFER ( Part III - Section 8) A.Total Transfers (be/yr) A.1 Reporting Ranges 0 1-490 500-999 A.2 Enter Estimate '------- Dlchrg# to POTW 6.___ a 6. _ 6. ------- Other on-lte location (Enter block number from Part 1, Section 2.) Other off-site location (Enter block number from Part 1, Section 2.) ii 1 1--1 r~~1 1 1------- 1 6.___ a 6.___ a 8. Basle of C. Type of Treatment/ Estimate Disposal (enter code) (enter code) 6-_b 6.___b CH S. c. 8.___ c. 1 ID ADDITIONAL INFORMATION ON WASTE TREATMENT (Part III - Section 7) A. General Wastestream (enter code) B. Treatment Method (enter code) C. Range of Influent Concentration (enter code) D. Sequential Treatment? (check If applicable) 7. b CD7.___ c 7.___d E. Treatment Efficiency Estimate F. Based on Operating Data? __________ Yu____Ng_ 7.___ e % 7. b 7.___c 7.___d 7__* _f % u J ----N-1 O J h. 7. b 7_* 7._r % r._. 7. b CH7.___ c 7.___ 7._< % o 1 _. 7. b 7.___d 7._# % ._f EPA Form 9350-1(1-68) CTL016323 -4 L -4 L n