MATERIAL - Houston



Fill out the forms for the materials stored, used or handled at your site by indicating yes or no in each area provided. These forms in their entirety shall be submitted with each permit application when appropriate. Having permit amounts requires a permit for the operation. The exempt amounts are for use in the routing of those permits.

PHYSICAL HAZARDS

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |EXEMPT AMOUNTS |EXEMPT |EXEMPT |HAVE AMOUNTS THAT |HAVE ABOVE EXEMPT |

| | | | |STORAGE |AMOUNTS |AMOUNTS USE OPEN – |REQUIRE A PERMIT? |AMOUNTS? |

| | | | | |USE CLOSED – vapors |vapors are liberated| | |

| | | | | |are not liberated | | | |

|COMBUSTIBLE LIQUIDS |II |Class II liquids include those |> 25 gallons inside or |120 gallons |120 gallons |30 gallons |NO ⃞ |NO ⃞ |

| | |having flash points at or above |> 60 gallons outside | | | |YES ⃞ |YES ⃞ |

| | |100˚F and below 140˚F. | | | | | | |

|COMBUSTIBLE LIQUIDS |IIIA |Class IIIA liquids include those|> 25 gallons inside or |330 gallons |330 gallons |80 gallons |NO ⃞ |NO ⃞ |

| | |having flash points at or above | | | | |YES ⃞ |YES ⃞ |

| | |140℉ and below 200℉. |> 60 gallons outside | | | | | |

|COMBUSTIBLE LIQUIDS |IIIB |Class IIIB liquids include those|Only - Tanks or Vessels|13,200 gallons |13,200 gallons |3,300 gallons |NO ⃞ |NO ⃞ |

| | |liquids having flash points at |> 60 gallons | | | |YES ⃞ |YES ⃞ |

| | |or above 200℉. | | | | | | |

|FLAMMABLE LIQUIDS |IA |Class IA liquids include those |> 5 gallons inside or |30 gallons |30 gallons |10 gallons |NO ⃞ |NO ⃞ |

| | |having flash points below 73℉ | | | | |YES ⃞ |YES ⃞ |

| | |and having a boiling point below|> 10 gallons outside | | | | | |

| | |100℉. | | | | | | |

|FLAMMABLE LIQUIDS |IB |Class IB liquids include those |> 5 gallons inside or |60 gallons |60 gallons |15 gallons |NO ⃞ |NO ⃞ |

| | |having flash points less than |> 10 gallons outside | | | |YES ⃞ |YES ⃞ |

| | |73℉ and boiling points at or | | | | | | |

| | |above 100℉. | | | | | | |

|FLAMMABLE LIQUIDS |IC |Class IC liquids include those |> 5 gallons inside or |90 gallons |90 gallons |20 gallons |NO ⃞ |NO ⃞ |

| | |having flash points at or above |> 10 gallons outside | | | |YES ⃞ |YES ⃞ |

| | |73℉ and below 100℉. | | | | | | |

|COMBINATION FLAMMABLE |(IA,IB,IC) |Mixture of storage or use of |> 5 gallons inside or |120 gallons |120 gallons |30 gallons |NO ⃞ |NO ⃞ |

|LIQUIDS | |more than one of these |> 10 gallons outside | | | |YES ⃞ |YES ⃞ |

| | |materials. | | | | | | |

|CRYOGENIC, FLAMMABLE |Definition: A liquid having |Examples: carbon monoxide, |> 1 gallon inside or |45 gallons |45 gallons |10 gallons |NO ⃞ |NO ⃞ |

|(Flammable in its vapor|a boiling point lower than |deuterium (heavy hydrogen), |> 60 gallons outside | | | |YES ⃞ |YES ⃞ |

|state) |-150℉ at 14.7 (psia). |ethylene, hydrogen and methane. | | | | | | |

|CRYOGENIC Inert | | |> 60 gallons inside or |Not Limited |Not Limited |Not Limited |NO ⃞ |Not Limited |

| | | |500 gallons outside | | | |YES ⃞ | |

PHYSICAL HAZARDS

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |EXEMPT AMOUNTS |EXEMPT |EXEMPT |HAVE AMOUNTS THAT |HAVE ABOVE EXEMPT |

| | | | |STORAGE |AMOUNTS |AMOUNTS USE OPEN |REQUIRE A PERMIT? |AMOUNTS? |

| | | | | |USE CLOSED – vapors |– vapors are | | |

| | | | | |are not liberated |liberated | | |

|ORGANIC PEROXIDE |I |Def: Those formulations that |Any amount. |5 pounds (liquid or |1 pound (liquid or |1 pound (liquid |NO ⃞ |NO ⃞ |

| | |are capable of deflagration but| |solid) |solid) |or solid) |YES ⃞ |YES ⃞ |

| | |not detonation. | | | | | | |

|ORGANIC PEROXIDE |II |Def: Those formulations that |Any amount. |50 pounds (liquid or|50 pounds (liquid or|10 pounds (liquid|NO ⃞ |NO ⃞ |

| | |burn very rapidly and that pose| |solid) |solid) |or solid) |YES ⃞ |YES ⃞ |

| | |a moderate reactivity hazard. | | | | | | |

|ORGANIC PEROXIDE |III |Def: Those formulations that |> 1 gallon liquid or 10 |125 pounds (liquid |125 pounds (liquid |25 pounds (liquid|NO ⃞ |NO ⃞ |

| | |burn rapidly and that pose a |pounds solid |or solid) |or solid) |or solid) |YES ⃞ |YES ⃞ |

| | |moderate reactivity hazard. | | | | | | |

|ORGANIC |IV |Def: Burn in same manner as |> 2 gallons liquid or 20 |Not Limited |Not Limited |Not Limited |NO ⃞ |Not Limited |

|PEROXIDE | |ordinary combustibles with |pounds solid | | | |YES ⃞ | |

| | |minimum reactivity hazard. | | | | | | |

|OXIDIZER |4 |In addition, the oxidizer will |Any amount. |1 pound (liquid or |0.25 pounds (liquid |0.25 pounds |NO ⃞ |NO ⃞ |

| |Def: An oxidizer that can |enhance the burning rate and | |solid) |or solid) |(liquid or solid)|YES ⃞ |YES ⃞ |

| |undergo an explosive reaction|cause spontaneous ignition of | | | | | | |

| |due to contamination or |combustibles. | | | | | | |

| |exposure to thermal or | | | | | | | |

| |physical shock. | | | | | | | |

|OXIDIZER |3 |contact or that will undergo |> 1 gallon liquid or 10 |10 pounds (liquid or|2 pounds (liquid or |2 pounds (liquid |NO ⃞ |NO ⃞ |

| |Def: An oxidizer that will |vigorous self-sustained |pounds solid |solid) |solid) |or solid) |YES ⃞ |YES ⃞ |

| |cause a severe increase in |decomposition due to | | | | | | |

| |the burning rate of |contamination or exposure to | | | | | | |

| |combustible materials with |heat. | | | | | | |

| |which it comes in | | | | | | | |

|OXIDIZER |2 |rate or that causes spontaneous|> 10 gallons liquid or 100 |250 pounds (liquid |250 pounds (liquid |50 pounds (liquid|NO ⃞ |NO ⃞ |

| |Def: An oxidizer that will |ignition of combustible |pounds solid |or solid) |or solid) |or solid) |YES ⃞ |YES ⃞ |

| |cause a moderate increase in |materials with which it comes | | | | | | |

| |the burning |in contact. | | | | | | |

|OXIDIZER |1 |does not cause spontaneous |> 55 gallons liquid or 500 |4,000 pounds (liquid|4,000 pounds (liquid|1,000 pounds |NO ⃞ |NO ⃞ |

| |Def: An oxidizer whose |ignition when it comes in |pounds of solid |or solid) |or solid) |(liquid or solid)|YES ⃞ |YES ⃞ |

| |primary hazard is that it |contact with combustible | | | | | | |

| |slightly increases the |material. | | | | | | |

| |burning rate but which | | | | | | | |

|OXIDIZING GAS |GASEOUS |Def: A gas that can support and|> 504 cubic feet at NTP |15 gallons liquid or |15 gallons liquid or|N/A |NO ⃞ |NO ⃞ |

| |LIQUIFIED |accelerate combustion of other | |1,500 cubic feet gas |1,500 cubic feet gas| |YES ⃞ |YES ⃞ |

| | |materials. | | | | | | |

|PYROPHORIC |N/A |Def: A chemical with an |Any amount. |4 pounds (liquid or |1 pound (liquid or |0 |NO ⃞ |NO ⃞ |

| | |autoignition temperature in | |solid) and 50 cubic |solid) and 10 cubic | |YES ⃞ |YES ⃞ |

| | |air, at or below a temperature | |feet gas |feet gas | | | |

| | |of 130℉. | | | | | | |

PHYSICAL HAZARDS

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |EXEMPT AMOUNTS |EXEMPT |EXEMPT |HAVE AMOUNTS THAT |HAVE ABOVE EXEMPT |

| | | | |STORAGE |AMOUNTS |AMOUNTS USE OPEN –|REQUIRE A PERMIT? |AMOUNTS? |

| | | | | |USE CLOSED – vapors |vapors are | | |

| | | | | |are not liberated |liberated | | |

|UNSTABLE (REACTIVE) |4 – This class includes |Def: A material, other than an |Any amount. |1 pound (liquid or |0.25 pounds (liquid |0.25 pounds |NO ⃞ |NO ⃞ |

| |materials that are sensitive |explosive, which in the pure | |solid) and 10 cubic |or solid) and 2 |(liquid or solid) |YES ⃞ |YES ⃞ |

| |to mechanical or localized |state or as commercially | |feet gas |cubic feet gas | | | |

| |thermal shock at normal |produced, will vigorously | | | | | | |

| |temperature and pressures. |polymerize, decompose, condense| | | | | | |

| | |or become self-reactive and | | | | | | |

| | |undergo other violent chemical | | | | | | |

| | |changes, including explosion, | | | | | | |

| | |when | | | | | | |

|UNSTABLE (REACTIVE) |3 – This class includes |Exposed to heat, friction or |Any amount. |5 pounds (liquid or |1 pound (liquid or |1 pound (liquid or|NO ⃞ |NO ⃞ |

| |materials that are sensitive |shock, or in the absence of an | |solid) and 50 cubic |solid) and 10 cubic |solid) |YES ⃞ |YES ⃞ |

| |to thermal or mechanical |inhibitor, or in the presence | |feet gas |feet gas | | | |

| |shock at elevated |of contaminants, or in contact | | | | | | |

| |temperatures and pressures. |with incompatible materials. | | | | | | |

|UNSTABLE (REACTIVE) |2- This class includes | |> 5 gallons liquid or 50 |50 pounds (liquid or|5o pounds (liquid or|10 pounds (liquid |NO ⃞ |NO ⃞ |

| |materials that can undergo | |pounds solid and |solid) and 250 cubic|solid) and 250 cubic|or solid) |YES ⃞ |YES ⃞ |

| |chemical change with rapid | |Any amount gas |feet gas |feet gas | | | |

| |release of energy at normal | | | | | | | |

| |temperatures and pressures, | | | | | | | |

| |and that can undergo violent | | | | | | | |

| |chemical change at elevated | | | | | | | |

| |temperatures and pressures. | | | | | | | |

|UNSTABLE (REACTIVE) |1 – Materials that in | |> 10 gallons liquid or 100|Not Limited |Not Limited |Not Limited |NO ⃞ |Not Limited |

| |themselves are normally | |pounds solid | | | |YES ⃞ | |

| |stable but which become | | | | | | | |

| |unstable at elevated | | | | | | | |

| |temperatures and pressure. | | | | | | | |

|WATER REACTIVE |3 – Materials that react |Def: A material that explodes; |Any amount. |5 pounds (liquid or |5 pounds (liquid or |1 pound (liquid or|NO ⃞ |NO ⃞ |

| |explosively with water |violently reacts; produces | |solid) |solid) |solid) |YES ⃞ |YES ⃞ |

| |without requiring heat or |flammable, toxic or other | | | | | | |

| |confinement. |hazardous gases; or evolves | | | | | | |

| | |enough heat | | | | | | |

|WATER REACTIVE |2 – Materials that may form |to cause self-ignition or |> 5 gallons liquid or 50 |50 pounds (liquid or|50 pounds (liquid or|10 pounds (liquid |NO ⃞ |NO ⃞ |

| |potentially explosive |ignition of nearby combustibles|pounds solid |solid) |solid) |or solid) |YES ⃞ |YES ⃞ |

| |mixtures with water. |upon exposure to water or | | | | | | |

| | |moisture. | | | | | | |

|WATER REACTIVE |1 – Materials that may react | |> 55 gallons liquid or 500|Not Limited |Not Limited |Not Limited |NO ⃞ |Not Limited |

| |with water with some release | |pounds solid | | | |YES ⃞ | |

| |of energy, but not violently.| | | | | | | |

HEALTH HAZARDS

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |EXEMPT AMOUNTS |EXEMPT |EXEMPT |HAVE AMOUNTS THAT |HAVE ABOVE EXEMPT |

| | | | |STORAGE |AMOUNTS |AMOUNTS USE OPEN – |REQUIRE A PERMIT? |AMOUNTS? |

| | | | | |USE CLOSED – vapors |vapors are liberated| | |

| | | | | |are not liberated | | | |

|CORROSIVE |N/A |Def: A chemical that causes |> 55 gallons liquid or |5,000 pounds solid, |5,000 pounds solid, |1,000 pounds solid |NO ⃞ |NO ⃞ |

| | |visible destruction of, or |1000 pounds solid |500 gallons liquid, |500 gallons liquid, |or 100 gallons |YES ⃞ |YES ⃞ |

| | |irreversible alterations in, |200 cubic feet gas at NTP |and 810 cubic feet |and 810 cubic feet |liquid | | |

| | |living tissue by chemical action| |gas |gas | | | |

| | |at the point of contact. | | | | | | |

|HIGHLY TOXIC |N/A |Def: A material which produces a|Any amount. |10 pounds (liquid or|10 pounds (liquid or|3 pounds (liquid or |NO ⃞ |NO ⃞ |

| | |lethal dose or lethal | |solid) or 20 cubic |solid) 20 cubic feet|solid) |YES ⃞ |YES ⃞ |

| | |concentration. | |feet gas |gas | | | |

| | |Lethal dose or concentrations | | | | | | |

| | |established in accordance with | | | | | | |

| | |CFR 29. | | | | | | |

|TOXIC |N/A |Def: A material which produces |> 10 gallons liquid or 100|500 pounds (liquid |500 pounds (liquid |125 pounds (liquid |NO ⃞ |NO ⃞ |

| | |lethal dose or a lethal |pounds solid and any |or solid) or 810 |or solid) or 810 |or solid) |YES ⃞ |YES ⃞ |

| | |concentration. |amount gas |cubic feet gas |cubic feet gas | | | |

| | |Lethal dose or concentrations | | | | | | |

| | |established in accordance with | | | | | | |

| | |CFR 29. | | | | | | |

MATERIALS OR OPERATIONS REQUIRING SPECIAL HANDLING

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |REQUIRES SPECIALTY INSPECTION |HAVE AMOUNTS THAT REQUIRE A |HAVE AMOUNTS THAT REQUIRE |

| | | | | |PERMIT? |SPECIALTY INSPECTION? |

|AEROSOL PRODUCTS |LEVEL 2 OR LEVEL 3 |than or equal to 13,000 Btu/lb.|> 500 lbs. Net Weight |Amounts exceeding: |NO ⃞ |NO ⃞ |

| |Def: Level 2 - aerosol |Level 3 - those with a total | |2,500 lbs. – Level 2 |YES ⃞ |YES ⃞ |

| |products are those with a |chemical heat of combustion | |1,000 lbs. – Level 3 | | |

| |total chemical heat of |that is greater than 13,000 | |2,500 lbs. Of Level 2 and 3 | | |

| |combustion that is greater|Btu/lb. | | | | |

| |than 8,600 Btu/lb., but | | | | | |

| |less | | | | | |

|COMBUSTIBLE FIBERS |LOOSE |excelsior, hat, hemp, henequen,|> than 100 cubic feet |> 100 cubic feet loose and |NO ⃞ |NO ⃞ |

| |BALED |istle, jute, kapok Oakum, rags,| |> than 1,000 cubic feet baled |YES ⃞ |YES ⃞ |

| |Def: Combustible fibers |sisal, Spanish moss, straw, | | | | |

| |include readily ignitable |tow, wastepaper or other like | | | | |

| |and free burning fibers |materials. | | | | |

| |such as cocoa fiber, | | | | | |

| |cloth, cotton, | | | | | |

|MAGNESIUM |OPERATION |Def: The pure metal and alloys,|Operation with > 10 pounds|> 125 pounds storage |NO ⃞ |NO ⃞ |

| |To melt, cast, heat-treat |of which the major part is | |> 25 pounds in open use |YES ⃞ |YES ⃞ |

| |or grind more than 10 |magnesium. | |(dust or powder produced) | | |

| |pounds. | | | | | |

MATERIALS OR OPERATIONS REQUIRING SPECIAL HANDLING

|MATERIAL |CLASS |DESCRIPTION |PERMIT AMOUNTS |REQUIRES SPECIALTY INSPECTION |HAVE AMOUNTS THAT REQUIRE A |HAVE AMOUNTS THAT REQUIRE |

| | | | | |PERMIT? |SPECIALTY INSPECTION? |

|ORGANIC COATINGS |PRODUCTION |Def: A liquid mixture of |Production > 1 gallon in a|All Organic Coating Manufacture |NO ⃞ |NO ⃞ |

| |More than one gallon of an |binders such as alkyd, |day | |YES ⃞ |YES ⃞ |

| |organic coating in one day. |nitrocellulose, acrylic or oil,| | | | |

| | |and flammable and combustible | | | | |

| | |solvents such as hydrocarbon, | | | | |

| | |ester, ketone or alcohol, | | | | |

| | |which, when spread in a thin | | | | |

| | |film, convert to a durable | | | | |

| | |protective and decorative | | | | |

| | |finish. | | | | |

|PYROXYLIN PLASTICS |OPERATION |Def: Plastic substances, |Storage or handling > 25 |> 125 pounds storage or > 25 pounds with|NO ⃞ |NO ⃞ |

| |Storage or handling of more |materials or compounds with |pounds and any assembly or|operations that produce dusts, powders, |YES ⃞ |YES ⃞ |

| |than 25 pounds of cellulose |cellulose nitrate as a base, by|manufacture. |shavings, chips, turnings, etc. | | |

| |nitrate (pyroxylin) plastics |whatever name known, in the | | | | |

| |and any assembly or |form of blocks, sheets, tubes | | | | |

| |manufacture of articles |or fabricated shapes. | | | | |

| |involving pyroxylin plastics.| | | | | |

I have filled out the information on this form to the best of my knowledge for the referenced location in accordance with how I intend to occupy the same.

Address ____________________________________________

Responsible Party _________________________________________ Title or Affiliation _________________________________________

(Print name legibly) (Please print legibly)

Responsible Party Signature_______________________________________________ Date _____________________

-----------------------

DEPARTMENTAL USE ONLY

PROJECT NUMBER ____________________________

ROUTING INFORMATION: HAZMAT INSPECTIONS YES [pic] NO [pic]

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download