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2. Hazardous Material Review Form
4. Facility Information
6. Name of Facility
7. Facility Contact Person
9. Street Address
11. Phone Number
12. 24 Hour Phone Number
14. Contractor Information
16. Installing Contractor
17. Contact Person
19. Contractor Phone Number
20. 24 Hour Phone Number
22. Is facility equipped throughout with approved automatic extinguishing system?
    -- Select One --YesNo
24. Material
25. CAS Number(s) or Hazardous Ingredient
27. Hazardous Class: Flammable, Combustible, Corrosive, Explosive, Oxidizer, etc.
29. Storage: Gas - cu ft, Liquid - gal, Solid - lbs
30. Quantity Stored
31. Quantity In-Process
33. Total Quantity
35. Material
36. CAS Number(s) or Hazardous Ingredient
38. Hazardous Class: Flammable, Combustible, Corrosive, Explosive, Oxidizer, etc.
40. Storage: Gas - cu ft, Liquid - gal, Solid - lbs
41. Quantity Stored
42. Quantity In-Process
44. Total Quantity
46. Material
47. CAS Number(s) or Hazardous Ingredient
49. Hazardous Class: Flammable, Combustible, Corrosive, Explosive, Oxidizer, etc.
51. Storage: Gas - cu ft, Liquid - gal, Solid - lbs
52. Quantity Stored
53. Quantity In-Process
55. Total Quantity
57. Material
58. CAS Number(s) or Hazardous Ingredient
60. Hazardous Class: Flammable, Combustible, Corrosive, Explosive, Oxidizer, etc.
62. Storage: Gas - cu ft, Liquid - gal, Solid - lbs
63. Quantity Stored
64. Quantity In-Process
66. Total Quantity
68. Material
69. CAS Number(s) or Hazardous Ingredient
71. Hazardous Class: Flammable, Combustible, Corrosive, Explosive, Oxidizer, etc.
73. Storage: Gas - cu ft, Liquid - gal, Solid - lbs
74. Quantity Stored
75. Quantity In-Process
77. Total Quantity
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80. Email address

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