(4) A covered employer, owner, or operator
required to report under these rules must provide the following information:
(a) The facility's reporting status,
including:
(A) Whether hazardous substances
were present at the site in reportable quantities;
(B) Whether Extremely Hazardous Substances
were present that met or exceeded the threshold planning quantity of 40 CFR
355, Appendix A and B. If the facility has Extremely Hazardous Substances
present that exceed the threshold planning quantity, provide the name, email
address, phone number, and 24-hour phone number of the facility emergency
coordinator as required under EPCRA section 303(d)(1);
(C) Whether the facility is subject to the
reporting requirements of Section 112(r) of the Clean Air Act. If the facility
is subject to the chemical accident prevention provisions codified in 40 CFR
part 68, also known as the Risk Management Program (RMP), provide the RMP
facility identification number assigned by EPA;
(D) If your facility is subject to the Toxic
Release Inventory (TRI) program under section 313 of EPCRA, provide the
identification number assigned by EPA;
(E) Whether the facility is subject to the
Process Safety Management (PSM) requirements of the Occupational Safety and
Health Administration (OSHA);
(b) Demographic information including:
(A) All applicable North American Industry
Classification System codes for the facility;
(B) A description of the type of business
conducted at the site;
(C) The Dun
and Bradstreet Number, if applicable;
(D) The owner's or operator's full name and
email address;
(E) The business
name which the entity operates under;
(F) The department or division, if
applicable;
(G) The physical site
address including the street, city, county, and zip code; or a grid location
acceptable to the responding fire department if no address exists;
(H) The latitude and longitude of the
facility;
(I) The facility phone
number for the site;
(J) The email
address of the business or contact person, if available;
(K) The mailing address, if different from
the site address;
(L) The potential
maximum number of occupants including visitors at the site;
(M) The name, day and night phone number and
email address of the person that can act as a referral if emergency responders
need assistance in responding to a chemical accident at the facility;
(N) The name of the responding fire
department by local jurisdiction;
(O) A brief summary of any procedures
established by the covered employer, owner or operator for the control of
hazardous substances in the event of an emergency;
(P) Whether the hazardous substance storage
location for each reportable hazardous substance is placarded according to
National Fire Protection Association (NFPA) Standard 704;
(Q) Whether the facility is occupied or
unoccupied; and
(R) The Federal
Employer Identification Number (FEIN), or for sole proprietors their Social
Security number.
(c) The
name and signature of the person completing the Hazardous Substance Report and
the date it was completed.
(d)
Information about each reportable hazardous substance meeting the reportable
quantity thresholds including, but not limited to:
(A) The chemical, mixture, or product
name;
(B) The chemical name of the
hazardous ingredient present in the highest concentration;
(C) Whether the substance reported contains
an extremely hazardous substance as listed in 40 CFR 355 ;
(D) Whether the substance meets the threshold
planning quantity as defined by 40 CFR 355 ;
(E) If the chemical contains an Extremely
Hazardous Substances, enter the name and CAS number of the Extremely Hazardous
Substances in the mixture;
(F)
Whether the substance reported contains a Clean Air Act, Section 112(r) listed
chemical;
(G) Whether the substance
reported contains a Process Safety Management listed chemical;
(H) Information regarding whether the
substance is pure or a mixture;
(I)
The physical state of the hazardous substance as it is released into the
environment at Standard Temperature and Pressure (STP) relating whether it is a
solid, liquid or a gas;
(J) The
unit of measure used to report the quantity range of the hazardous substance,
relating whether it is reported in pounds, gallons, cubic feet or
millicuries;
(M) The maximum amount of
each reported hazardous substance for each location reported;
(N) The total amount transported to the
facility;
(O) The total amount
transported from the facility;
(P)
The total estimated number of days the hazardous substance was
on-site;
(Q) The type of container
the substance is stored in;
(R) The
pressure and temperature at which the substance is stored;
(S) All applicable hazard classifications for
each reportable hazardous substance;
(T) The Chemical Abstract Service (CAS)
number, if known;
(U) The
four-digit United Nations (UN) or North American (NA) number, if
known;
(V) The EPA Pesticide
Registration number if applicable; and
(W) The storage location.
(e) Upon request of the State Fire
Marshal, a covered employer, owner, or operator must provide Safety Data Sheets
(SDS);
(f) Other information that
may be requested by the State Fire Marshal in order to meet the intent of The
Community Right-to-Know and Protection Act.