106 KAR 1:081. Kentucky Emergency Response Commission fee system requirements.

 

      RELATES TO: KRS 39.800-39.990, 42 U.S.C. 11001-11050

      STATUTORY AUTHORITY: KRS 39.817, 39.845, 39.850, 39.890, 42 U.S.C. 11002(c), 11003(c), (d)

      NECESSITY, FUNCTION, AND CONFORMITY: This administrative regulation sets forth the requirements to be followed by facilities subject to paying a fee.

 

      Section 1. Definitions. (1) "Category One Facility" means any facility owned or operated by local, state or federal government which is exempted from paying any fee in accordance with KRS 39.817. This exemption applies solely to fees and does not exempt any Category One Facility from reporting requirements pursuant to KRS 39.800 to 39.905.

      (2) "Category Two Facility" means any facility that has not less than 10,000 pounds and not more than 499,999 pounds of each of ten (10) or fewer hazardous substances. The combined total of all hazardous substances shall not exceed 499,999 pounds.

      (3) "Category Three Facility" means any facility that has 10,000 pounds or more of each of eleven (11) or more hazardous substances. The combined total of all hazardous substances shall not exceed 499,999 pounds.

      (4) "Category Four Facility" means any facility that has a total inventory of over 499,999 pounds of hazardous substances.

      (5) "Category Five Facility" means any facility that has an extremely hazardous substance as set out in Section 6 of this administrative regulation in excess of the threshold planning quantity.

      (6) "DES/SARA-312" means the state annual chemical inventory reporting form due March 1 each year, covering the preceding calendar year.

      (7) "DES/SARA-312-C" means the confidential state annual chemical inventory reporting form due March 1 each year, covering the preceding calendar year which may be used if a facility elects to withhold location information on a specific chemical from disclosure to the public pursuant to 42 USC 11044(a).

      (8) "Hazardous chemical" means any substance for which a facility is required to prepare or have available a material safety data sheet under the Occupational Safety and Health Act

of 1970 and federal regulations promulgated under that Act.

      (9) "Hazardous substance" means any substance defined in KRS 39.805(5) and for annual inventory reporting purposes shall include hazardous chemicals.

      (10) "KyERC" means the Kentucky Emergency Response Commission.

 

      Section 2. Facility Requirements. (1) In accordance with the planning requirements of KRS 39.845 and 39.850, 42 USC 11002(c) and 11003(c)(d), no later than sixty (60) days after a facility notifies the Kentucky Emergency Response Commission that it is subject to the requirements of this section, the facility shall provide emergency response planning information to the local emergency planning committee and shall assist the local emergency planning committee develop a Tab Q-7 or commission-approved equivalent as set out in Section 6 of this administrative regulation for all extremely hazardous substances set out in Section 6 of this administrative regulation in excess of the threshold planning quantity for submission in accordance with the requirements of 106 KAR 1:091.

      (2) After initial submission and approval of the Tab Q-7 or commission-approved equivalent in accordance with subsection (1) of this section, each March 1 any facility that has an extremely hazardous substance as set out in Section 6 of this administrative regulation in excess of the threshold planning quantity shall review the Tab Q-7 or commission-approved equivalent and send certification to the local emergency planning committee stating that there were no changes and therefore the plan is correct as is; or the plan has been revised and the revisions are included with the certification.

      (3) A Category Five Facility which is not subject to the annual chemical inventory reporting requirement due on DES/SARA-312 and, if applicable DES/SARA-312-C shall comply with Section 2(1) and (2) of this administrative regulation and shall file the fee in accordance with Section 4 of this administrative regulation.

      (4) Any facility subject to the annual chemical inventory reporting requirements contained in KRS Chapter 39.890, and 42 USC 11022 shall submit Form DES/SARA-312 and, if applicable DES/SARA-312-C as set out in Section 6 of this administrative regulation no later than March 1 each year in accordance with the filing instructions in Section 4 of this administrative regulation.

 

      Section 3. Fees shall be payable in accordance with the schedule listed below except the same owner or owners of two (2) or more facilities in a single county subject to paying a fee shall pay a fee not to exceed a total of $250 for all those facilities in that county.

      (1) Category One Facility fee is $0.

      (2) Category Two Facility fee is $40.

      (3) Category Three Facility fee is $250.

      (4) Category Four Facility fee is $250.

      (5) Category Five Facility fee is $250.

 

      Section 4. Filing Requirements for Fees and Forms DES/SARA-312 and DES/SARA-312-C. A computer-generated form containing all the information in DES/SARA-312 and DES/SARA-312-C may be accepted. All fees and forms DES/SARA-312 and, if applicable DES/SARA-312-C, shall be filed simultaneously, no later than March 1 each year. Checks shall be made payable to "Kentucky State Treasurer" and shall be marked "For KyERC Fee Account". Fees and forms shall be mailed to: Chairman, Kentucky Emergency Response Commission, EOC Building-Boone National Guard Center, Frankfort, Kentucky 40601-6168.

 

      Section 5. Penalties. Failure to comply with provisions of this administrative regulation shall result in penalties as provided in KRS 39.990(3).

 

      Section 6. The forms referred to in Sections 1(6), (7), 2(1), (2), (3), (4) and 4 of this administrative regulation is are set out in this section. The list of extremely hazardous substances referred to in Section 2(1), (2) of this administrative regulation are set out in this section.

 


 

The List of Extremely Hazardous Substances and their Threshold Planning Quantities (Alphabetical Order)

CAS No.

Chemical Name

Threshold

Notes

Planning

quantity

(pounds)

75865

ACETONE CYANOHYDRIN

1000

 

1752303

ACETONE THIOSEMICARBAZIDE

1000/10000

e

107028

ACROLEIN

500

 

79061

ACRYLAMIDE

1000/10000

d,l

107131

ACRYLONITRILE

10000

d,l

814686

ACRYLYL CHLORIDE

100

e,h

111693

ADIPONITRILE

1000

e,l

116063

ALDICARB

100/10000

c

309002

ALDRIN

500/10000

d

107186

ALLYL ALCOHOL

1000

 

107119

ALLYLAMINE

500

e

20859738

ALUMINUM PHOSPHIDE

500

b

54626

AMINOPTERIN

500/10000

e

78535

AMITON

500

e

3734972

AMITON OXALATE

100/1000

e

7664417

AMMONIA

500

1

300629

AMPHETAMINE

1000

e

62533

ANILINE

1000

d,1

88051

ANILINE,2,4,6-TRIMETHYL-

500

e

7783702

ANTIMONY PENTAFLUORIDE

500

e

1397940

ANTIMYCINA

1000/10000

c,e

86884

ANTU

500/10000

 

1303282

ARSENIC PENTOXIDE

100/10000

d

1327533

ARSENOUS OXIDE

100/10000

d,h

7784341

ARSENOUS TRICHLORIDE

500

d

7784421

ARSINE

100

e

2642719

AZINPHOS-ETHYL

100/10000

e

86500

AZINPHOSMETHYL

10/10000

 

98873

BENZAL CHLORIDE

500

d

98168

BENZENAMINE,3(TRIFLUOROMETHYL)-

500

e

100141

BENZENE,I(CHLOROMETHYL)-4-NITRO-

500/10000

e

98055

BENZENEARSONIC ACID

10/10000

e

3615212

BENZIMIDAZOLE,4,5-DICHOLORO-2- (TRIFLUOROMETHYL)-

500/10000

e,g

98077

BENZOTRICHLORIDE

100

d

100447

BENZYL CHLORIDE

500

d

140294

BENZYL CYANIDE

500

e,h

15271417

BICYCLO(2.2.1)HEPTANE-2-CARBONITRILE,5- CHOLORO-6((((METHYLAMINO)CARBONYL)

OXY)IMMINO-,(l S-(2-ALPHA,2-BETA,4-ALPHA, 5-ALPHA,6E))-

500/10000

e

534076

BIS(CHLOROMETHYL)KETONE

10/10000

e

4044659

BITOSCANATE

500/10000

e

10294345

BORON TRICHLORIDE

500

e

7637072

BORON TRIFLUORIDE

500

e

353424

BORON TRIFLUORIDE COMPOUND WITH METHYL ETHER(1:1)

1000

e

28772567

BROMADIOLONE

100/10000

e

7726956

BROMINE

500

e,l

1306190

CADMIUM OXIDE

100/10000

e

2223930

CADMIUM STEARATE

1000/10000

c,e

7778441

CALCIUM ARSENATE

500/10000

d

8001352

CAMPHECHLOR

500/10000

d

56257

CANTHARIDIN

100/10000

e

51832

CARBACHOL CHLORIDE

500/10000

e

26419738

CARBAMIC ACID, METHYL-,O-(((2,4-DIMETHYL-1, 3-DITHIOLAN-2-yl)METHYLENE)AMINO)-

100/10000

e

1563662

CARBOFURAN

10/10000

 

75150

CARBON DISULFIDE

10000

 

786196

CARBOPHENOTHION

500

e

57749

CHLORDANE

1000

d

470906

CHLORFENVINFOS

500

e

7782505

CHLORINE

100

 

24934916

CHLORMEPHOS

500

e

999815

CHLORMEQUAT CHLORIDE

100/10000

e,h

79118

CHLOROACETICACID

100/10000

e

107073

CHLOROETHANOL

500

e

627112

CHLOROETHYLCHLOROFORMATE

1000

e

67663

CHLORFORM

10000

d,l

542881

CHLOROMETHYL ETHER

100

d,h

107302

CHLOROMETHYL METHYL ETHER

100

c,d

3691358

CHLOROPHACINONE

100/10000

e

1982474

CHLOROXURON

500/10000

e

21923239

CHLORTHIOPHOS

500

e,h

10025737

CHROMIC CHLORIDE

1/10000

e

10210681

COBALT CARBONYL

10/10000

e,h

62207765

COBALT,((2,2'-(1,2-ETHANEDIYL-BIS(NITRILOMETHYLIDYNE))

EiIS(6-FLUOROPHENOLATO)) (2-)N,NI,O,Ol

100/10000

e

64868

COLCHICINE

10/10000

e,h

56724

COUMAPHOS

100/10000

 

5836293

COUMATETRALYL

500/10000

e

95487

CRESOL,O

1000/10000

d

535897

CRIMIDINE

100/10000

e

4170303

CROTONALDEHYDE

1000

 

123739

CROTONALDEHYDE(E)-

1000

 

506683

CYANOGEN BROMIDE

500/10000

 

506785

CYANOGEN IODIDE

1000/10000

e

2636262

CYANOPHOS

1000

e

675149

CYANURIC FLUORIDE

100

e

66819

CYCLOHEXIMIDE

100/10000

e

108918

CYCLOHEXYLAMINE

10000

e,l

17702419

DECABORANE(14)

500/10000

e

8065483

DEMETON

500

e

919868

DEMETON-S-METHYL

500

e

10311849

DIALIFOR

100/10000

e

19287457

DIBORANE

100

e

111444

DICHLOROETHYL ETHER

10000

d

149746

DICHLOROMETHYLPHENYLSILANE

1000

e

62737

DICHLORVOS

1000

 

141662

DICROTOPHOS

100

e

1464535

DIEPOXYBUTANE

500

d

814493

DIETHYL CHLOROPHOSPHATE

500

e,h

164254

DIETHYLCARBAMAZINE CITRATE

100/10000

e

71636

DIGITOXIN

100/10000

c,e

2238075

DIGLYCIDYL ETHER

1000

e

20830775

DIGOXIN

10/10000

e,h

115264

DIMEFOX

500

e

60515

DIMETHOATE

500/10000

 

2524030

DIMETHYL PHOSPHOROCHLORIDOTHIOATE

500

e

77781

DIMETHYL SULFATE

500

d

75785

DIMETHYLDICHLOROSILANE

500

e,h

57147

DIMETHYLHYDRAZINE

1000

d

99989

DIMETHYL-P-PHENYLEDIAMINE

10/10000

e

644644

DIMETILAN

500/10000

e

534521

DINITROCRESOL

10/10000

 

88857

DINOSEB

100/10000

 

1420071

DINOTERB

500/10000

e

78342

DIOXATHION

500

e

82666

DIPHACINONE

10/10000

e

152169

DIPHOSPHORAMIDE, OCTAMETHYL-

100

 

298044

DISULFOTON

500

 

514738

DITHIAZANINE IODIDE

500/10000

e

541537

DITHIOBIURET

100/10000

 

316427

EMETINE, DIHYDROCHLORIDE

1/10000

e,h

115297

ENDOSULFAN

10/10000

 

2778043

ENDOTHION

500/10000

e

72208

ENDRIN

500/10000

 

106898

EPICHLOROHYDRIN

1000

d,l

2104645

EPN

100/10000

e

50146

ERGOCALCIFEROL

1000/10000

c,e

379793

ERGOTAMINE TARTRATE

500/10000

e

1622328

ETHANESULFONYL CHLORIDE,2-CHLORO-

500

e

10140871

ETHANOL,1,2-DICHLORO-,ACETATE

1000

e

563122

ETHION

1000

 

13194484

ETHOPROPHOS

1000

e

538078

ETHYLBIS(2-CHLOROETHYL)AMINE

500

e,h

371620

ETHYLENE FLUOROHYDRIN

10

c,e,h

75218

ETHYLENE OXIDE

1000

d,l

107153

ETHYLENEDIAMINE

10000

 

151564

ETHYLENEIMINE

500

d

542905

ETHYLTHIOCYANATE

10000

e

22224926

FENAMIPHOS

10/10000

e

122145

FENITROTHION

500

e

115902

FENSULFOTHION

500

e,h

4301502

FLUENETIL

100/10000

e

7782414

FLUORINE

500

k

640197

FLUOROACETAMIDE

100/10000

i

144490

FLUOROACETIC ACID

10/10000

e

359068

FLUOROACETYL CHLORIDE

10

c,e

51218

FLOUROURACIL

500/10000

e

944229

FONOFOS

500

e

50000

FORMALDEHYDE

500

d,l

107164

FORMALDEHYDE CYANOHYDRIN

1000

e,h

23422539

FORMETANATE HYDROCHLORIDE

500/10000

e,h

2540821

FORMOTHION

100

e

17702577

FORMPARANATE

100/10000

e

21548323

FOSTHIETAN

500

e

3878191

FUBERIDAZOLE

100/10000

e

110009

FURAN

500

 

13450903

GALLIUM TRICHLORIDE

500/10000

e

77474

HEXACHLOROCYCLOPENTADIENE

100

d,h

4835114

HEXAMETHYLENEDIAMINE,NIN-DIBUTYL-

500

e

302012

HYDRAZINE

1000

d

74908

HYDROCYANIC ACID

100

 

7647010

HYDROGEN CHLORIDE (GAS ONLY)

500

e,l

7664393

HYDROGEN FLUORIDE

100

 

7722841

HYDROGEN PEROXIDE (CONC. GREATER THAN 52%)

 

 

7783075

HYDROGEN SELENIDE

10

e

7783064

HYDROGEN SULFIDE

500

 

123319

HYDROQUINONE

500/10000

 

13463406

IRON,PENTACARBONYL-

100

e

297789

ISOBENZAN

100/10000

e

78820

ISOBUTYRONITRILE

10000

e,h

102363

ISOCYANIC ACID,3,4-DICHLOROPHENYL ESTER

500/10000

e

465736

ISODRIN

100/10000

 

55914

ISOFLUORPHATE

100

c

4098719

ISOPHORONE DIISOCYANATE

100

b,e

108236

ISOPROPYL CHLOROFORMATE

1000

e

119380

ISOPROPYLMETHYLPYRAZOLYL DIMETHYL-CARBAMATE

500

e

78977

LACTONITRILE

1000

e

21609905

LEPTOPHOS

500/10000

e

541253

LEWISITE

10

c,e,h

58899

LINDANE

1000/10000

d

7580678

LITHIUM HYDRIDE

100

b,e

109773

MALONONITRILE

500/10000

 

12108133

MANGANESE, TRICARBONYL METHYLCYCLO-PENTADIENYL

100

e

51752

MECHLORETHAMINE

10

c,e

950107

MEPHOSFOLAN

500

e

1600277

MERCURIC ACETATE

500/10000

e

7487947

MERCURIC CHLORIDE

500/10000

e

21908532

MERCURIC OXIDE

500/10000

e

10476956

METHACROLEIN DIACERATE

1000

e

760930

METHACRYLIC ANHYDRIDE

500

e

126987

METHACRYLONITRILE

500

h

920467

METHACRYLOYL CHLORIDE

100

e

30674807

METHACRYLOYLOXYETHYLISOCYANATE

100

e,h

10265926

METHAMIDOPHOS

100/10000

e

558258

METHANESULFONYL FLUORIDE

1000

e

950370

METHIDATHION

500/10000

e

2032657

METHIOCARB

500/10000

 

16752775

METHOMYL

500/10000

h

151382

METHOXYETHYLMERCURIC ACETATE

500/10000

e

80637

METHYL 2-CHLOROACRYLATE

500

e

74839

METHYL BROMIDE

1000

1

79221

METHYL CHLOROFORMATE

500

d,h

60344

METHYL HYDRAZINE

500

 

624839

METHYL ISOCYANATE

500

f

556616

METHYL ISOTHIOCYANATE

500

b,e

74931

METHYL MERCAPTAN

500

 

3735237

METHYL PHENKAPTON

500

e

676971

METHYL PHOSPHONIC DICHLORIDE

100

b,e

556649

METHYL THIOCYANATE

10000

e

78944

METHYL VINYL KETON

10

e

502396

METHYLMERCURIC DICYANAMIDE

500/10000

e

75796

METHYLTRICHLOROSILANE

500

e,h

1129415

METOLCARB

100/10000

e

7786347

MEVINPHOS

500

 

315184

MEXACARBATE

500/10000

 

50077

MITOMYCIN C

500/10000

d

69232224

MONOCROTOPHOS

10/10000

e

2763964

MUSCIMOL

500/10000

a,h

505602

MUSTARD GAS

500

e,h

13463393

NICKEL CARBONYL

1

d

54115

NICOTINE

100

c

65305

NICOTINE SULFATE

100/10000

e

7697372

NITRIC ACID

1000

 

10102439

NITRIC OXIDE

100

c

98953

NITROBENZENE

1000

 

1122607

NITROCYCLOHEXANE

500

e

10102440

NITROGEN DIOXIDE

100

 

62759

NITROSDIMETHYLAMINE

1000

d,h

991424

NORBORMIDE

100/10000

e

PMN82147

ORGANORHODIUM COMPLEX (PMN-82-147)

10/10000

e

630604

OUABAIN

100/10000

c,e

23135220

OXAMYL

100/10000

e

78717

OXETANE, 3,3-BIS(CHLOROMETHYL)

500

e

2497976

OXYDISULFOTON

500

e,h

10028156

OZONE

100

e

1910425

PARAQUAT

10/10000

e

2074502

PARAQUAT METHOSULFATE

10/10000

e

56382

PARATHION

100

c,d

298000

PARATHION-METHYL

100/10000

c

12002038

PARIS GREEN

500/10000

d

19624227

PENTABORANE

500

e

2570265

PENTADECYLAMINE

100/10000

e

79210

PERACETIC ACID

500

e

594423

PERCHLOROMETHYLMERCAPTAN

500

 

108952

PHENOL

500/10000

 

4418660

PHENOL 2,2'-THIOBIS(4-CHLORO-6-METHYL-

100/10000

e

64006

PHENOL,3-(I-METHYLETHYL)-,METHYLCARBAMATE

500/10000

e

58366

PHENOXARSINE, 10,101-OXIDI

500/10000

e

696286

PHENYL DICHLOROARAINE

500

d,h

59881

PHENYLHYDRAZINE HYDROCHLORIDE

1000/10000

e

62384

PHENYLMERCURY ACETATE

500/10000

 

2097190

PHENYLSILATRANE

100/10000

e,h

103855

PHENYLTHIOUREA

100/10000

 

298022

PHORATE

10

 

4104147

PHOSACETIM

100/10000

e

947024

PHOSFOLAN

100/10000

e

75445

PHOSGENE

10

1

732116

PHOSMET

10/10000

e

13171216

PHOSPHAMIDON

100

e

7803512

PHOSPHINE

500

 

2703131

PHOSPHONOTHIOIC ACID, METHYL-,O-ETHYL 0- (4-(METHYLTHIO) ESTER

500

e

50782699

PHOSPHONOTHIOIC ACID, METHYL-,S-(2-(BIS (I-METHYLETHYL)AMINO)ETHYL O-ETHYL ESTER

100

e

2665307

PHOSPHONOTHIOIC ACID, METHYL-,O-(4-NITRO- PHENYL)O-PHENYL ESTER

500

e

3254635

PHOSPHORIC ACID, DIMETHYL4-(METHYLTHIO) PHENYL ESTER

500

e

2587908

PHOSPHOROTHIOIC ACID, O,O-DIMETHYL-S- (2-METHYLTHIO) ETHYL ESTER

500

c,e,g

7723140

PHOSPHORUS

100

b,h

10025873

PHOSPHORUS OXYCHLORIDE

500

d

10026138

PHOSPHORUS PENTACHLORIDE

500

b,e

1314563

PHOSPHORUS PENTOXIDE

10

b,e

7719122

PHOSPHORUS TRICHLORIDE

1000

 

57476

PHYSOSTIGMINE

100/10000

e

57647

PHYSOSTIGMINE, SALICYLATE(1:1)

100/10000

e

124878

PICROTOXIN

500/10000

e

110894

PIPERIDINE

1000

e

23505411

PIRIMIFOS-ETHLY

1000

e

10124502

POTASSIUM ARSENITE

500/10000

d

151508

POTASSIUM CYANIDE

100

b

506616

POTASSIUM SILVER CYANIDE

500

b

2631370

PROMECARB

500/10000

e,h

106967

PROPARGYL BROMIDE

10

e

57578

PROPIOLACTONE, BETA-

500

e

107120

PROPIONITRILE

500

 

542767

PROPIONITRILE, 3-CHLORO-

1000

 

70699

PROPIOPHENONE, 41-AMINO

100/10000

e,l,g

109615

PROPYL CHLOROFORMATE

500

e

75569

PROPYLENE OXIDE

10000

1

75558

PROPYLENEIMINE

10000

d

2275185

PROTHOATE

100/10000

e

129000

PYRENE

1000/10000

c

140761

PYRIDINE, 2-METHYL-5-VINYL-

500

e

504245

PYRIDINE, 4-AMINO-

500/10000

4

1124330

PYRIDINE, 4-NITRO-,I-OXIDE

500/10000

e

53558251

PYRIMINIL

100/10000

e,h

14167181

SALCOMINE

500/10000

e

107448

SARIN

10

e,h

7783008

SELENIOUS ACID

1000/10000

 

7791233

SELENIUM OXYCHLORIDE

500

e

563417

SEMICARBAZIDE HYDROCHLORIDE

1000/10000

e

3037727

SILANE, (4-AMINOBUTYL)DIETHOXYMETHYL-

1000

e

7631892

SODIUM ARSENATE

1000/10000

d

7784465

SODIUM ARSENITE

500/10000

d

26628228

SODIUM AZIDE(NA(N3))

500

b

124652

SODIUM CACODYLATE

100/10000

e

143339

SODIUM CYANIDE(NA(CN))

100

b

62748

SODIUM FLOUOROACETATE

10/10000

 

13410010

SODIUM SELENATE

100/10000

e

10102188

SODIUM SELENITE

100/10000

h

10102202

SODIUM TELLURITE

500/10000

e

900958

STANNANE, ACETOXYTRIPHENYL-

500/10000

e,g

57249

STRYCHNINE

100/10000

c

60413

STRYCHNINE, SULFATE

100/10000

e

3689245

SULFOTEP

500

 

3569571

SULFOXIDE, 3-CHLOROPROPYLCOTYL

500

e

7446095

SULFUR DIOXIDE

500

e,l

7783600

SULFUR TETRAFLUORIDE

100

e

7446119

SULFUR TRIOXIDE

100

b,e

7664939

SUFURIC ACID

1000

 

77816

TABUN

10

c,e,h

13494809

TELLURIUM

500/10000

e

7783804

TELLURIUM HEXAFLUORIDE

100

e,k

107493

TEPP

100

 

13071799

TERBUFOS

100

e,h

78002

TETRAETHYL LEAD

100

c,d

597648

TETRAETHYLTIN

100

c,e

75741

TETRAMETHYL LEAD

100

c,e,l

509148

TETRANITROMETHANE

500

 

10031591

THALLIUM SULFATE

100/10000

h

6533739

THALLOUS CARBONATE

100/10000

c,h

7791120

THALLOUS CHLORIDE

100/10000

c,h

2757188

THALLOUS MALONATE

100/10000

c,e,h

7446186

THALLOUS SULFATE

100/10000

 

2231574

THIOCARBAZIDE

1000/10000

e

39196184

THIOFANOX

100/10000

 

297972

THIONAZIN

500

 

108985

THIOPHENOL

500

 

79196

THIOSEMICARBAZIDE

100/10000

 

5344821

THIOUREA, (2-CHLOROPHENYL)-

100/10000

 

614788

THIOUREA, (2-METHYLPHENYL)-

500/10000

e

7550450

TITANIUM TETRACHLORIDE

100

e

584848

TOLUENE 2,4-DIISOCYANATE

500

 

91087

TOLUENE 2,6-DIISOCYANATE

100

 

110576

TRANS-1,4-DICHLOROBUTENE

500

e

1031476

TRIAMIPHOS

500/10000

e

24017478

TRIAZOFOS

500

e

76028

TRICHLOROACETYL CHLORIDE

500

e

115219

TRICHLOROETHYLSILANE

500

e,h

327980

TRICHLORONATE

500

e,k

98135

TRICHLOROPHENYLSILANE

500

e,h

1558254

TRICHLORO(CHLOROMETHYL)SILANE

100

e

27137855

TRICHLOR(DICHLOROPHENYL)SILANE

500

e

998301

TRIETHOXYSILANE

500

e

75774

TRIMETHYLCHLOROSILANE

1000

e

824113

TRIMETHYLOLPROPANE PHOSPHITE

100/10000

e,h

1066451

TRIMETHYLTIN CHLORIDE

500/10000

e

639587

TRIPHENYLTIN CHLORIDE

500/10000

e

555771

TRIS(2-CHLOROETHYL)AMINE

100

e,h

2001958

VALINOMYCIN

1000/10000

c,e

1314621

VANADIUM PENTOXIDE

100/10000

 

08054

VINYL ACETATE MONOMER

1000

d,l

81812

WARFARIN

500/10000

 

129066

WARFARINSODIUM

100/10000

e,h

28347139

XYLYENE DICHLORIDE

100/10000

e

58270089

ZINC, DICHLORO(4,4-DIMETHYL-5((((METHYLAM-

 ION)CARBONYL)OXY)IMINO)PENTANENITRILE) (T-4)-

100/10000

e

1314847

ZINC PHOSPHIDE

500

 

 

*Only the statutory or final RQ is shown. for more information, see 40 CFR Table 302.4.

Notes:

a    This chemical does not meet acute toxicity criteria. Its TPQ is set at 10,000 pounds.

b    This material is a reactive solid. The TPQ does not default to 10,000 pounds for nonpowder, nonmolten, nonsolution form.

c    The calculate TPQ changed after technical review as described in the technical support document.

d    Indicates that the RQ is subject to change when the assessment of potential carcinogenicity and/or other toxicity is completed.

e    Statutory reportable quantity for purposes of notification under SARA sect 304(a)(2).

f     The statutory 1 pound reportable quantity for methyl isocyanate may be adjusted in a future rulemaking action.

g    New chemicals added that were not part of the original list of 402 substances.

h    Revised TPQ based on new or reevaluated toxicity data.

i     Chemicals on the original list that do not meet toxicity criteria but because of their high production volume and recognized toxicity are considered chemicals of concern ("Other Chemicals").

j     TPQ is revised to its calculated value and does not change due to technical review as in proposed rule.

k    The TPQ was revised after proposal due to calculation error.

 

Tier Two

 

Emergency And Hazardous Chemical Inventory

 

Specific Information By Chemical

Facility Identification

Name____________________________________________

Street____________________________________________

City__________County__________State______Zip_______

SIC Code """" Dun & Brad Number ""-"""-""""

Owner/Operator Name

Name______________________ Phone (__)_________

Mail Address___________________________________

 

Emergency Contact

Name_____________________ Title________________

Phone (___)___________ 24 Hr. Phone (___)_________

Name_____________________ Title________________

Phone (___)___________ 24 Hr. Phone (___)_________

FOR OFFICIAL USE ONLY

 

ID#:_________________ Fee Received $_______________

Date received:_________ Check Number _______________

Important: Read all instructions before completing form

Report Period: From January 1 to December 31, 19___

" check if information below is identical to the information submitted last year

CONFIDENTIAL LOCATION INFORMATION SHEET

Container type

Pressure

Temperature

Storage Codes and Locations

(Confidential)

 

Storage Locations

Options

CAS """""" "" " Chem. Name

 "  "  "    ______________________________________

 "  "  "    ______________________________________

 "  "  "    ______________________________________

 "  "  "    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 



CAS !!!!!! !! ! Chem. Name

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 



CAS !!!!!!-!!-! Chem. Name

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 !  !  !    ______________________________________

 



Certification (Read and sign after completing all sections

I certify under penalty of law that I have personally examined and am familiar with the information submitted in pages one through ____, and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete.

 

__________________________________________________________________

Name and official title of owner/operator OR owner/operator's authorized representative

 

__________________________________________________________________

Signature and Date Signed

Optional Attachments

! I have attached a site plan.

! I have attached a list of site coordinate abbreviations.

! I have attached a description of dikes and other safeguare measures.

Check appropriate box:

! $250 fee attached

! $40 fee attached

! No fee required

 

Tier Two

 

Emergency And Hazardous Chemical Inventory

 

Specific Information By Chemical

Facility Identification

Name____________________________________________

Street____________________________________________

City__________County__________State______Zip_______

SIC Code !!!! Dun & Brad Number !!-!!!-!!!!

Owner/Operator Name

Name______________________ Phone (__)_________

Mail Address___________________________________

 

Emergency Contact

Name_____________________ Title________________

Phone (___)___________ 24 Hr. Phone (___)_________

Name_____________________ Title________________

Phone (___)___________ 24 Hr. Phone (___)_________

FOR OFFICIAL USE ONLY

 

ID#:_________________ Fee Received $_______________

Date received:_________ Check Number _______________

Important: Read all instructions before completing form

Report Period: From January 1 to December 31, 19___

! check if information below is identical to the information submitted last year

CHEMICAL

DESCRIPTION

Physical and

Health Hazards

(Check all that apply)

Inventory

Container type

Pressure

Temperature

Storage Codes and Locations

(Confidential)

 

Storage Locations

Options

CAS !!!!!!-!!-! Trade !

Chem. Name____________________

______________________________

Check all that apply:

! Pure                  ! Mix

! Solid                 ! Liquid

! Gas                   ! EHS

EHS Name____________________

! Fire

! Sudden release of pressure

! Reactivity

! Immediate (acute)

! Delayed (chronic)

!! Max. Daily Amounts (code)

!! Avg. Daily Amount (code)

!!! No. of Days On Site (days)

 

For code 05: Enter actual weight in pounds: _____

 !  !  !    __________________

 !  !  !    __________________

 !  !  !    __________________

 !  !  !    __________________

 !  !  !    __________________

         __________________

 



CAS !!!!!!-!!-! Trade !

Chem. Name____________________

______________________________

Check all that apply:

! Pure                  ! Mix

! Solid                 ! Liquid

! Gas                   ! EHS

EHS Name____________________

! Fire

! Sudden release of pressure

! Reactivity

! Immediate (acute)

! Delayed (chronic)

!! Max. Daily Amounts (code)

!! Avg. Daily Amount (code)

!!! No. of Days On Site (days)

 

For code 05: Enter actual weight in pounds: _____

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 



CAS !!!!!!-!!-! Trade !

Chem. Name____________________

______________________________

Check all that apply:

! Pure                  ! Mix

! Solid                 ! Liquid

 

! Gas                   ! EHS

EHS Name____________________

! Fire

! Sudden release of pressure

! Reactivity

! Immediate (acute)

! Delayed (chronic)

!! Max. Daily Amounts (code)

!! Avg. Daily Amount (code)

!!! No. of Days On Site (days)

 

For code 05: Enter actual weight in pounds: _____

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 !  !  !    ___________________

 



Certification (Read and sign after completing all sections

I certify under penalty of law that I have personally examined and am familiar with the information submitted in pages one through ____, and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete.

 

__________________________________________________________________

Name and official title of owner/operator OR owner/operator's authorized representative

 

__________________________________________________________________

Signature and Date Signed

Optional Attachments

! I have attached a site plan.

! I have attached a list of site coordinate abbreviations.

! I have attached a description of dikes and other safeguare measures.

Check appropriate box:

! $250 fee attached

! $40 fee attached

! No fee required

 


KENTUCKY EMERGENCY RESPONSE COMMISSION

TIER TWO INSTRUCTIONS

GENERAL INFORMATION

 

Submission of this Tier Two form is required by the Kentucky Emergency Response Commission in accordance with Title III of the Superfund Amendments and Reauthorization Act of 1986, Section 312 and KRS 39.990 and subsequent administrative regulations. The purpose of this Tier Two form is to provide state and local officials and the public with specific information on hazardous chemicals present at your facility during the past year.

 

CERTIFICATION

 

The owner or operator or officially designated representative of the owner or operator must certify that all information included in the Tier Two submission is true, accurate, and complete. On the first page of the Tier Two report, enter your full name and official title. Sign your name and enter the current date. Also, enter the total number of pages included in the Confidential and Nonconfidential information Sheets as well as all attachments. An original signature is required on at least the first page of the submission. Submissions to the SERC, LEPC, and fire department must each contain and original signature on at least the first page. Subsequent pages must contain either an original signature, a photocopy of the original signature, or a signature stamp. Each page must contain the date on which the original signature was affixed to the first page of the submission and the total number of pages in the submission.

 

YOU MUST PROVIDE ALL INFORMATION REQUESTED ON THIS FORM TO FULFILL ANNUAL CHEMICAL INVENTORY REQUIREMENTS.

 

THE KENTUCKY EMERGENCY RESPONSE COMMISSION REQUIRES SUBMISSION OF THE TIER TWO FORM.

 

WHO MUST SUBMIT THIS FORM

 

This request applies to the owner or operator of any facility that is required, under administrative regulations implementing the Occupational Safety and Health Act of 1970, to prepare or have available a Material Safety Data Sheet (MSDS) for a hazardous chemical present at the facility. MSDS requirements are specified in the Occupational Safety and Health Administration (OSHA) Hazard Communication Standard, found in Title 29 of the Code of Federal Regulations at 1910.1200.

 

WHAT CHEMICALS ARE INCLUDED

 

You must report the required information on this Tier Two form for each hazardous chemical present at your facility in quantities equal to or greater than established threshold amounts (discussed below), unless the chemicals are excluded under Section 311(e) of Title III. Hazardous chemicals are any substance for which your facility must maintain an MSDS under OSHA's Hazard Communication Standard.

 

WHAT CHEMICALS ARE EXCLUDED

 

Section 311(e) of Title III excludes the following substances:

      (I) Any food, food additive, color additive, drug, or cosmetic regulated by the Food and Drug Administration:

      (II) Any substance present as a solid in any manufactured item to the extent exposure to the substance does not occur under normal conditions of use:

      (III) Any substance to the extent it is used for personal, family, or household purposes, or is present in the same form and concentration as a product packaged for distribution and use by the general public:

      (IV) Any substance to the extent it is used in a research laboratory or a hospital or other medical facility under the direct supervision of a technically qualified individual:

      (V) Any substance to the extent it is used in routine agricultural operations or is a fertilizer held for sale by a retailer to the ultimate customer.

 

OSHA regulations, Section 1910.1200(b), stipulate exemptions from the requirement to prepare or have available an MSDS.

 

REPORTING THRESHOLDS

 

Minimum thresholds have been established for Tier Two reporting under Title III, Section 312. These thresholds are as follows:

 

For Extremely Hazardous Substances (EHSs) designated under section 302 of Title III, the reporting threshold is 500 pounds (or 227 kg.) or the threshold planning quantity (TPQ), whichever is lower:

 

For all other hazardous chemicals for which facilities are required to have or prepare an MSDS, the minimum reporting threshold is 10,000 pounds (or 4,540 kg.).

 

You need to report hazardous chemicals that were present at your facility at any time during the previous calendar year at levels that equal or exceed these thresholds. For instructions on threshold determinations for components of mixtures, see "What About Mixtures?" on page 2 of these instructions.

 

Please read these instructions carefully. Print or type all responses.

 

WHEN TO SUBMIT THIS FORM

Owners or operators of facilities that have hazardous chemicals on hand in quantities equal to or greater than set threshold levels must submit a Tier Two form by March 1.

 

WHERE TO SUBMIT FEE

(See Fee Schedule on page 4)

 

Checks shall be made payable to: "Kentucky State Treasurer" and shall be marked "For KyERC Fee Account". Fees and form shall be mailed to:

 

Chairman, Kentucky Emergency Response Commission

EOC Building, Boone National Guard Center

Frankfort, KY 40601-6168

 

WHERE TO SUBMIT THIS FORM

 

Send a completed Tier Two form(s) to each of the following organizations:

      1. Your State Emergency Response Commission.

      2. Your Local Emergency Planning Committee.

      3. The fire department with jurisdiction over your facility.

 

PENALTIES

 

Any owner or operator who violates any Tier Two reporting requirements shall be subject to penalties as set forth in P.L. 99-499, Title III, Section 325 and KRS Chapter 39.990 and subsequent administrative regulations.

 

If your Tier Two responses require more than one page use additional forms and fill in the page number at the bottom of the form.

 

REPORTING PERIOD

 

Enter the appropriate calendar year, beginning January 1 and ending December 31.

 

FACILITY IDENTIFICATION

 

Enter the full name of your facility (and company identifier where appropriate).

 

Enter the full street address or state road. If a street address is not available, enter other appropriate identifiers that describe the physical location of your facility (e.g. longitude and latitude). Include city, county, state, and zip code.

 

Enter the primary Standard industrial Classification (SIC) code and the Dun & Bradstreet number for your facility. The financial officer of your facility should be able to provide the Dun & Bradstreet number. If your firm does not have this information, contact the State or regional office of Dun & Bradstreet to obtain your facility number or have one assigned.

 

OWNER/OPERATOR

 

Enter the owner's or operator's full name, mailing address, and phone number.

 

EMERGENCY CONTACT

 

Enter the name, title, and work phone number of at least one local person or office who can act as a referral if emergency responders need assistance in responding to a chemical accident at the facility.

 

Provide an emergency phone number where such emergency information will be available 24 hours a day, every day. This requirement is mandatory. The facility must make some arrangement to ensure that a 24 hour contact is available.

 

IDENTICAL INFORMATION

 

Check the box indicating identical information, located below the emergency contacts on the Tier Two form, if the current chemical information being reported is identical to that submitted last year. Chemical descriptions, hazards, amounts, and locations must be provided in this year's form, even if the information is identical to that submitted last year.

 

CHEMICAL INFORMATION: Description, Hazards, Amounts, and Locations

 

The main section of the Tier Two form requires specific information on amounts and locations of hazardous chemicals, as defined in the OSHA Hazard Communication Standard.

 

If you choose to indicate that all of the information on a specific hazardous chemical is identical to that submitted last year, check the appropriate optional box provided at the right side of the storage codes and locations on the Tier Two form. Chemicals descriptions, hazards, amounts, and locations must be provided even if the information is identical to that submitted last year.

 

-     What units should I use?

 

      Calculate all amounts as weight in pounds. To convert gas or liquid volume to weight in pounds, multiply by an appropriate density

      factor.

 

-     What about mixtures?

 

      If a chemical is part of a mixture, you have the option of reporting either the weight of the entire mixture of only the portion of the mixture that is a particular hazardous chemical (e.g.. if a hazardous of only 5 percent of a particular hazardous chemical, you can indicate either 100 lbs. of the mixture or 5 lbs. of the chemical).

 

      The option used for each mixture must be consistent with the option used in your Section 311 reporting.

 

      Because EHSs are important to Section 303 planning, EHSs have lower thresholds. The amount of an EHS at a facility (both pure EHS substances and EHSs in mixtures) must be aggregated for purposes of threshold determination. It is suggested that the aggregation calculation be done as a first step in making the threshold determination. Once you determine whether a threshold for an EHS has been reached, you should report either the total weight of the EHS at your facility, or the weight of each mixture containing the EHS.

 

CHEMICAL DESCRIPTION

 

      1. Enter the Chemical Abstract Service registry number (CAS). For mixtures, enter the CAS number of the mixtures as a whole if it has been assigned a number distinct from its constituents. For a mixture that has no CAS number, leave this item blank or report the CAS number of as many constituent as possible.

 

If you are withholding the name of a chemical in accordance with criteria specified in Title III, Section 322, enter the generic class or category that is structurally descriptive of the chemical (e.g., list toluene disocyanate as organic (sooyante) and check the box marked Trade Secret. Trade secret information should be submitted to EPA and must include a substantiation. Please refer to EPA's final regulation on trade secrecy (53 FR 28772, July 29, 1988) for detailed information on how to submit trade secrecy claims.

 

      2. Enter the chemical name or common name of each hazardous chemical.

 

      3. Check box for ALL applicable descriptors: pure or mixture; and solid, liquid, or gas; and whether the chemical is or contains an EHS.

 

      4. If the chemical is a mixture containing EHS, enter the chemical name of each EHS in the mixture.

 

EXAMPLE:

You have pure chlorine gas on hand, as well as two mixtures that contain liquid chlorine. You write "chlorine" and enter the CAS number. Then you check "pure" and "mix" - as well as "liquid" and "gas".

 

PHYSICAL AND HEALTH HAZARDS

 

For each chemical you have listed, check all the physical and health hazard boxes that apply. These hazard categories are defined in 40 CFR 370.2. The two health hazard categories and three physical hazard categories are a consolidation of the 23 hazard categories defined in the OSHA Hazard Communication Standard, 29 CFR 1910.1200.

 

Hazard Category Comparison

For Reporting Under Section 311 and 312

EPA's Hazard Categories

OSHA's Hazard Categories

Fire Hazard

Flammable

Combustion Liquid

Pyrophoric

Oxidizer

Sudden Release of Pressure

Explosive

Compressed Gas

Reactive

Unstable Reactive

Organic Peroxide

Water Reactive

Immediate (Acute) Health Hazards

Highly Toxic

Toxic

Irritant

Sensitizer

Corrosive

Other hazardous chemicals with an adverse effect with short term exposure

Delayed (Chronic) Health Hazard

Carcinogens

Other hazardous chemicals with an adverse effect with long term exposure

 

MAXIMUM AMOUNT

 

      1. For each hazardous chemical, estimate the greatest amount present at your facility on any single day during the reporting period.

      2. Find the appropriate range value code in Table I.

      3. Enter this range value as the Maximum Amount.

      4. If range value 05 (100,000 to 999,999) is used for the maximum daily amount, enter the actual weight in pounds in the Inventory column directly below the code number. This is necessary to determine the appropriate fee category.

 

TABLE I REPORTING RANGE

Range

Weight Range in Pounds

Value

From...

To...

01

0

99

02

100

999

03

1,000

9,999

04

10,000

99,999

05

100,000

999,999

06

1,000,000

9,999,999

07

10,000,000

49,999,999

08

50,000,000

99,999,999

09

100,000,000

499,999,999

10

500,000,000

999,999,999

11

1 billion

higher than 1 billion

 

EXAMPLE:

 

You received one large shipment of solvent mixture last year. The shipment filled five 5,000-gallon storage tanks. You know that the solvent contains 10 percent benzene, which is a hazardous chemical.

 

You figure that 10 percent of 25,000 gallons is 2,500 gallons. You also know that the density of benzene is 7.29 pounds per gallon, so you multiply 2,500 gallons by 7.29 pounds per gallon to get a weight of 18.225 pounds.

 

Then you look at Table I and find that the range value o4 corresponds to 18.225. You enter 04 as the Maximum Amount.

 

AVERAGE DAILY AMOUNT

 

      1. For each hazardous chemical, estimate the average weight in pounds that was present at your facility during the year.

      To do this, total all daily weights and divide by the number of days the chemical was present on the site.

      2. Find the appropriate range value in Table I.

      3. Enter this range value as the Average Daily Amount.

 

EXAMPLE:

The 25,000-gallon shipment of solvent you received last year was gradually used up and completely gone in 315 days. The sum of the daily volume levels in the tank is 4,536,000 gallons. By dividing 4,536,000 gallons by 315 days on site, you calculate an average daily amount of 14,400 gallons.

 

You already know that the solvent contains 10 percent benzene, which is a hazardous chemical. Since 10 percent of 14,400 is 1,440, you figure that you had an average of 1,440 gallons of benzene. You also know that the density of benzene is 7.29 pounds per gallon, so you multiply 1,440 by 7.29 to get a weight of 10,500 pounds.

 

Then you look at Table I and find that the range value 04 corresponds to 10,500. You enter 04 as the Average Daily Amount.

 

(If you are using the form as a worksheet for completing a Tier One form, you should write 10,500 in the shaded area.)

 

NUMBER OF DAYS ON SITE

Enter the number of days that the hazardous chemical was found on site.

 

EXAMPLE:

The solvent composed of 10 percent benzene was present for 315 days at your facility. Enter 315 in the space provided.

 

STORAGE CODES AND STORAGE LOCATIONS

 

List all nonconfidential chemical locations in this column, along with storage types/conditions associated with each location. Please note that a particular chemical may be located in several places around the facility. Each row of boxes followed by a line represents a unique location for the same chemical.

 

Storage Codes: Indicate the types and conditions of storage present.

 

      a. Look at Table II. For each location, find the appropriate storage type and enter the corresponding code in the first box.

      b. Look at Table III. For each location, find the appropriate storage types for pressure and temperature conditions. Enter the applicable pressure code in the second box. Enter the applicable temperature code in the third box.

 

TABLE II - STORAGE TYPES

CODES

TYPES OF STORAGE

A

Above ground tank

B

Below ground tank

C

Tank inside building

D

Steel drum

E

Plastic or nonmetallic drum

F

Can

G

Carboy

H

Silo

I

Fiber drum

J

Bag

K

Box

L

Cylinder

M

Glass bottles or jugs

N

Plastic bottles or jugs

O

Tote bin

P

Tank wagon

Q

Rail car

R

Other

 

TABLE III - TEMPERATURE AND PRESSURE CONDITIONS

CODES

STORAGE CONDITIONS (PRESSURE)

1

Ambient pressure

2

Greater than ambient pressure

3

Less than ambient pressure

 

(TEMPERATURE)

4

Ambient temperature

5

Greater than ambient temperature

6

Less than ambient temperature but not cryogenic

7

Cryogenic conditions

 

EXAMPLE:

 

The benzene in the main building is kept in a tank inside the building, at ambient pressure and less than ambient temperature.

 

Table II shows you that the code for a tank inside a building is C. Table III shows you that the code for ambient pressure is 1, and the code for less than ambient temperature is 6.

 

You enter: C 1 6

 

Storage Locations

 

Provide a brief description of the precise location of the chemical, so that emergency responders can locate the area easily. You may find it advantageous to provide the optional site plan or site coordinates as explained below.

 

For each chemical, indicate at a minimum the building or lot. Additionally, where practical, the room or area may be indicated. You may respond in narrative form with appropriate site coordinates or abbreviations.

 

If the chemical is present in more than one building, lot, or area location, continue your responses down the page as needed. If the chemical exists everywhere at the plant site simultaneously, you may report that the chemical is ubiquitous at the site.

 

Optional Attachments: If you choose to attach one of the following, check the appropriate Attachments box at the bottom of the Tier Two form.

 

      a. A site plan with site coordinates indicated for building, lots, areas, etc. throughout your facility.

      b. A list of site coordinate abbreviations that correspond to building, lots, areas, etc. throughout your facility.

      c. A description of dikes and other safeguard measures for storage locations throughout your facility.

 

EXAMPLE:

 

You have benzene in the main room of the main building, and in tank 2 in tank field 10. You attach a site plan with coordinates as follows: main building = G-2, tank field 10 = B-6. fill in the Storage Location as follows:

 

B-6 (Tank 2) G-2 (Main Room)

 

CONFIDENTIAL INFORMATION

 

Under Title III, Section 324, you may elect to withhold location information on a specific chemical from disclosure to the public, if you choose to do so.

 

-     Enter the word "confidential" in the Nonconfidential Location section of the Tier Two form on the first line of the storage locations.

 

-     On a separate Tier Two Confidential Location Information Sheet, enter the name and CAS number of each chemical for which you are keeping the location confidential.

 

-     Enter the appropriate location and storage information, as described above for nonconfidential locations.

 

-     Attach the Tier Two Confidential Location information Sheet to the Tier Two form. This separates confidential locations from other information that will be disclosed to the public.

 

CERTIFICATION

 

Instructions for this section are included on page one of these instructions.

 

FEE SCHEDULE

 

Check appropriate box on the form.

$0

Category One Facility is owned or operated by local, state or federal government.

$40

Category Two Facility has no less than 10,000 pounds and no more than 499,999 pounds of each of ten (10) or fewer hazardous substances. The combined total of all hazardous substances shall not exceed 499,999 pounds.

$250

Category Three Facility has 10,000 pounds or more of each 11 or more hazardous substances. The combined total of all hazardous substance shall not exceed 499,999 pounds.

$250

Category Four Facility has a total of over 499,999 pounds of hazardous substances.

$250

Category Five Facility has an extremely hazardous substance in excess of the threshold planning quantity.

 

TAB Q-7-___

COVERED FACILITIES

 

FACILITY        FAC EMERG RESP COORD   COMMUNICATIONS

________        _______________________    Office#_____________

St.______                                                          Home#_____________

City_____       Title____________________   R. Freq_____________

                                                                          Pager $_____________

               ALTERNATE

      FAC EMERG RESP COORD

      _______________________                      Office#______________

                                                                          Home#_____________

      Title____________________                    R.Freq______________

 

HAZARDOUS CHEMICAL(S)

 

NAME    UN ID#     FORM      PACKAGED     MAXIMUM    HEALTH

               CAS #                      CONTAINER    QUANTITY       RISK

 

SKETCH OF FACILITY AND STORAGE AREAS:

 

FACILITY RESPONSE POINT (RP) AND DIRECTIONS:

 

STAGING AREA (Support units will report and await assignment by local organization):

 

TRANSPORTATION ROUTES AND MODES OF TRANSPORTATION (include supplier and telephone number - describe how chemicals are handled - list hazardous points along the routes):

 

SPECIAL FACILITIES LIKELY TO BE AFFECTED BY A RELEASE (List affected facilities and day/night contacts):

 

PROTECTIVE ACTIONS (In-place sheltering of evacuation - give brief description of area(s) where protection actions may be required - add evacuation procedures to Annex EE):

 

EMERGENCY EQUIPMENT ON HAND/TRAINING/EXERCISING:

 

SPILL CONTAINMENT/CLEAN-UP/DISPOSAL:

 

EMERGENCY NOTIFICATION

 

Local 24 hr. warning number (LEPC): ____-____-____

      Haz-mat Coord. (Day) ____-____-____ (Night) ____-____-____

      Alt. Coord. (Day) ____-____-____ (Night) ____-____-____

      __________________ Fire Dept. ____-____-____

      __________________ Police Dept. ____-____-____

      DES Coord.:

      (Day) ____-____-____ or ____-____-____

      (Night) ____-____-____ or ____-____-____

______________ Rescue ____-____-____or____-____-____

____________Ambulance ____-____-____or____-____-____

 

Kentucky Emergency Response Commission (KERC) 502- 564-7815

 

Kentucky DES Area Coordinator:

      (O) ____-____-____

      (H) ____-____-____

 

Nat. Resources & Envir. Prot. Cabinet (NR&EPC): 502-564-2380

National Response Center (NRC): 1-800-424-8802

Evir. Prot. Agency (EPA) Hotline: 1-800-535-0202

Hours: 8:30 a.m. - 7:30 p.m., Mon-Fri. including federal holidays

Chemtrec: 1-800-424-9300

      (18 Ky.R. 1697; Am. 2310; eff. 1-27-92.)