HomeMy WebLinkAboutEx19_Hazardous_Materials_Inventory_StatementHazardous Materials Inventory Statement (HMIS)
Fire & Emergency Services Department 1055 S. Grady Way
Renton, WA 98057
425-430-7000 (Phone)
425-430-7044 (Fax)
Date
Page of
Business
Name:
Contact
Person:
Operation
Address:
City, State,
Zip:
Mailing
Address:
City, State,
Zip:
Telephone:
No.Hazard
Class
Common Trade
Name
Chemical
Components
& Concentration
Chemical
Abstract
Service
Registry No.Physical StatePurityMaximum
Quantity
on Hand
Unit
Container TypeSite
Map
Page
Site
Map
Grid IndoorOutdoorIFC 2703.5/
NFPA 704 Rating
H F R XXX
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Form: CRR-HMIS Revised 01/25/2009
If needed, please print additional copies.
EXHIBIT 19
RECEIVED
Clark Close 05/31/2022
PLANNING DIVISION
4/4/2022
1 1
Blue Origin
Cecil Goodson
1415 Maple Ave. SW Renton, WA 98057
21601 76th Ave. S Kent, WA 98032
832-638-6067
See Attached
Print Form
DocuSign Envelope ID: 0C50F956-C05E-4AB3-B622-213397BAE02B
Abbreviations for HMIS
Fire & Emergency Services Department 1055 S. Grady Way
Renton, WA 98057
Column 1 - Hazard Class
BLA Blasting Agenda
COM IIIA Class III-A Combustible
COM IIIB Class III-B Combustible
COR Corrosive
CRY Cryogenic
EXP Explosive
FLAG Flammable Compressed Gas
FLA IA Class I-A Flammable
FLA IB Class I-B Flammable
FLA IC Class I-C Flammable
COM II Class II Combustible
FLS Flammable Solid
HTX Highly Toxic
INT Inert Compressed Gas
LPG Liquified Petroleum Gas
OXYG Oxidizing Compressed Gas
OXY 4 Class 4 Oxidizer
OXY 3 Class 3 Oxidizer
OXY 2 Class 2 Oxidizer
OXY 1 Class 1 Oxidizer
NFL Non-Flammable Compressed Gas
ORG IV Class IV Organic Peroxide
ORG III Class III Organic Peroxide
ORG II Class II Organic Peroxide
ORG I Class I Organic Peroxide
OHH Other Health Hazard
PYR Pyrophoric
RAD Radioactive
TOX Toxic
URE 4 Class 4 Unstable (Reactive)
URE 3 Class 3 Unstable (Reactive)
URE 2 Class 2 Unstable (Reactive)
URE 1 Class 1 Unstable (Reactive)
WRE 3 Class 3 Water Reactive
WRE 2 Class 2 Water Reactive
WRE 1 Class 1 Water Reactive
Form: CRR-HMIS Revised 01/25/2009
Column 5 - Physical State
S = Solid
L = Liquid
G = Gas
Column 6 - Purity
P = Pure
M = Mixture
W = Waste
Column 7 - Units
G = Gallons
L = Liters
F = Fluid Ounces
Q = Quarts
P = Pounds
K = Kilograms
M = Grams
N = Pints
T = Milliliters
I = Milligrams
O = Troy Ounces
C = Cubic Feet
R = Curie
U = Microcurie
Column 8 - Container Type
A = Aboveground Tank
B = Belowground Tank
C = Tank Inside Building
D = Steel Drum
E = Plastic or Non-Metal Drum
F = Metal Can
G = Carboy
H = Silo
I = Fiberdrum
J = Bag
K = Box
L = Compressed Gas Cylinder
M = Glass Bottle
N = Plastic Container
O = Tote Bin
P = Tank Wagon
Q = Rail Car
R = Other
425-430-7000 (Phone)
425-430-7044 (Fax)
DocuSign Envelope ID: 0C50F956-C05E-4AB3-B622-213397BAE02B
No. Hazard Class Common Trade Name Chemical Components and Concentration CAS No. Physical statePurity Max Quantity on Hand UnitContainer TypeSite Map PageSite Map Grid Indoor Outdoor H F R XXX1TOX1,2,4-TCB1,2,4 - Trichlorobenzene, 0.99120-82-1LP1LMA2.3F.8/3X200N/A2 FLA IB Acetone Acetone, 1 67-64-1 L P 31 L N/MA2.3C/3 + E/5 + F.8/3 X 1 3 0 N/A3 FLA IB, TOX Acetonitrile Acetonitrile, 99% 75-05-8 L M 3 L MA2.3F.8/3 X 2 3 0 N/A4 ALON Aluminum Oxinitride, 99.995 +% 12633-97-5 S P 2000 M NA2.3F.8/3 X 1 0 1 N/A5 Brulin AquaVantage 815 GDModified polyether anionic surfactant (1-5%), Non-ionic surfactant (1-5%), Sodium Tripolyphosphate (1-5%)7758-29-4 L M 110 G EA2.3F.8/3 X6 OXY 1, HTX Chromium Trioxide Chromium Trioxide, 98.0 +% 1333-82-0 S P 25 M MA2.3F.8/3 X 3 0 1 OX7 TOX Dichloromethane Methylene Cholride, 0.995 75-09-2 L P 4 L MA2.3F.8/3 X 2 1 0 N/A8 COR, TOX Dionex Carbonate, Methanesulfonic Acid, and Hydroxide EGC Eluent Generator CartridgesAlkane sulfonic acid (0.192), Water, 75-75-2 L M Unknown NA2.3F.8/3 X 3 1 1 N/A9 FLA IB Ethanol Ethanol, 95.5+% 64-17-5 L P 1 L NA2.3F.8/3 X 1 3 0 N/A10 TOX Ethylene Glycol Ethane-1,2-diol, 1 107-21-1 L P 20 L NA2.3F.8/3 X 3 1 0 N/A11 HCLHydrochloric acid 1.0 M, 0.0359 7647-01-0 L M 3.6 L NA2.3F.8/3 X 3 0 1 N/A12 NFL Helium Helium Gas, 1 7440-59-7 G P 249.5 L LA2.3, A1.1C/3 + X/3 X X 1 0 0 N/A13 FLA IB, TOX Hexane N-Hexane, 95 +% 110-54-3 L P 20 L NA2.3F.8/3 X 1 3 0 N/A14 COR, FLA IA, TOX Hydranal Methanol (60-100%), Imidazole (10-30%), Sulphur dioxide (5-10%)67-56-1 L M 1 L NA2.3F.8/3 X 3 3 0 N/A15 FLAG Hydrogen Hydrogen, 1 1333-74-0 G P 598.8 L LA1.1X/1 X 0 4 0 N/A16 IPAIsopropyl alcohol, 0.7/0.99 67-63-0 L M/P 27 L N/MA2.3E/5 + C/3 X 2 3 0 N/A17 TOX Kyro 30 Ethylene Glycol, Water, Corrosion Inhibitors N/A L M 10 L NA2.3F.8/3 X 2 1 1 N/A18 FLA IA, TOX Methanol Methanol, 1 67-56-1 L P 15 L NA2.3F.8/3 X 1 3 0 N/A19Mineral oilHydrocarbons, 60-10%N/ALP4KNA2.3F.8/3X001N/A20 Gear Lube Alkarylamine (1-5%), Olefin sulphide (1-5%), Alkyl Phosphate ester anime salt (1-5%), Phosphoric acid esters anime salt (1-2.5%), Severely hydrotreated heavy paraffinic distillate (1-5%)36878-20-3, 68937-96-2, 64742-54-7L M 6 L NA2.3F.8/3 X21 N, N-Dimethyl-formamide N, N-Dimethyl-formamide, 99.8+ % 68-12-2 L P 2 L MA2.3F.8/3 X 2 2 0 N/A22 NFL Nitrogen Nitrogen Gas, 1 7727-37-9 G P 598.8 L LA2.3, A1.1F/3 + F/3.5 + B/3 + X/3 X X 0 0 0 N/A23 CRY Nitrogen Nitrogen, 1 7727-37-9 L P 600 P DA1.1X/2 + X/3 X 3 0 0 SA24 OXYG Oxygen Oxygen, 1 7782-44-7 G P 598.8 L LA1.1X/2 X 0 0 0 OX25 COR Phosphoric Acid Phosphoric Acid, 0.1-0.98 7664-38-2 L M/P 2 L NA2.3F.8/3 X 3 0 1 N/A26 Potassium Phosphate Potassium Phosphate, 1 7778-77-0 S P 5000 MA2.3F.8/3 X 0 0 0 N/A27 FLA IA Propane Propane, 1 74-98-6 G P 240 P LA1.1X/3 X 2 4 0 N/A28 SaltSodium Chloride, 99.0-101.0% 7647-14-5 S P 2500 M NA2.3F.8/3 X 0 0 0 N/A29 HTX Sodium Fluoride Sodium Fluoride, 1.01 7681-49-4 S P 100 M NA2.3F.8/3 X 2 0 1 N/A30 Sodium Hydroxide Sodium Hydroxide (10M), 0.3011 1310-73-2 L M 4 L NA2.3E/5 X 3 0 1 N/A31 COR Sodium Hydroxide solution Sodium Hydroxide solution, 20% 1310-73-2 L M 2 L NA2.3E/5 X 3 0 1 N/A32 Vacuum Pump Oil Blend of mineral oils and additives N/A L M 1 L NA2.3E/5 X 1 0 1 N/A33 FLAG WD-40 LVP Aliphatic Hydrocarbon (45-50%), Petroleum Base Oil (<35%), Aphatic Hydrocarbon (<25%), Carbon Dioxide (2-3%) 64742-47-8, 64742-56-9, 64742-65-0, 64742-53-7, 64742-54-7, 64742-71-8, 64742-47-8, 124-38-9G/L M 4 G MA2.3E/5 + C/3 X 2 2 0 N/AIFC 2703.5/NFPA 704 RatingDocuSign Envelope ID: 0C50F956-C05E-4AB3-B622-213397BAE02B
MAPLE AVENUE SW 60'-4" R.O.W.405 100'-0" R.O.W.EXITEXITEXITEXIT / ENTRYEXITEXITEXITEXITEXIT225'-0"76'-1"
86'-5"18'-0"32'-0"17'-6"175'-0"162'-6"
50'-0"12'-6"49'-11"12'-6"62'-7"
datesheetjob no.
drawn
checked
date no.revision
LANCE MUELLER & ASSOCIATES
A R C H I T E C T S A I A
130 LAKESIDE SUITE 250 SEATTLE, WA 98122 (206) 325-2553A1.1PERMIT SITE PLAN, GENERAL NOTES BLUE ORIGIN
DaVINCI BUILDING T.I.
1415 MAPLE AVE. SW, RENTON, WASHINGTON 98057 GENERAL NOTESABBREVIATIONSSCALE: 1" = 20'-0"SITE PLAN010204060SITE PLAN NOTESVICINITY MAPNOT TO SCALESW 16TH STLIND AVE. SW
MAPLE AVE SW I-405167LOCATION OF OFF-SITEPARKING 1601 EVALLEY RDPROJECTLOCATION1415 MAPLEAVE SWMAPLE AVE. SW X/3ITEMS 12, 22, 23, 27X/1ITEM 15X/2ITEMS 23 & 24DocuSign Envelope ID: 0C50F956-C05E-4AB3-B622-213397BAE02B
654321AABBCCDDEEGGFFF.8F.3E.54.43.52.6D.54.83.92.92.4121DARK ROOM122AVIONICSLAB123CLEAN ROOM124FUELCELLTESTING125CHEM. LAB120MOCKUPASSEMBLY & TESTING116BREAK112LOBBY 117ARISER 118STAIR#2 114MEN 113WOMEN 110ELECT 111JAN 108OFFICE 109SHOWER 107HALL ELEV.126ELEVMACH121122123B123A124125126E118E117AE115E114E113E113E110E112E108E107E120AE120B120CE120DE120EE120FE120GE120HE120JE120KE121119AAABCCA1A1A1A1CBBD2B2B1B1BB2BBC1B225A5.2C2D127A5.2AA4.1BA4.1CA4.1DA4.1EA4.2FA4.2GA4.2JA5.2123456CA4.2A2.3PERMIT1ST FLOOR PLAN BLUE ORIGIN
DaVINCI BUILDING T.I.
1415 MAPLE AVE. SW, RENTON, WASHINGTON 98057 datesheetjob no.
drawn
checked
date no.revision
LANCE MUELLER & ASSOCIATES
A R C H I T E C T S A I A
130 LAKESIDE SUITE 250 SEATTLE, WA 98122 (206) 325-2553SCALE: 1/8" = 1'-0"1ST FLOOR PLAN0481624 FLOOR PLAN NOTESBXxLEGEND SAFETY GLAZING NOTES F.8/3ITEMS 1-11, 13, 14, 17-21, 25, 26, 28, 29C/3ITEMS 2, 12, 16, 33E/5ITEMS 2, 16, 30-33F/3ITEMS 22F/3.5ITEM 22B/3ITEM 22DocuSign Envelope ID: 0C50F956-C05E-4AB3-B622-213397BAE02B