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<br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 THIS DOCUHENT MUST BE CERTIFIED. <br />8 <br />9 ARE YOU USING THE FACILITY EMERGENCY PLANNING OUTLINE? YES [] <br />10 <br />11 FACILITY NAME: ADVANCE CIRCUITS, INC. <br />12 <br /> <br />~~ I <br /> <br />15 <br />16 <br />17 <br />18 <br />19 <br />20 <br /> <br />~~ I <br /> <br />~~ EMERGENCY CONTACT 12: <br />25 <br /> <br />~~ IlJM ff1 crA (' 4A V <br />28 T <br />29 <br /> <br />~~ Chemical NameJAHMONIUM HYDROXIDE <br />32 Y 1 <br />~~ Delete? 0 I <br /> <br />35 <br />36 Locat ions: <br />37 diked storage tank <br /> <br />~: I <br /> <br />40 <br />41 Y N Y N Y N <br /> <br />42 Site Plan 0 lID Trade Secret 0 lID Pure 0 lliI <br />43 <br />44 YN YN <br /> <br />45 Fire 0 lID Pr.ssur. Release 0 lID <br />46 <br />47 <br />48 Chemical <br />49 <br />50 Delete? <br />51 . <br />52 <br />53 Locations: <br />54 isolated exterior room inside building <br /> <br />~: I <br /> <br />57 <br />58 Y N Y N Y .N <br /> <br />59 Site Plan 0 1m Trade Secret 0 lID Pure 0 [!!] <br />60 <br />61 Y N Y N <br /> <br />62 Fire 0 lID Pressure R.lease [i] 0 <br />63 <br />64 <br />65 Hav. you changed any infor..ation on this report? YES iii NO [] <br />66 <br />67 CERTIFICATION; <br />68 submitted in this and all attached documents, and that based on .y i <br />69 ing the infor..ation, I believe that the subNitted information is tn <br />70 <br /> <br />:: I htl/j/f I ~~r--ILv k; j,fv I1frl <br /> <br />74 Name and offic~al title of owneq/operator OR Signa ure <br />75 operator's authorized representative. <br />76 <br />77 <br />78 <br /> <br />7: PAGE GJ OF [II <br /> <br />STATE vF MINNESOTA <br />DEPARTMENT OF PUBLIC SAFETY <br />EMERGENCY RESPONSE COMMISSION <br />1(12) 643-3000 <br /> <br />r- SECTION 312 TIER TWO ~ ERC IDI <br />I TURNAROUND REPO 1~ 19" <br />REPORT DATE 02/0 '~~ <br />SIC CODE: 3679 <br /> <br /> <br /> <br />COUNTY:RAHSEY <br /> <br />NO I1a <br /> <br />I I <br /> <br />REPORT/FEE CONTACT: DAN MCCARTHY <br /> <br />II <br /> <br />FACILITY ADDRESS:1633 TERRACE DRV <br />CITY STATE ZIP: ROSEVILLE <br /> <br />EMERGENCY CONTACT 11: <br />BRIAN MOYNIHAN <br /> <br />CONTACT ADDRESS: 1633 TERRACE DRV <br /> <br />MN <br /> <br />55113 <br /> <br />6121636-1011 <br />II ~'~/930 - '?6..~~;j CONTACT CITY ST ATE ZIP: ROSEVILLE <br />. . I . <br /> <br />MN <br /> <br />55113 <br /> <br />Iltl-'/936" <n.s~ I <br /> <br />REPORT/FEE CONTACT PHONE: <br /> <br />612/636-1011 <br /> <br />011 <br />II <br /> <br />CAS: <br />1336-21-6 <br /> <br />Max: <br />4 <br /> <br />Avg. : <br />4 <br /> <br />Days: <br />365 <br /> <br />II <br /> <br />II <br /> <br />II <br /> <br />Storage Codes: <br /> <br />II <br /> <br />II <br /> <br />A14 <br /> <br />10000 <br /> <br />Y <br />Mixture 00 <br /> <br />Y N <br /> <br />Reactivity 0 liD I.....diat. <br /> <br />N YN YN YN YN <br />o Solid 0 lID Liquid 00 0 G~s 0 lID EHS 0 liD <br />Y .N Y N <br />Heal th 00 0 Delayed Health 0 liD <br /> <br />Y N <br />Haz-Componen~s 0 I!D <br /> <br />N~me ~ CHLORINE <br /> <br />01 <br /> <br />011 <br />II <br /> <br />CAS: <br />7782-50-5 <br /> <br />Max: <br />4 <br /> <br />Avg.: <br />3 <br /> <br />Days: <br />365 <br /> <br />II <br /> <br />II <br /> <br />II <br /> <br />I <br /> <br />Storage Codes: <br />Ll4 - - - <br /> <br />II <br /> <br />II <br /> <br />10000 <br /> <br />Y N Y <br />Mixture 0 1m Solid 0 <br />Y N Y <br />Reactivity 0 lID IIImediate Health [i] <br /> <br />N YN YN YN <br />lID Liquid rn 0 Gas rn 0 EHS I!J 0 <br />N Y N Y N <br />o D.layed Health 0 lID Haz-Components 0 lID <br /> <br /> <br />~ <br /> <br />L <br /> <br />.J <br /> <br />~ <br />)< <br />.. <br />~ <br />