Tier II Chemical Inventory Form Instructions - US EPA

1 Page 1 of 11 Instructions TIER II Inventory form Submission of t hi s Tier I I for m (when requested) i s r equired under section 312 of t he E mergency Planning and Community Right -to-Know A ct ( EPCRA) w hi ch was enacted as Title III of t he Superfund Amendments and Reaut horization Act of 1986, Public Law 99-499, 42 Section 11022. The purpose of t his Tier I I for m is t o provide S tate a nd local o fficials and the public w ith specific inf ormation on hazardous c hemicals p resent at y our f acility during the past y ear. CERTIFICATION The owner or o perator o r t he officially designated representative of t he owner or o perator m ust certify tha t a ll i nf ormation inc luded in the Tier I I submission is t rue, accurate, a nd compl ete.

2 On the first page of the Tier I I report, enter y our f ull name and official t itle . Sign your name and enter t he c ur rent date. Also, enter the tot al number o f pages included in the C on fide nt ial a nd Non-Confidential Inf or mation Sheet as well as all attachments. An origina l s ignature is r equired on at l east t he first page of t he submission. Subsequent pages must contain eithe r an or iginal s igna tur e, or a s ignatur e s tamp. Not e: Check with your St ate f or s pecific r equirement s for the submission and certific ation. YOU MUST PROVIDE ALL THE INFORMATION REQUESTED ON THIS form TO FULFILL TIER II REPORTING REQUIREMENTS.

3 This for m may also be u sed as a w orksheet f or compl eting the Tier I for m or m ay be submitted in place of the Tier I for m. Your S tate m ay have specific requirements. WHO MUST S UBMIT T HIS form Section 312 of EPCRA r equires t hat t he owner or operator of a facility submit t heir Tier I I form if s o requested by a S tate e mergency response commission, a loc al emergency pl anning committee, or local f ire department with jurisdiction ov er t he f acility. This request m ay apply to the owner or o perator of any facility that i s required under r egul ation s impl ementing the O ccupational S afety and Health Act of 1970, to prepare o r have a vailable a Material S afety Data Sheet ( MSDS) f or a hazardous Chemical present at t he facility.

4 MSDS requirements a re specified in the Occupation al S afety and Health Admini stration (OSHA) H azard Communication Standard (HCS), f ound in Title 29 of t he C od e of F ederal Regul ations (CFR) a t This for m does not have to be submitt ed if a ll of the c hemicals l ocated at y our f acility are excluded under Section 311(e) o f EPCRA (di scussed below). WHAT C HEMICALS ARE I NCLUDED If you are submitting the Tier I I for m in lieu of Tier I , you must r epor t t he r equired infor mation on this Tier I I for m for each hazardous Chemical pr esent at y our f acility in quantities equal t o or greater t han established threshold amounts (di scussed below), unless the chemicals a re excluded under Section 311(e) o f EPCRA.

5 Hazardous c hemical m eans any hazardous Chemical as defined under 29 CFR ( c) except t hat such term does not i nclude substances excluded from section 311( e), a s di scussed below. If you elect t o submit Tier I rather t ha n Tier I I, you may still be r equired to submit T ier I I inf ormation upon request. Page 2 of 11 WHAT C HEMICALS ARE E XCLUDED Section 311( e) o f EPCRA e xclud es the fol lowing substances: 1) Any food, food additive, color additive, dr ug , or c osmetic regul ated by the Food and Drug Admini stration; 2) Any substance p resent as a solid in any manufactured item to the e xt ent exposure to the s ub-stance does n ot o ccur under normal conditions o f use.

6 3) Any substance t o the e xtent it i s u sed for personal, f amily, or h ousehol d purposes, or is p resent i n the s ame f or m and concentration as a p roduct packaged for di stribution and use by the general public; 4) Any substance t o the e xtent it i s u sed in a research laboratory or a h os pi tal o r o the r medical f acility under t he d irect supervision of a technically qualified indi vidual; a nd 5) Any substance t o the e xtent it i s u sed in routine agricultur al operations or is a fertiliz er he ld for s ale by a r etailer t o the ul timate customer. OSHA r egul ations, Section (b), stipulate exemptions f rom the r equirement t o pr epare to have a vailable an MSDS.

7 REPORTING T HRESHOLDS Minimum thr esholds have been established for Tier I /Tier I I reporting in 40 CFR part 370). The se thresholds are as follows: For Extremely Hazardous S ubstances ( EHSs) designated under EPCRA S ection 302 the reporting thr eshold is 500 pounds (or 2 27 kg.) or the thr eshold planning quantity (TPQ), whi chever i s lower. (EHSs and their TPQs a re lis ted in 40 CFR part 355, Appendix A and B. For g asoline (all g rades combi ned) at a r etail g as station, the t hreshold level i s 75,000 gallon s ( or approx imately 283,900 liters), if t he tank(s) w as stor ed entirely undergrou nd and was in compliance at a ll times during the preceding calendar y ear with all applicable U nderground Stor age Tank (UST) r equirements at 4 0 CFR part 280 or r equirements of the S tate U ST pr og ram approv ed by the A gency under 40 CFR part 281.

8 For diesel f uel ( all g rades combi ned) a t a retail gas station, t he t hreshold level i s 100,000 gallons (or approximately 378,500 liters), if t he tank(s) w as s tored entirely underground and the tank(s) w as in compl iance at a ll times during the pr eceding calendar y ear with all applicable Underground Storage Tank (UST) r equirements at 40 CFR p art 280 or r equirements o f t he S tate UST prog ram approv ed by t he A gency under 40 CFR part 281. Not e: A retail gas s tation means a retail f acility engaged in selling gasoline and/or d iesel fuel princ ipa lly t o the public f or mot or v ehicle use on land.

9 For a ll o the r hazardous chemicals f or w hich facilities are r equired to have or prepare an MSDS, the mini mum reporting threshol d is 10,000 pounds (or kg.) . You need to report h azardo us chemicals tha t were p resent at y our f acility at any time during the p revious calendar y ear at l evels tha t equal or exceed these thresholds. For i nstruc tions on thr eshold determinations for components of mixt ur es, see What A bo ut Mixtur es? i n this document. Not e: St ates m ay have lower reporting thresholds and additional c hemicals covered by the s tate r igh t-to- know r egulat ion s.

10 Con tac t your s tate for any s pecific r equirements for that state. Page 3 of 11 WHEN TO SUBMIT THIS form Owners o r operator s of facilitie s t hat have hazardo us c hemicals p resent at t he f acility in quantities equal to or g reater than set t hreshol d levels m ust s ubmit e ither Tier I or Tier II for m by March 1. Not e: All s tat es c urrently r equire facilities to submit f ederal T ier II i nventory form or t he stat e develop ed form or format i ncluding on- line reporting and certification. Con tac t y our s tate for the specific requirements for tha t s tate. WHERE TO SUBMIT T HIS form Send the compl eted Tier II for m(s) t o each of t he f ollowing or ganizations: 1) Your S tate E mergency R esponse C ommission or E mergency Response C ommission of t he Tribe.