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Home My WebLink AboutApplication APPLICANT 6/30/2008 ~ City of Spnngfleld Development Services Department 225 Fifth Street Spnngfleld, OR 97477 SPRINGFIELD ~,., \ Drinking Water Protection Overlay District Development Applicant Name: Dick Beemer Icompany: IAddress: , IAPPlicant's Rep.: Icompany: IAddress: , I Property Owner: McGlade & Alberts LLC Icompany: IAddress: 4055 SDnnq Blvd Euqene. OR 97405 I IASSESSOR'S MAP NO: 17-02-31-00 ITAX LOT NOeS): 501 I Property Address: 130 S 32nd Street. Spnnqfield. OR 97477 ISize of Property: 496 , IZOning: I Existing Use: Vacant I Description of If you are filling In this form by hand, please attach your proposal descnpt,on to this appl'catlon Proposal: 521-1818 Beemer Enterpnses 4078 N Clarey, Euqene. OR 97402 Phone: Fax: Phone: Fax: Acres ~ Sauare Feet D Community Commercial (CC) . -, -. . ..- . . ~ . . Associated Cases: "DC2-C2e50c' - ~1 y (sr:f--. ') lease No.: 1)'~cz_fbtO-6OLf-j~ I Date: ~/YD leA::, I Reviewed by: ~ I a 0.$2 I . . 6D I Application Fee: $/ q 0 Technical Fee: $ '-11 Postaae Fee: $0 ITOTAL FEES: $ !; 0 31. 50 I PROJECT NUMBER: cP (4j~- ~'D:l{,=r IL'}}f, "~-', ~~~J~"-~~-1J~~~0-.L......';~jL-LL::ll~--,2,.,~uare~:~~;:;~.j:;:;d!3!:M--~~'",- ".t:."'----.-.:zJ.~ -..::..'-. iL ___I Vll:0 - i G1u..- C--\- JUN 3 0 2008 Onglnal Submittal Revised 1/1/08 Molly Markanan 1 of 5 Signatures Applicant: Owner: The undersigned acknowledges that the information In thIs application IS correct and accurate 7: wfJ a. E .ft(/~ Signature ~\W-~ C;. \3t.WVlL- Print Date: '- - Z 7 . 0 8 If the applicant 1$ not the owner, the owner hereby grants permiSSion for the applicant to act In his/her behalf (J-, uu~ Signature {t, wl/~/~ Print Revised 1/1/08 Molly Markanan Date: b/~~job \ (, '\. Date Received' JUN 3 0 2008 Onglnal Submittal 2 of 5 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone ~ l' of Spnngfield Official ReceIpt ,~~velopment ServIces Department PublIc Works Department RECEIPT #. 3200800000000000447 Date. 06/30/2008 2 12 I2PM Job/Joul n.l1 Number DRC2008-00041 DRC2008-0004 I DescnptlOn CTY Dnnkmg Water ProtectIOn + 5% Technology Fee Payments fYPl of Paymlnt Check P..d By BINEHAM CONSTRUCTION Item Total Check Number AuthOrizatIOn Received By Batch Number Number How Received Amount Due 990 00 4950 $1,03950 Amount Paid tJ 30384 In Person Payment Total $1,03950 $1,03950 Date Received: JUN 3 0 2008 Onglnal Submltta' cRLlemll Page 1 of 1 6/30/2008 CITY OF SPRINGFIELD VICINITY MAP DRC2008-00041 130 S 320d Street n...-..' n'.' ,.. -. . - - ~ f Ll1N-sTl 1 ~ Sll~ Map 17-02-31-00 Tax Lot 501 North + uj d 2'i ~ I ./1 J. en LLW I .: Date Received: JUN 3 0 2008 Original submitt'" -----____~------~-------- rPROPOSED BIG TOWN -Hfp I,:L J -l(---:'~-- _ ~ ._ __:ERO - -- 1-1::) ...._~".. -\' dJ i 1- ' l..t-r, I I ~.-' nH-! ., -" rr~'~.: - I ~ -I"', :L~z~~ - ~... ~:: . :~~~~~~ ,., ,I;...: ,:~>,~:.aq. '.- J..~t: . ~~r~~~~-" 1fUrII'rl 'I r.;rbll"lil~I.\II~'D: ~ t :1: ~ __J!: ~I!- ~~ - T--t~ ....- Y , , ' t~ltt ,/" ,',....---------'-.-:~:::~~~---~7-.J 1', " -. +__1:- t / -~ ;~~\ .----~--~ti;~i-~ - - +.~~ .' ~-.:-.:--11-r~ ~ ~ t ~h__~ I: :: . . 77/7H'l t I /:,11 .~ t----: Q.......u... ' L__~ .hh__ .nt ----- 'W' ------------ , -- lJo.. '. .,~~ ~ ~ ~ Jt. - - ''''-.. . . . . ,,- i::r--':'i--.:"["---T-.. I I I I I I I I I r , I 1 I I ,... I , I I , , . ~ : , , .. , ~: I~Jt.:~~-~-~:~'\i ...., I ~~ fJ:- : , , , , , . , , Ii i I t .., , MAIN STREET rf) ) . ... '. v. '. "", Date Received: JuN 3 6 2600 Original submittal- ~ - " 1~ ~ t _I ~ ---,~ '. ~ t I .1.,___n";r" , .... I J II, I' II h rt -".. ... . .. .. ------- t\~7 . rf t i" .~!::J I' I .... -. I.! III 10 YR TOTZ I r ~~'1-~'" -- ~ -,:'. I~i " . 1'~ , ~.J."--:-~ t I I -". " ^",_.. .. '. " t! N" 20 YR TOTZJ f--.~ j'" ,<__ ' 'II:!!" '1lU . .... VICINITY \'I . H~ " ~!:. <<l ~ Ii!; !'i '", S.i. - ~ i~ .2: 0 III li::o' o ~ ; It ,I I. " I; ~ I o I;; ~ :x: ~ ~ t ~ S bo,;;"O ~ ... ! ... .S> ol :!l ~ ~ J~II!JJ 'I' Ii"! <i ~ ! ~ I I SH7ET Df I c:::r a4-K41tS" fUllS 3t1~ 66 RETURN TO CASCA~ ., (LE CO r Date Received. /7 D2.. 3r 4I'5a , Unl1l a change IS requested, all tax statements shall be sent to JUN 3 0 2008 Maal Properties, LLC 4055 Spnng Boulevard Eugene, OR 97405 After recordmg return to Onglnal Submittal , Division of Chief Deputy Clerk ~nn~lnl~n1 Lane County Deeds and Records 'UUV- U ,~ 11111" 111111111111111111 1111111111111111111 $36,00 00767119210..0,0129,;)03",031 12/21/200501:14:18 PM RPR-DEED Cnt=l Stn=l CASHIER 05 $15.00 $11 00 $10.00 Maal Properties, LLC 4055 Spnng Boulevard Eugene, OR 97405 ()k/ STATUTORY WARRANTY DEED ~ Maal Properl1es, LLC, Grantor, conveys and warrants to Alberts Development, LLC, an Oregon limited liability company, Grantee, an undivided one-half (\1,)' mterest m the real property descnbed on the attached Exhibit A (the "Property"), free of encumbrances except all covenants, condll1ons, reslncl1ons, encumbrances and liens, If any, affecl1ng l1tle whICh appear m the public records and any of those VISible from a phYSical exammatlOn of the Property and the followmg addll10nal conditIOn Deed of Trust, including the terms and prOVISIOns thereof. executed by Maal PropertIes. LLC. an Oregon ilmlted lzabzllty company. as Grantor(s). to FIrst Amencan Title Insurance Company. as Trustee, for the benefit oj Umpqua Bank, as Beneficzary, dated October 15, 2004, Recorded October 29, 2004. ReceptIOn No 2004-084171, Officzal Records of Lane County. Oregon, gIven to secure payment ofa Notefor $1.025.000 00 The true and actual conslderal1on for thiS conveyance IS $977,900 THIS INSTRUMENT WILL NOT ALLOW USE OF THE PROPERTY DESCRIBED IN THIS INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS AND REGULATIONS BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK WITH THE APPROPRI- ATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY APPROVED USES AND TO DETERMINE ANY LIMITS ON LAWSUITS AGAINST FARMING OR FOREST PRACTICES AS DEFINED IN ORS 30 930 THE PROPERTY DESCRIBED IN THIS INSTRUMENT MAY NOT BE WITHIN A FIRE PROTECTION DISTRICT PROTECTING STRUCTURES THE PROPERTY IS SUBJECT TO LAND USE LAWS AND REGULATIONS, WHICH, IN FARM OR FOREST ZONES, MAY NOT AUTHORIZE CONSTRUCTION OR SITING OF A RESIDENCE AND WHICH LIMIT LAWSUITS AGAINST FARMING OR FOREST PRACTICES AS DEFINED IN ORS 30 930 IN ALL ZONES BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK WITH THE STATUTORY WARRANTY DEED -1 N \K - O\McGlade. Charles T 15381\Mam & 32nd Street Property I 5381-2\Documents\Deed 111405 clean doc , , r APPROPRIATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY APPROVED USES AND EXISTENCE OF FIRE PROTECTION FOR STRUCTURES DATED /1.---[1.-- ,2005 MAAL PR,ojE(irrS, LLC By 1/ I ( iJ ib ).y Veronica Atfero, Trustee ofthe Veronica Alfero Trust, Member STATE OF OREGON ) ) ss COUNTY OF LANE ) J (j I On thiS (2-6 day of ~ 2005, before me personally appeared Veromca Alfero, Trustee of the Veromca Alfero Trust for Maal Properties, LLC, who beIng duly sworn acknowledged the foregoIng Instrument to be his YO ntary act l~:~~:' '[;roo ~ Date Received JUN 3 0 2008 Ongmal Submittal STATUTORY WARRANTY DEED - 2 N \K ~ O\McGladc=, Charles T IS381\M:am & 32nd Street Property I 5381-2\Documents\Dced 111405 clean doc . .. EXHIBIT A Parcell of Land Partition Plat No 2002-PI597, Lane County PartitIOn Records III Lane County, Oregon EXCEPT that portIOn conveyed to the City of Spnngfield by Deed Recorded Apn126, 2004, ReceptIOn No 2004-030403, Lane County Oregon Deed Records Date Received JUN 3 0 2008 Ongmal Suomi!!..: STATUTORY WARRANTY DEED - 3 N \K - O\McGlade, Charles T 15381\Mam & 32nd Street Property lS381.2\Documents\Deed 111405 clean doc JUN-l0-200B 10 53 JIm HIggIns 541 4B5 0307 P 02 - CASCADE Trn.e co. ImIIW~imm~ml!m~~~ PRELIMINARY TITLE REPORT SUPPLEMENTAL ~BERTS DEVELOPMENT, LLC ATTN TODD ~BERTS, MANAGER POBOX 10545 EUGENE, OR 97440 June 09, 2008 Report No 0251943 Your No Seller Buyer MCGLADE & ALBERTS, LLC TO COME PRELIMINARY REPORT FOR Owner's Standard Pol~cy $T/C PREMIUMS Owner's Standard Prem~um Government Servlce Fee Temporary B,ll,ng $T/C $25 00 $225 00 We are prepared to ,ssue 2006 (6/17/06) ALTA t,t1e ,nsuranCe pol,cy(ies) of CHICAGO TITLE INSURANCE COMPANY of OREGON, ,n the usual form ,nsur,ng the t,tle to the land descr,bed as follows parcel 1 of Land Part:Lt,on plat No 2002-P1597, recorded August 30, 2002, Receptlon No 2020-067378, Lane County DeedB and Records EXCEPT THEREFROM that portlon descrlbea In Deed to the C,ty of Sprlngfleld, recorded Aprll 26, 2004, Recept~on No 2004-030403, Lane County Deeds and Records Vescee Date Received MCGLADE & ALBERTS LLC an Oregon lImIted lIabIlIty company JUN 3 0 2008 DATED AS OF JUNE 04, 2008 AT 8 00 A M Onglnal Submittal Schedule B of the P01~CY{les) to be lssued wl11 contaln the Eollow~ng general and special except10ns unless removed prlor to lssuance GENERAL EXCEPTrONS (Standard Coverage POllCY Except,ons) 1 Ta.xes or assessments which are not shown as eX1st1ng liens by the records of any taxi'19 author.l.t.y that levies taxes or assessments on real property or by the PubllC Records proceedlngs by a pub11c agency Wh1Ch may result in taxes or assessments, or not1ces of such proceedings, whether or not shown by the records of such agency Or by the Publ1c Records 2 Facts, r1ghts, lnterests or cla1ms whleh are not shown by the public Records but Wh1Ch could be ascerta1ned by an inspect~on of the Land or by maklng lnqu1ry of persons In posseSS1on thereOf No ltablilly IS assumed hereunder until polIcy has been Issued and full poltcy pi enlIum has been pard MAr>> OFFrCE . 8ll WrLLAMETTE ST FLORE>>CE . 1901 HWY 101 - S 2 EUGENE FAX' 485-0307' E-~IL: · EUC;:E>>E, OREGON 97401' PH. (541) . FLORENCE, OREGON 97439 . PH: (541) 1nfo@caBcBde~itIB.com . FLORENCE FAX. 687-2233 997-8417 997-8246 JUN-I0-200S 10 53 JIm HIgglns 541 4S5 0307 P 03 Order No Page 2 0251943 3 Easements. or claIms of easement, not shown by the PublIc Records, reservatIons or exceptIons in pacents or J.n Acts authorlZ:1.ng the Issuance thereof, water rIghts, claIms or tltle to water 4 Any encroachment, encumbrance, vIolatIon I varIatIon, or adverse CIrcumstance aftectlng the Tltle that would be dlsclosed by an accurate and complete land survey of the Land 5 Any lIen, or I"l.ght to a llen, for services, labor, mater~alt equIpment rental or workers compensatIon heretofore or hereafter furn~shedl lmposed by law and not shown by the Publ,c Records SPECIAL EXCEPTIONS 6 Easement, includIng the terms and prOVIsIons thereof, granted CIty of Sprlngfleld, oy lnstrument recorded October 20, 1997, Receptlon No 9771235, Lane Cou~ty Offlclal Recorda 7 Easements, notes, cond~tlons and restr1ctlons shown, set forth, and/or de12neated on the recorded Partit~on plat 8 Declaration of Eaeement (storm draln), lnc1udlng the terme and provie~one thereof, recorded August 30, 2002, Recept20n No 2002-067380, Lan@ County Off~c~al Records 9 Declaratlon of Easement (vehlcle and pedestrian access), lncludlng the terms and provlslons th~reof, recorded Aug~st 30,2002, ReceptlonNo 2002-067382, Lane County Offlcial Recorde 10 Declaratlon of Easement (parklng)I lncluding the terms and provlslons thereof, recorded August 30, 2002, Reception No 2002-007382, Lane County Ortlclal Recorae 11 Terms and provlslons of Easement Agreement, recorded May 30, 2003, Recepelon No 2003-049379, Lane county Offlclal Records 12 Easement, lncludlng the terms and prOV1Slons thereof, granted Clty of Sprlngf2eld, by lnstrument recorded Aprll 26, 2004, Receptlon No 2004-030403, Lane County Offlclal Records 13 Easement, lncludlng the terms and prov~s~ons thereof, granted C~ty of Sprlngf1eldl by ~nstrument recorded May 14, 2004, Recept~on No 2004-036268, Lane County Offlclal Records 14 Terms and provieions of Declaratlon of Eaaement, recorded December 23. 2004, Recept lOn No 2004-097587, Lane County Offlcla1 Recorde 15 Terms and proviS1.0ns of Declaratlon of Easement, recorded December 23, 2004, Receptlon No 2004-097588, Lane County Off1c~al Records. 16 Deed of Trust (Llne of Credlt), 1nc1uding the terms and provlB1ons thereof, executed by McGlade & Alberts, LLC, an Oregon Ilm1ted 12abll~ty Company, Grantor, to F2rst Amerlcan Tltle Insurance Company I Trusteel for the benef1t of Umpqua Bank, Benefl.c1.ary, dated November 16, 2007, recorded November 20, 2007, ReCeptlon No 2007-077952, Lane County Off1clal Records, to SeCure payment of a note In the amount of $3,0001000 00 17 Aseignment of rents due or to become due and aCCrulng from said property, lncludlng the terms and proviaions thereof, from MCGa1de & Alberts, LLC, an Oregon llmlted llaolllty company, to Umpqua Bank, dated November 16. 2007, recorded November 20, 2007, Receptlon No 2007-077953, Lane COU'"lty Off1cla1 Recorda Date Received JUN 3 0 2008 OnQII'FlI SubmlttaL___ JUN-l0-200B 10 53 JIm HIggIns 541 4B5 0307 P 04 Order No page 3 0251943 18 Fl.na.nclng Statement recorded November 20, 2007. Recept~on No. 2007~077Si54, Lane County Off~clal Records, 11StS MeGlade &Alberts, LLC, as Debtor, and Umpqua Ban</ as Credltor, with securlty lntormatlon obta1nable trom cred1tor 19 A copy of the Artlcles of OrganlZatlon and/or Operatlng Agreement of MCGlade & Alberts, LLC should be furnlshed to Cascade T1tle Company for the purpose of ascertaln1ng members authorlzed to execute on behalf of the Llmlted Llabl11ty Company NOTE Taxes, Account No 1699527, Assessor's Map No 17 02 31, #501, Code 19-00, 2007-2008, 1n the amount of $14,380 05, PAID IN FULL NOTE As of the date hereof, there are no matters agalnst MCGLADE & ALBERTS, LLC, AN OREGO"! LIMITED LIABILITY COMPANY, wh1ch would appear as except10ns 10 the POllCY to lssue, except as shown herein NOTE The POllCY to be lssued may contain an arh1trat1on clause When the Amount ot Insurance 15 less than the amount, If any, set forth ~n the arbitratlon clause, all arbltrab1e matters shall be arbltrated at the opt1on of elther the Company or the Insured as the excluslve remedy of the partles Th1.S report :La prellminary to the lSBuance of a pol~cy of t~tle lnsurance and shall become null and vOld unless a POllCY >s >ssued and the full prem>um pald Cascade T~tle Co. /' By . _1.:. _~ bL4-~ V' ,lv~ kd Title Off>cer' JIM HIGGINS cc MAAL PROPERTIES, LLC ATTN CHARLES T MCGLADE, M D 4055 SPRING BOULEVARD EUGENE, OR 97405 cc OLSON & MOR~IS SURVEYORS FAX NO 541-485-3253 Date Received: JUN 3 0 2008 Onglnal suomntaL_- JUN-l0-2008 10 54 JIm HIggins ~ r II ",,~ ~_~_'1~'2"_: -g~~fJ~~! i ~ 7 ~L "C II 1.... 5.32 AC ~ I .tCl^^ . ~2 --;.;;:::-- ~~I -;r.es. ~PARCEl 2 I f~OM:c: 1J ..~lJ ...;; ~ ~. 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S B~7~~:7' - III ~ r I "<III,., I ~ ~R:) S 0010 I) V . .~ -,-, .INDus- --------------]J- ~ 1 64 AC · ~ $ ... ""AL{ "'lflf'_ ,2..LO<> :. ~..~.,~" - "-~-" I '((", 502 - --- oI,:-l 3400 1:1 601 <:: 975 AC 115 59 AC " 11 64 AC ~ PCL 2 j I tl ~ I .1 Ilil ~ I 5.32058 [J1 ' I ~/'!I :: ,: L - - -r I ~ ~ " :" f 34G-1 II I ,l: ; I l r ); .:" I I' 'J Y ~'4'b'7'~~ I~:' ~ \ ; 1/,,," \ ' /..; . ~~ ~ \ , ~""~ ..vr'>J' \. ~ ...il' .vr.~, ... 9. .4I'c!S' ~~:-..... 7 "70,-I~ ~~ 6. -- .J.T-14... - '1:3'ds. ~4q" ~'lt. o.'JO'o"J'... _ ,~~ C" <1_". ....'Z I') :l . ; 1 ~N 89''''9 ~7' v III S'3 of' .,. V _ c7lDO 53100 "'200' $.37679 $ 00'10 13 ~ 503 19.20 AC peL 3 ~ ~,j.. S '.It m '" ~ 541 485 0307 P 05 ~~1l ~~ - /0 Z /;= iL ~ . ~ , -.l :'~) o n: t<) ,..., . ,I' II I II I. " , SEE Mt I MCKr .,. 02 31 17 OREGON 1 S,EEJ\4AP '- - ~ ) '~ ,..::.; , 17 02 31 .. ~: II\-Dc-?J J Date Recelved~~~p~~~ liH~OC~~~~~Ty ~~~~T~~~ NO LIABILITY FOR INACCURACIES, JUN 3 0 2008 Onglnal Submittal SEE I TOTAL P 05 Big Town Hero Hazardous Material Plan' Big Town Hero operatIOns mclude few hazardous materials The mam chemICals used are dish soap and quaternary samtlzel These me used as part of a dispenser system, where the chermcdl contamers are plugged mto the dispenser and rmxed with water at preset levels TIle vendor's techniCians check the system about once every two months There would only be a couple of contmners With a volume of 96 flUid ounces each at a bme DocumentatIOn for the chemicals IS attached Other chermcals mclude bathroom cleaner, wmdow cleaner, toner mld other usual office supplies purchased off-Site for on-site use Such materials are retail Sized Our understanding IS that such materials are exempt Date Received JUN 3 0 2008 Ongll"al Sutm,tt~, ~ 920965-Q3 MATERIAL SAFETY DATA SHEET USA MEDICAL EMERGENCIES ONLY (24 Hour ServlCe) 1-800-328-Q026 MedJcal Calls from Outside of the USA 1-651-222-5352 INSTITUTIONAL DIVISION EcoJah lnc Ecolab Center SL Paul MN 55102 Product Information 1-800-352-5326 Issue Date August] 3,2002 I 0 IDENTIFICA nON I I I Product Name KEYSTONE QUATERNARY DETERGENT/DISINFECTANT 1 2 Product Type Quat Detergent DlSlnfectant - EP A No 303-209-1677 1 3 Hazard Ratll1g Health 3 FJre J React!vJty 0 Substances Subject to SARA 313 Reportmg Are Inchcated by "II" 20 HAZARDOUS COMPONENTS I (m mglm3) CAS No %PELTWA 2 1 Quatelllary ammOnlum chlonde compounds mIxture 5-20 No No 22 Ethanol (ethyl alcohol) 64-17-5 1-5 ]900 1880 23 SurfaclJlJ1t 2605-78-91-5 No No 24 Chelaung ogenl64-02-8 1-5 No No PEL = OSHA B ]lOur average In alrTWA = ACGIH 8 hour average In alT 3 0 PHYSICAL DATA I 3 1 Appearance Clear gree'1 hqUld, fresh floral fragrance 3 2 SolubilIty In Water MlXe~ With water m all proportIons 3 3 pH 73 - 8 I (olI00%), 7 6 - 8 6 (at I 256 mluuon) 3 4lruual BOIbug Pomt 212 deg F 1100 deg C 35 SpeCIfic GraVIty I DID @ 68 deg F I 20 deg C 4 0 F1RE AND EXPLOSION DATA I 4 1 Specml Fn"C Hazards May flash, but does not support combUSTIon 42 FJre FIghtmg Methods Use method appropnate for surroundmg fire 43 Flash Pornt Notdetemuned, Ethanol flashes at58 deg F /13 deg C 50 REACTIVITY DATAl 5 1 StabIlity Stable under normal condlnons of use and handllllg 5 2 Condll.lons to Avoid Antonlc surfactants reduce effectiveness of quat compounds Use only accordmg to label duectJOns 60 SPILL OR LEAK PROCEDURES I WEAR PROPER PROTECTIVE EQUIPMENT 6 1 Cleanup DIke or dam large spIlls Pump to contamers or soak up on mert absOlbent Flush reSIdue or small spIlls to samtary sewer 62 Waste DISpOSaJ Consult state/locnl authorIty for Inmts on chemical waste dISpOSal ---- --------------- 7 o HEALTH HAZARD DATA I DANGER 7 1 Effects of Overexposure to Concentrate Eyes Causes severe IITltntlOn Untreated contact may cause cherrucal bums, pelmanent dama~e, or blmdness Skm Causes moderate to severe Imtabon Untreated contact may cause severe untatJon or chemlcol bums If Swallowed HannfuJ May cause chemIcal bums of mouth, throat and stomach If Inhaled Mlsts may cause llT1tntlon to mouth, throat, or lungs 8 0 FIRST AID I 8 1 Eyes Flush at once With cool runnmg water Remove contact lenses and contmue flushmg for 15 mmutes, holdmg eyelIds apart. so as to IIDse enUre eye SEEK MEDICAL ATTENTION IMMEDIATELY 82 Skm Immedtately flush slan WIth plenty of cool runnmg water for at least 15 nunutes wbIle removIng contanunated clothIng and shoes DISCatd or wash before reuse 8 3 If Swallowed RInse mouth at once, then dnnk 1 or 2 large glasses of water DO NOT mduce vomltmg NEVJ:R gIVe anythmg by mouth to an unconscIous person 84 If Inbaled Immechately move to fresh OIT IMMEDIATELY CALL TIlE MEDICAL EMERGENCY NUMBER, 1-80D--328-Q026, A POISON CONTROL CENTCR, OR A PHYSICIAN 9 0 FROTECTIVE MEASURES I Date ReceIved JUN 3 0 2008 Onglnsl Submittal ---~.._- 1 " 9 I FOR CONCENTRATE Eyes Wear chemIcal spla<;h goggles SIan Wear any JmpervlOllS glove ReSplffitory AVOId breathIng mIsts or vapors of tIlls product 100 ADDITIONAL INFORMATION I 101 Purpose of 8/J3f20021ssue COITect hne ] 3 and sectIon 2, QC and edJtonal update Replaces November 5, 1998 Issue KEEP OUT OF REACH OF CHILDREN The above mfonnauon IS belteved to be correct With respect to the formula used to manufacture lhe product m the country of anglO As ddta, standards, and reguJatlOns change, and COl1dltlOns of use and handlmg are beyond our control, NO WARRANTY, EXPRESS OR IMPLlED, IS MADE AS TO THE COMPLETENESS OR CONTINUING ACCURACY OF THIS INTORMA TION Date Received JUN 3 0 2008 Onglnal Submittal 2 1<" 917948-01 MATERIAL SAFETY DATA SHEET USA MEDICAL EMERGENCIES ONLY (24 Hour Semce) 1-800-328-0026 MedIcal Calls from Outside oflbe USA 1-651-222-5352 INSTITUTIONAL DIVISION Ecolah Inc Ecolab CenterSL Paul MN 55102 Product lnfomlsl.1on 1-800-352-5326 Issue Date March] 8, 2002 I 0 IDENTIFICATION I I I Product Name KEYSTONE ULTRA POT &PAN DETERGENT 1 2 Product Type LiqUid Manual Warewash Detergent Concentrate 1 3 Hazard Ratmg Health 2 Fll'e 0 ReactiVity 0 Substances Subject to SARA 313 Reportmg Are IndIcated by n/P' 20 HAZARDOUS COMPONENTS I (m mg/m3) CAS No %PELTWA 2 1 Nomomc sUlfactants mixture 5-20 No No 22 Amomc surfactants mixture 20-50 No No PEL = OSHA 8 hour average In an TW A = ACGIH 8 hour average In au 30 PHYSICAL DATA I 3 1 Appearance Clear bluc hqUld, CitruS fragrance 3 2 Solublhty m Water MIxes with water In all proportions 3 3 pH 65 - 8 0 (at 100%) 34 Imoa1 B01hngPomt >212 deg F /100 deg C 35 SpecJfic GI1lVlly I 080 @ 68 deg F 120 deg C 4 0 FIRE AND EXPLOSION DATA I 4 J Spec131 Fire Hazards None, does not support combustlon 42 FIre Flghtmg Methods Use method approprIate for surroundmg fIre 5 o REACTIVITY DATA I 5 1 StabIlity Stable under nonna! condlbons of use and handlmg 52 CondItIons to AVOld Do notfilx with other chemlcaJs Use standard hyglene practIces to mamtam product 11ltegnty 60 SPD..L OR LEAK PROCEDURES I USE PROPER PROTECTIVE EQUIPMENT 6 1 Cleanup Small amounts may be sewered DIke or dam large spllls Pump to contamers or soak up on mert absorbent Flush reSidue small spIlls to samtary s~wer 62 Waste DIsposal Consult state!JocaJ authonttes for llmlts on chemlcal waste dlsposal ------------.- ----- ~--_._..~_.._---- 70 HEALTH HAZARD DATA I WARNING 7 1 Effects of Overexposure to Concentrate Eyes Causes moderate UTJtal10n Skm May cause IlTltaUOII upon prolonged or repented ex.posure If Swallowed May cause stomach dIsbess, nausea 01 vorrutmg 8 0 FIRST AID I 8 1 Eyes Flush With cool running water Remove contact lenses and contmue flushmg for 15 mmutes 82 Skm Flush slon WIth water, wash With soap and water Remove and wash contammated c10thlllg before reuse 83 If Swdllowed Rmse mouth, then drmk 1 or 2 large glasses of water DO NOT mduce VOmIbng NEVER give anythmg by mouth to an unconscIOus person Date ReceIVed IF lRRIT A nON OR DISCOMFORT PERSIST, CALL A PHYSICIAN 90 PROTECTNE MEASURES I 9 I FOR CONCENTRATE No protecllve equIpment IS necessary under normal use condJt1ons Eyes If splashmg may occur, eye protecUon recommended Skm Rubber gloves reconunended fOl prolonged or repeated exposure JUN 3 0 2008 OnglOal submittal 100 ADDITIONAL INFORMATION I 10 1 Purpose of 3/1812002 Issue Formula change, assOCIated editS Replaces Augusl 21, 2000 Issue 1 KEEP OUT OF REACH OF CHILDREN The above mfonnallon IS beheved to be correct wIth respect to the fonnula used to manufacLllre the product As data, standards and regulatIOns change, and condJuons of use and handlIng are beyond our coutrol, NO WARRANTY, EXPRESS OR IMPLIED, IS MADE AS TO THE COMPLETENESS OR CONTINUING ACCURACY OF THIS INFORMATION 2