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Home My WebLink AboutApplication APPLICANT 5/18/2009 . I ~ . City of Springfield Development Services Depaltment 225 Fifth Street Springfield, OR p7477 SPRINGFIELD ...,n, ,l ~- Drinking W,ater Protection Overlay District Development Applicant!-lame: Ami Shah on behalf of Walqreen Co. Company: Address: Walg!.~~.!!.. Co. 106 Wilmot Road. MS 1620. Deerfield. IL 60015 Fax: (847) 3~.s-3}87 (847) 315-4900 . ,-,,',:: 'c;. -i: ,,:,,':',:c,\:<tf~::-' !,: :~;".:;;-"-:;:.:,:! .:,'. ':,:-.::;~':.'.; :;-;.','i)"';;; i,'''''-'~~:f:'::~;;,'''.'.,<,}.'~:'y.:'':S ;',:~",.~1;~'.';\".:,\ .?:!.1 ,i:',},-;:Ji'<::':;~;:;: ' .... ,-, ,. ,-""." -,:.:,.. ; t':!:~it;,')~:":;.":,: ;. ,:,::-/:.",~.':;,::"/'.~ :;::; "\{!j:cj "'_".,.("':.):\,-1.~:r.l;::'1'".;;.;;,:o",',.;ia :.,;;,: :,'.',:::~'~Vi;." ;c;- . ~pplicant's Rep.: John M. Souza, PE Phone (206) 447-1450 (206) 374-2279 Company: Address: KTA Associates, Inc. Fax: 800 Fifth Ave. Suite 4100 Seattle, WA 98104 Property Owner: PeaceHealth !companv: Peace Health I !Address: Attn: Services 123 International I TAX LOT NO(S): Phone I Fax: 541-686-7198 541-434-7486 Sorinqfield OR 97477 Property Address: 3377 Riverbend Drive I:,i~~;.e~.~~,~e,~,~,tr,:"."",.;,;,:,~;,;",@",.""""""""".' "'"'''' IZoning: Medical Services Zoninq Existing Use: Vacant Room permitted for Hosoital in-house oharmacy Description 'of If you are filling in this form by hand, please attach your proposal description to this application. Proposal; Walqreens Clinical Pharmacy !Signatures: Please si t . ~ . ~ c . ... ASSESSOR'S MAP NO: 17032200 Sprinqfield, OR ~ 97477 Acres D Lj I 02- Square Feet IX] . ',- '--. ';'.; ; ';".':',,,-,J:<."',,- ':-<'_;':i::~:".'."; __ ~_'i~.;;:j",,':<, ;,.;.:::",'.>~ i.C'" ;';";"':"';"-;.':;1,':;... :../.,,:~....,;;;.:_,.:.. I Associated Cases: Icase No.: D fLL11Jfl- ()([) /q I Date: ,t;Li1/ ()q I Reviewed b~~' 'f11~ IAPPlication Fee: $ 4/ nltJ I Technical Fee:'$ 1<SJOeJ I Postage Fee: $0 IOTAL FEES:$j D7/. O() I PROJECT NUMBER: ;,.~(jf':Wi<\.~I[;:O;:'f;~i"'I:.;.<fi#.?4~"><ff.tA'ji~j'J:ti!ffr",~i)'"JJ:,w!i~!',~~s,"'I:.:ft:lli"'-",.}~;.:;:w~~~~~t.~~Jl'iZ.~';t{i~~its~~~;!~i;'~W!:~7;Y'~~5?f~~'~,,1t~1:l!~~~\;l;;1'~~l,%-}W,"'lI~':;~';~~i.:-~-'t7~';.:'I_'~'!';:'~;;J..Z,!,~~~: Date Received: MAY 1 8 2009 Revised 1/15/09 ddk . Original Submittal J of 5 Signatures .Lhe undersigned acknowledges that the mformatlon In this application is correct and accurate. APPljCant:r~k'\\\~~, -"---J -I~' '-. . . . ( .1'\\\\\\ -...." ')' '),'1 II~, 1/ / 0. L.I / . f\\ I \'\\., __ .21;;:,'/;' . V (..-.--------... . Date: J [t.. 0 J 1-' .~~~ Go . ".----, 'l;l-;:.A s-.'~l V:u ft"t-J1 ~d- tR",l?e~f'\- 1>.... ~'\Vi''''''-f'''<SVI'' Print f If the applicant is Ilot the owiler'~-th"e o~~ner hereby gra'nlS permIssion for the appllcant to act In his/her behalf. Owner: /J1~kJi11LC_I-' ~ ~ s(gnature Mark H. Dahl/Tamara E. Miller Print Date: 4/9/09 Date Received: MAY 18 2009 Original Submittal Revised 1/15/09 ddk' 2 of 5 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone :,ty of Springfield Official Receipt JJevelopment Services Department Public Works Department RECEIPT #: 3200900000000000373 Date: 05/18/2009 9:52:53AM Paid By KT ^ ASSOCIATES Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 1,020.00 51.00 $1,071.00 Job/Journal Number DRC2009-000 19 DRC2009-000 19 Descril>tion CTY Drinking Water Protection + 5% Technology.Fee Payment's: Type of Payment Check Amount Paid emm 2413 In Person Payment Total: $1,071.00 $1,071.00 Date Received: MAY 1 8 2009 Original Submittal cReccintl Page 1 of I 5/18/2009 ~ IzTA A Professional Envir rvice CortJorat10 . . KT A Associates, Inc. 800 5~ Avenue Suite 4100 Seattle, WA 98104 206-447-1450 www.lctainc.net May 13, 2009 City of Springfield Development Services Department Alln: Planning Division 225 Fifth Street Springfield, OR 97477 Re: Drinking Water Protection Overlay District Development Application for the Walgreens Clinical Pharmacy in Springfield, OR Dear Planning Division, We are pleased to provide you with three complete sets of the Drinking Water Protection Overlay District Development Application for the Walgreens Clinical Pharmacy in Springfield, OR (located on the 1 st Floor of the Riverbend Medical Pavilion). Additionally, three sets of related documents, as required by the DWP Overlay District Development Submittal Requirements Checklist, are also included with this Application. The larger document of the two within each set includes both the Hazardo'us Materials Management Plan (HMMP) and the Hazardous Materials Inventory Statement (HMIS) for the Facility. The Application Fee of $1,071.00 is also included in this package. If there's anything that Walgreens or I can do to expedite the review and approval process, please let us know. As a courtesy, J have provided a single copy of all documents to both Springfield Fire and Life Safety and the Springfield Utility Board in addition to the three sets of documents you are receiving. If you have any questions, issues. or concerns, please do not hesitate to contact me directly. Sincerely, KT A Associates, Inc. '" rJ4J1~ Date Received: MAY 1 8 2009 John M. Souza, PE Senior Environmental Engineer Original Submittal Cc: Ami Shah, Walgreen Company SEA TILE PORTLANO DENVER OLYMPIA BOISE May 13, 2009 Walgreens Clinical Pharmacy at Riverbend Medical Pavilion Springfield, Oregon Drinking Water Protection Overlay District Development Application Narrative Applicant: Walgreen Company 106 Wilmot Road, MS 1620 Deerfield,lL 60015 Representative: John M. Souza, PE KTA Associates, Inc. 800 Fifth Avenue, Suite 4100 Seattle, WA 98104 Phone: (206) 447-1450; Fax: (206) 374-2279 isouzalalktainc.net 1. Land Use Reauest The Applicant seeks approval of this Drinking Water Protection (DWP) Overlay District Development Application in support of the project to develop the Walgreens Clinical Pharmacy on the 1 st Floor of the Riverbend Medical Pavilion in Springfield, Oregon (hereinafter referred to as "Walgreens Clinical Pharmacy"). The Walgreens Clinical Pharmacy in Springfield, Oregon will be located on the 1st Floor of the Riverbend Medical Pavilion at 3377 Riverbend Drive. The Riverbend Medical Pavilion, owned by Peace Health, was previously granted Site Plan approval (DRC2006-0059) and DWP Overlay District Development Application approval (DRC2008-00072). In addition, a copy of the deed and preliminary title report for this property was previously submitted to the City as part of the Site Plan approval process for the Riverbend Medical Pavilion by Peace Health. Copies of these documents are also attached to this Application for reference within Attachments 1 and 2. This Application is limited to the Walgreen Company development and operation of the Walgreens Clinical Pharmacy within the vacant 1st Floor room permitted for a Hospital in-house pharmacy in the Riverbend Medical Pavilion. Springfield Development Code (SDC), Chapter 5.1-125 establishes Type I review of the DWP Overlay District Development Application. The Application includes this narrative and all supporting materials consistent with SDC, Chapters 3.3-200 and 5.4-105 and the DWP Overlay District Development Application requirements. Date Received: MAY 1 8 2009 Original Submittal w Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 Page 2 2. Prior Use The DWP Overlay District Development Application requires identification of past uses of hazardous materials on site that pose a risk to groundwater but existed on the property before May 15, 2000. As described in previous Peace Health submittals, the prior property owner of the Peace Health Riverbend property commissioned a Phase 1 Environmental Site Assessment (Omnicon Environmental Management, May 21, 2001) to identify potential environmental exposures on-site. The assessment found that the site has been in small-scale agricultural and rural residential uses, and that past uses have posed no demonstrable risk to groundwater. 3. Sorinafield Deyelooment Code. Chaoter 3.3-200 Springfield Development Code (SDC), Chapter 3.3-200, Drinking Water Protection (DWP) Overlay District, sets forth procedures and standards protecting the City of Springfield's groundwater resources. SDC, Chapters 3.3-210 and 3.3-220 establish Time of Travel Zones (TOTZ) within the City and areas subject to the provisions of SDC, Chapter 3.3-200. For the subject site, the footprint of the Peace Health Riverbend Medical Pavilion property was overlaid onto a digital file taken from the City's adopted Drinking Water Protection Area Maps to illustrate the applicable TOTZ in relation to planned improvements (refer to Attachment 3, which was previously submitted with the Riverbend Medical Pavilion DWP Application). SDC 3.3-220 Time of Trayel Zones The Walgreens Clinical Pharmacy in the Riverbend Medical Pavilion is located within Tax Lot 902 and both the 1-5 year TOTZ and the 5-10 year TOTZ cross this tax lot. SDC, Chapter 3.3-220 C.3. states that for tax lots covering more than one TOTZ, regulations in the more restrictive zone would govern. Therefore, the Walgreens Clinical Pharmacy is governed by the more restrictive provisions of the 1-5 year TOTZ established in the SDC. SDC 3.3-225 Reyiew This DWP Overlay District Development Application is required when criteria under SDC, Chapter 3.3-225 A.1. and 2. are met. Since the subject site previously had agricultural and/or rural residential uses and is now proposed to house a medical services building, the change in land use meets criterion A.1. Although no use, storage, or sale of materials associated with the property's use will pose any risk to groundwater, the proposed use will result in an increase in the quantity of "hazardous materials," which the Code defines as "those chemicals or substances which are physical or health hazards as defined and classified in the Springfield Fire Code..." Because the nature of the use requires materials that are so classified in the Springfield Fire Code, the proposal meets criterion A.2. Having met criteria from SDC, Chapter 3.3-225 A.1. and 2., this Application is therefore required. , Application requirements outlined under SDC, Chapter 3.3-225 D. are addressed below. 1. A Hazardous Materia/Inventory Statement and a Material Safety Data Sheet for any or all materials entered into the Statement unless exempted under Section 3.3-230 of this article. Hazardous material weights shall be converted to volume measurement for purposes of determining amounts - 10 pounds shall be considered equal to 1 gallon as specified in Springfield Fire Code 2703.1.2.; An inventory of hazardous materials is included in tabular format (Hazardous Material Inventory Statement) in Appendix A of the Walgreens Clinical Pharmacy Hazardous Material Management Plan Date Received: MAY I 8 2009 Oriainal S:lIhmitt,,1 . Drinking Water Protection Ovenay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 Page 3 (HMMP), which is included with this Application. Material Safety Data Sheets (MSDSs) for each material or product listed on the HMIS is provided in Appendix B of the Walgreens Clinical Pharmacy HMMP. 2. A list of the chemicals to be monitored through the analysis of groundwater samples and a monitoring schedule if groundwater monitoring is anticipated to be required; There is no need for ongoing groundwater sampling and monitoring at the Walgreens Clinical Pharmacy because no products containing DNAPLs will be used or stored on site, and there will be no releases of hazardous chemicals into the environment that could pose a risk to groundwater quality. 3. A detailed description of the activities conducted at the facility that involve the storage, handling, treatment, use, or production of hazardous materials in quantities greater than the maximum allowable amounts as stated in Section 3.3-235 A.; SDC, Chapter 3.3-235 A.1. establishes quantity limitations for hazardous materials within the 0-1 year TOTZ. No portion of the subject site is within the 0-1 year TOTZ; therefore, the above criterion is not applicable to this project. 4. A description of the primary and secondary containment devices proposed, and, if applicable, clearly identified as to whether the devices will drain to the storm or sanitary sewer; The Walgreens Clinical Pharmacy will provide secondary containment for hazardous materials to be stored at the Walgreens Clinical Pharmacy in accordance with the SDC, Chapter 3-3-200, which incorporates Springfield Fire Code 2704.2.2 by reference. Secondary containment provisions for hazardous materials and applicable personnel training are described in the HMMP. 5. A proposed Hazardous Material Management Plan for the facility that indicates procedures to be followed to prevent, control, collect, and dispose of any unauthorized release of a hazardous material; The attached HMMP describes the procedures for protection, control, collection, and disposal of hazardous materials, including any unauthorized releases of hazardous materials. 6. A description of the procedures for inspection and maintenance of containment devices and emergency equipment; The HMMP outlines the procedures for inspection and maintenance as required. 7. A description of the plan for disposition of unused hazardous materials or hazardous , material waste products over the maximum allowable amounts including the type of transportation and proposed routes. The attached HMMP describes as required above the protocols and procedures for proper disposition of hazardous materials and waste materials. The Walgreens Clinical Pharmacy is unlikely to generate regulated hazardous waste at this time. All expired hazardous materials will be returned to the product vendor. Any hazardous materials or waste materials that must be disposed will be collected by an approved waste material disposal vendor and disposed in accordance with State and local requirements. The waste material disposal vendor will collect these items from the Walgreens Clinical Pharmacy waste material storage area on the Riverbend Medical Pavilion 1st Floor for transport off the Riverbend property via Riverbend Drive and MLK Parkway. Date Received: ' MAY I 8 2009 Original Submittal Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mev 13 2009 Page 4 SDC 3.3-230 Exemptions Prior communications with the Springfield Utility Board staff for the Peace Health Riverbend DWP approval and implementation indicated that materials designed for human consumption, including ingested or administered medications, may be considered exempt from OWP provisions. However, those materials that may be considered hazardous materials would not be exempt from appropriate storage requirements where there is a risk to groundwater. SDC 3.3-235 Standards for Approyal of DWP Oyerlay District Applications Within Time of Trayel Zones Since the 1-5 year TOTZ Standards are applicable to the Walgreens Clinical Pharmacy, the standards in SOC, Chapter 3.3-235 B. apply. 1. The storage, handling, treatment, use, application, or production or otherwise keeping on premises of more than 20 gallons of hazardous materials that pose a risk to groundwater in aggregate quantities not containing DNAPLs are allowed only upon compliance with containment and safety standards specified by the most recent Fire Code adopted by the City. No products containing ONAPLs will be used, stored, or sold at the Walgreens Clinical Pharmacy. Other hazardous materials meeting the above criterion and identified herein shall comply with all containment and safety standards established in the Springfield Fire Code. 2. Unless exempted, all hazardous or other materials that pose a risk to groundwater shall be stored in areas with approved secondary containment in place (Springfield Fire Code 2702.1 and 2704.2.2). As identified in response to SOC, Chapter 3.3-225 0.4. above, secondary containment will be provided as required in accordance with the above criterion. Such containment features within the Walgreens Clinical Pharmacy are outlined in Section 4.0 of the attached HMMP and comply with the above-cited provision in the Springfield Fire Code and this criterion. 3. All new use of DNAPLs shall be prohibited. No products containing ONAPLs will be used, stored, or sold at the Walgreens Clinical Pharmacy, so the proposal complies with the prohibition of this criterion. 4. Any change in type of use or an increase in the maximum daily inventory quantity of any DNAPL shall be considered a new use and shall be prohibited. The proposed medical pharmacy activities at the Walgreens Clinical Pharmacy will not include the use, storage, or sale of any products containing ONAPLs, which is consistent with this criterion. 5. The following certain types of facilities or changes in chemical use and/or storage of hazardous or other materials that pose a risk to groundwater shall be prohibited: a. Hazardous material product pipelines used to transport the hazardous material off of the tax lot where it is produced or used; b. Injection wells, except dry wells for roof drainage; c. Solid waste landfills and transfer stations; d. Fill materials containing hazardous materials; e. Land uses and new facilities that will use, store, treat, handle, and/or prod\ll(e DNAPLs. uate Received: MAY I 8 2009 Original Submittal Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 Page 5 The proposed medical pharmacy activities at the Walgreens Clinical Pharmacy will not include any of the listed activities or facilities, consistent with this criterion. 6. Requirements found in Springfield Fire Code 2704.2.2.5 for a monitoring program and monitoring methods to detect hazardous or other materials in the secondary containment system shall be met for all amounts of hazardous materials that pose a risk to groundwater unless exempted. The attached HMMP includes provisions in Section 4.0 and 7.0 for monitoring methods and monthly inspections. 7. The following requirements for inspection and recordkeeping procedures for monthly in- house inspection and maintenance of containment and emergency equipment for all amounts of hazardous or other materials that pose a risk to groundwater shall be met unless exempted: Schedules and procedures for inspecting safety and monitoring and emergency equipment. The applicant shall develop and follow a written inspection procedure acceptable to the Director for inspecting the facility for events or practices which could lead to unauthorized discharges or hazardous materials. An inspection check sheet shall be developed to be used in conjunction with routine inspections. The check sheet shall provide for the date, time, and location of inspection; note problems and dates and times of corrective actions taken; and include the name of the inspector and the countersignature of the designated safety manager for the facility. The attached HMMP includes provisions in Section 7.0 for monthly inspections and in Section 8.0 for record keeping procedures. Date Received: MAY 1 ~ """'tl I,; .........:J Original SUbmiiiai . Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 ATTACHMENT 1 PROPERTY DEED Date Received: MAY I 8 2CJ9 Original Submittal . Division of Chief Deputy Clerk Lane County Deeds and Records l~~l.~~~m /~, I ' '. After Recording Return to: Roger~.Saydack Arnold Gallagher Saydack Percell Roberts & Potter, PC P.O. Box 1758 Eugene,O,R 97440-1758 11111111111111111111"" 111111 111111111 1111111111 $46,00 00247068200100885720050055 12/31/2001 08:17:26 AM RPR-DEED Cnt=1 Stn=6 CRSHIER 05 $25.00 $11,00 $10.00 Until a Change is Requested Mail Tax Statements To: PeaceHealth, a Washington Non-profit Corporation P.O. Box 1479 Eugene, OR 97440-1479 GRANTOR: Arlie & Company, an Oregon Corporation 722 Country Club Road Eugene, OR 97401 GRANTEE: PeaceHealth, a Washington Non-profit . Corporation P.O. Box 1479 Eugene, OR 97440-1479 After Recording Return To: Western Title & Escrow Company 497 Oakway Rd Suite 340. Eugene OR 97401 &0 -030 3<f 0 I STATUTORY WARRANTY DEED , , " , Arlie & Company, ,an Oregon corporation, hereinafter called Grantor, hereby conveys and warrants to PeaceHealth, a Washington non-profit corporation, hereinafter called Grantee, and all of Grantee's heirs, successors and assigns, all of that certain real property with all tenements, hereditaments and appurtenances thereto belonging or in any wise appertaining, situated in the County of Lane, State of Oregon, described as follows, to-wit: , See Exhibit A attached hereto and by this reference specifically made'a part hereof; together with the Grantor's interest, as Lessor, under any and all leases pertaining thereto. ' To Have and to Hold the same unto the Grantee and Grantee's heirs, successors and assigns forever. And the Grantor hereby covenants to and with the Grantee and Grantee's heirs, successors and assigns that the real property is free from all liens and encumbrances except as shown on Exhibit B'attached hereto. The true and actual consideration for this conveyance stated in terms of dollars is Ten Million Six Hundred Seventy-eight Thousand Six Hundred Seventy-two Dollars ($10,678,672), **which is paid to an accomodator pursuant to an IRS 1031 Exchange. In construing this deed, where the context so requires, the singular includes the plural and all granunatical changes shall be made so that this deed shall apply equally to companies and to individuals. r'" Date Received: STATUTORY WARRANTY DEED-I N:\P -1\PeaceHealtb Oregon Region 13967\Arlie & Company 13967-0004\Docunlenls\Sta1. War.Deed.Parcel A.wpd MAY 1 8 2009 Original Submittal . I' 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 APPROPRIATE 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. IN WITNESS WHEREOF, the Grantor has executed this instlUment effective DG'-El<1 Bt:-J<. 31 . 2001. Grantor: >V)W STATE OF OREGON ) ) ss. County of Lane ) :' \ The foregoing instrument was acknowledged before me this31~day of December, 2001, by SU2"+~Alfi" K. At2l.f/F ,the p~~S,()~r of Arlie & Company, on behalf of the '"",,,"oa . I If Notary~~regon My Commission Expires: ''''---------_.... _.......'..- - -~'~--"-....." 1 ~ N",U^, , , KAREN EICHELBERGER I '-. ..' NOTARY PUBLIC- OREGON I . '. COMMISSION NO, 338910 I , _~1Y_c::~.~I~S!.?t-I.."~P':1~ _rn:.T:.'3.i~ Date Received: ,,.--., MAY 1 8 2009 STATUTORY WARRANTY DEED. 2 N:\P -1\PeaccHealth Oregon Region 13967\Arlie & Company 13967-OOO4\Documenls\SfllI.War.0eed.P:rrce1 A.wpd Original Submitt"'l r---. ! ' ,-r-, , ~'. EXHIBIT A A parcel of land located in the Northeast 1/4 of Section 22, and the Northwest 1/4 of Section 23, Township 17 South, Range 3 West, Willamette Meridian, more particularly described as follows: Commencing at the Northeast corner of the William M. Stevens Donation Land Claim No. 46, Township 17 South, Range 3 West, Willamette Meridian; thence South 260 39' 56" East along the East line of said William M. Stevens Donation Land Claim No. 46, 981.30 feet to the true point of beginning; thence South 260 39' 56" East along said East line, 445.17 feet' to the Northeast corner of that property as described in that deed, recorded on Reel 1747, Instrument No. 92-11169, Lane County Oregon Deed Records; thence leaving said East line South 630 18' 39" West, 225,00 feet to the Northwest corner of that property described in said deed recorded on Reel 1747, Instrument No. 92-11169; thence North 480 25' 14" West, 13,21 feet; thence South 350 II' 420 West, 13.52 feet; thence South 310 36' 210 West, 42.87 feet; thence Southwesterly, 106.97 feet along the arc of a 105.74 foot radius curve right, (the chord of which bears South 520 45' 20" West, 102.47 feet); thence North 890 58' 00" West, 322.04 feet; thence North, 18.21 feet; thence North 890 58' 00" West, 1012.99 feet to a point on the East line of that property conveyed to the City of Springfield as described in that deed recorded ,on Reel 843, Instrument No. 77-22531, Lane County Oregon Deed Records; thence along said East line North 30 53' 37" West, 391.66 feet to a 5/8 inch iron rod marking the Northeast corner of said City of Springfield property; thence South 890 56' 00" West along the North line of said City of Springfield property, 425.58 feet to a 5/8 inch iron rod on the East margin of Game Farm Road (County Road No.3), 30.00 feet from, when measured at right angles' to the centerline of said Game Farm Road; thence North 20 54' 56" West along said East margin, 110.62 feet to a 5/8 inch iron rod; thence North 40 II' 55" West along said East margin 320.76 feet to a 5/8 inch iron rod; thence continuing along said East margin North 890 21' 57" East, 5.00 feet to a point, 35.00 feet from, when measured at right angles to the centerline of said Game Farm Road; thence continuing along said East margin North 40 II' 56" West, 122.68 feet to a 5/8 inch 'iron rod; thence leaving said East margin North 890 59' 16" East, 347.61 feet to a 5/8 inch iron rod; thence North 000 09' 13" East, 65.02 feet to a 5/8 inch iron rod; thence North 000 06' 43" East, 156.20 feet; thence North 890 59' 16" East, 308,00 feet; thence South 260 43' 44" East, 654.70 feet; thence North 890 56' 00" East, 992.70 feet to the point of beginning, in Lane County, Oregon. Date Received: MAY t 8 2009 Original Submittal f', EXHIBIT B The rights of the public in and to that portion of the premises herein described lying within any public road or highway. An easement created by instrument, including the terms and provisions thereof, Recorded. February 29, 1991 Recorder's Reception No. 91-09965 Lane County Oregon Official Records In favor of: City of Springfield An easement created by instrument, including the terms and provisions thereof, Recorded: March 5, 1991 Recorder's Reception No. 91.10574' Lane County Oregon Official Records In favor of: City of Springfield ~. , " An easement created by instrument, including the terms and provisions thereof, Recorded: December 14, 1990 Recorder's Reception No. 90-59952 Lane County' Oregon Official Records In favor of: City of Springfield An easement created by instrument, including the terms and provisions thereof, Recorded: October 22, 1991 Recorder'S Reception No. 91.S08Gl Lane County Oregon Official Records In faVor of: City of Springfield An easement created by instrument, including the terms ana provisions thereof, Recorded. Ausust (;, 1947 in Book 353, Page 220 ( Lane County Oregon Deed Records In favor of: United States of America An easement created by instrument, including the terms and provisions thereof, Recorded: I\Pril 25; 1968 Recorder's Reception No; 22343 Lane County Oregon' Official Records In favor of: City of Eugene ('. Fence line encroachment Engineering Survey along the North line as disclosed-by Branch Date Received: MAY 1 8 2009 Original Submittal r--,. Annexation Agreement, includi.ng the terms and provisions thereof, between the City of Springfield and Ai:1ie " Company, an Oregon ct)rporation, recorded June 8. 200~, Recorder's Reception No. 2001-034714, Lane County Oregon Official Records. Fence line encroachment along che "North line as di.sclosed by Branch Engineering Survey, Project No. 94-157. 1\n.easement created'by instrument, including the terms and provisions thereof. Recorded: April 18, 1977 Recorder's Reception No. 77-22531 Lane County Oregon Official Records In favor of: City of Springfield EasemencB'set forth in that certain Lot'Line Adjustment Deed recorded October 2. '2001, Recorder's Reception No. . 2001~06491!1, Lane County Oregon Official Records. /----\ ,r-~, Date Received: MAY 1 8 2009 Original Submittal Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 ATTACHMENT 2 PRELIMINARY TITLE REPORT Date Received; MAY 1 8 2009 Original Submittal " .~ ver Teen Land Title COtllpany PRELIMINARY TITLE REPORT ( \ TO: KPFF CONSULTING ENGINEERS EMAIL: tod.kelso@kpffcivilpdx.com ATTN: TOD KELSO RE: PEACE HEALTH ~ / Order reports and listing kits online at (www.cvergreenlandtitle.com) :ie&umuj 27,2009 ELT-55927 Date Received: MAY 1 8 Z2:9 Original Submittal Main Office: 1651 Centennial Blvd. Springfield, OR 97477 Phone # (541) 74]-]981 Fax # (541) 741-06]9 Branch Office: 625 Country Club Rd. . EugenE. Oregon 97401 P.O. Box 10211 . Eugene, Oregon 97aao Phone #(541) 687-9794 Fax # (54!) 687-0924- 1651 CENTENNIAL BLVD. . SPRINGFIELD, OR 9747i P.O. BOX 931 . SPRINGFiElD, OR 97477 PHONE: 541.741.19B1 FAX: 541.741.0619 A ~ ~~ ','" ,',-,O",,?; . , ~-...,. ~i "'^ gX~Jg{~~n TITLE INSURANCE SERVICES' ESCROW ClOSINGS ~ 625 COUNTRY ClUB RD. . EUGENE, OR 97401 P.O. BOX 10211 . EUGENE, OR 97440 PHONE: 541.687.9794 FAX: 541.687.0924 February 27, 2009 Our Order No.: EL T -55927 5th SUPPLEMENTAL TITLE REPORT PeaceHealth 123 International Way Springfield, Oregon 97477 Attn: Philip Farrington Estimated Premium for: PARTIAL BILLING $200.00 TOTAL $200.00 Dear Philip' We are prepared to issue on request and on recording of the appropriate documents, a policy or policies as applied for, with coverages as indicated, based on this preliminary report. LEGAL DESCRIPTION: Lot 8, RIVERBEND, PHASE II, as platted and recorded June 3, 2008, Reception No. 2008- 030895, Lane County Oregon Plat Records, in Lane County, Oregon. Showing fee simple title as of February 23,2009, at 8:00 a.m., vested in: PEACEHEALTH, a Washington non-profit corporation Subject only to the exceptions shown herein and to the terms, conditions and exceptions contained in the policy form. No liability is assumed until a full premium has been paid. Date Received: MAY 1 8 2009 CONTINUED Original Submittal .-.- "IN OUR BUSINESS, YOU MATTER MOST" \IVWW .evergreen landtitle.com ELT - 55927 Page 2 SCHEDULE B GENERAL EXCEPTIONS 1. Taxes or assessments which are not shown as existing liens by the records of any taxing authority that levies taxes or assessments on real property or by the public records; proceedings by a public agency which may result in taxes or assessments, or notices of such proceedings, whether or not shown by therecords of such agency or by the public records. 2. Facts, rights, interests or claims which are not shown by the public records but which could be ascertained by an inspection of the land or by making inquiry of persons in possession thereof. 3. Easements, or claims of easement, not shown by the public records; reservations or exceptions in patents or in Acts authorizing the issuance thereof; water rights, claims or title to water. 4. Any encroachment (of existing improvements located on the subject land onto adjoining land or of existing improvements located on adjoining land onto the subject land), encumbrance, violation, variation, or adverse circumstance affecting the title that would be disclosed by an accurate and complete land survey of the subject land, 5. Any lien, or right to a lien, for services, labor, material, equipment rental or workers compensation heretofore or hereafter furnished, imposed by law and not shown by the public records. CURRENT EXCEPTIONS MAY 1 8 2009 Original Submittal ELT - 55927 Page 3 7. Rights ofthe public in any portion of said premises lying within the limits of streets, roads and highways. 8. Any adverse claim based upon the assertion that the location of the McKenzie River has moved and that any portion ofthe subject property has been created by artificial means or has accreted to such portions so created, or based on the provisions ofORS 274.905 through 274.940. 9. Rights of the public and of governmental bodies in and to that portion of that portion of the premises herein described lying below the high water mark of the McKenzie River and the ownership of the State of Oregon in and to that portion lying below the high water mark thereof . 10. Easement, granted to the United States of America, including the tenns and provisions thereof, by instrument Recorded August 6, 1947, Book 353, Page 220, Lane County Oregon Records. 11. Easement, granted to the United States of America, including the tenns and provisions thereof, by instrument Recorded August 6, 1947, Book 353, Page 224, Lane County Oregon Records. 12. Easement, granted to the United States of America, including the tenns and provisions thereof, by instrument Recorded August 6,1947, Book 353, Page 232, Lane County Oregon Records. ' , 13. Easement, granted to the United States of America, including the tenns and provisions thereof, by instrument Recorded August 9, 1950, Reception No. 25660, Lane County Oregon Records. 14. Waterline Easement, granted to Oakway Water District, including the tenns and provisions thereof, by instrument Recorded November 13, 1968, Reception No. 44944, Lane County Oregon Records. 15. Reservation for 60' Roadway Easement as contained in Warranty Deed Recorded April 5, 1991, Reception No. 91-15745, Lane County Oregon Records, NOTE: Said Easement will tenninate upon the dedication of St. Joseph Place as a Public Street. Date Received: CONTINUED MAY 1 8 2009 Original Submittal ELT - 55927 Page 4 16. Annexation Agreement, including the tenns and provisions thereof, between the City of Springfield, and Arlie & Company, an Oregon corporation, by instrument Recorded June 8, 2001, Reception No. 2001-034714, Lane County Oregon Records. Assignment of Annexation Agreement, including the tenns and provisions thereof, from Arlie & Company, an Oregon corporation, to PeaceHeaIth, a Washington non-profit corporation, by instrument Recorded December 31, 2001, Reception No. 2001-088566, Lane County Oregon Records. Said Annexation Agreement was amended by instrument Recorded October 8, 2003, Reception No. 2003-098507, Lane County Oregon Records. 17. Annexation Agreement, including the tenns and provisions thereof, between PeaceHealth, a Washington corporation, and the City of Springfield, by instrument Recorded June 5, 2002, Reception No. 2002-043161, and amended by instrument Recorded October 8, 2003, Reception No. 2003-098507, Lane County Oregon Records. 18. Improvement Agreement, including the tenns and provisions thereof, between the City of Springfield, and PeaceHealth, by instrument Recorded June 30, 2005, Reception No. 2005- 048788, Lane County Oregon Records. 19. Easement Agreement, including the tenns and provisions thereof, between PeaceHealth, Inc., and Jolm E. Jacqua and Rosamond R. Jacqua, by instrument Recorded August 19,2005, Reception No. 2005-064895, Lane County Oregon Records, 20. Gas Pipeline Easement, granted to Northwest Natural Gas Company, including the tenns and provisions thereof, by instrument Recorded January 23, 2006, Reception No. 2006-004903, Lane County Oregon Records. 21. Declaration of Access and Maintenance Agreement, including the tenns and provisions thereof, between PeaceHealth, a Washington non-profit corporation, Willamalane Park and Recreation District, an Oregon special district, and the City of Springfield, a municipal corporation of the State of Oregon, by instrument Recorded May 10,2006, Reception No. 2006-032093, Lane County Oregon Records. 22. Unrecorded Lease, including the terms and provisions thereof, between Peacehealth, a Washington nonprofit corporation, Lessor, and NSC Properties, LLC, an Oregon limited liability company, Lessee, as disclosed by Memorandwn of Lease Recorded August 7, 2007, Reception No. 2007-055315, Lane County Oregon Records. (Affects Tax Lot 902) 23. Line of Credit Deed of Trust, including the terms and provisions thereof, executed by NSC Properties, LLC, an Oregon limited liability company, as to a leasehold interest, as Grantor(s), to First American Title Insurance Company; as Trustee, for the benefit of Umpqua Bank, as Beneficiary, Dated August 1,2007, Recorded August 7, 2007, Reception No. 2007-055316, Official Records of Lane County, Oregon, given to secure payment of a Note for $30,000,000.00. (Affects Tax Lot 902) Date Received: CONTINUED MAY 1 8 2009 Original Submittal ELT - 55927 Page 5 24. Assignment of Rents, as additional security for the payment of the indebtedness secured by the Deed of Trust as insured herein, which assignment was executed by NSC Properties, LLC, an Oregon limited liability company, as to a leasehold interest, to Umpqua Bank, by instrument Recorded August 7, 2007, Reception No. 2007-055317, Lane County Oregon Records. (Affects Tax Lot 902) 25. Assigmnent of Lease for Security Purposes, as additional security for the payment of the indebtedness secured by the Deed of Trust as insured herein, which assignment was executed by NSC Properties, LLC, an Oregon limited liability company, to Umpqua Bank, an Oregon state-chartered bank, by instrument Recorded August 7, 2007, Reception No. 2007-055318, Lane County Oregon Records. (Affects Tax Lot 902) 26. V.e.e. Financing Statement, including the tenns and provisions thereof, between NSC Properties, LLC, Debtor, and Umpqua Bank, Secured Party, by instrument Recorded August 7, 2007, Reception No. 2007-055319, Lane County Oregon Records. (Affects Tax Lot 902) 27. Covenants, Conditions, and Restrictions, but omitting restrictions, if any, based on race, color, religion or national origin, imposed by instrument, including the tenns and provisions thereof, Recorded April 8, 2008, Reception No. 2008-019743, Lane County Oregon Records. 28. Levies and Assessments, if any, by virtue of the fact that the Covenants, Conditions and Restrictions contain among other things provisions for said levies and assessments ofthe RiverBend Tenants' Association. 29. Restrictions as shown on the recorded plat as follows: "No buildings, structures, trees, shrubbery or other obstructions shall be placed on or located within the public utility easements." 30. Easements as shown on Easement Table of the recorded plat ofRIVERBEND, PHASE II. 31. Temporary Public Access Easement, granted to the City of Springfield, a municipal corporation, including the tenns and provisions thereof, by instrument Recorded June 3, 2008, Reception No. 2008-030896, Lane County Oregon Records. 32. Improvement Agreement including Notice of Potential Assessment Lien, including the tenns and provisions thereof, by instrument Recorded June 3,.2008, Reception. No. 2008- 030898, Lane County Oregon Records. 33. Improvement Agreement including Notice of Potential Assessment Lien, including the tenns and provisions thereof, by instrument Recorded June 3, 2008, Reception No. 2008- 030900, Lane County Oregon Records. 34. Public Way Use Agreement, including the tenns and provisions thereof, by instrument Recorded June 3, 2008, Reception No. 2008-030902, Lane County Oregon Records. CONTINUED Date Received: MAY 1 8 2009 Original Submittal ELT - 55927 Page 6 35. Construction Lien in favor of Hathaway's, Inc., an Oregon corporation, Claimant, in the amount of $2,694,844.49 including costs, by instrument Recorded October 24,2008, Reception No. 2008-058616, Lane County Oregon Records. 36. Construction Lien in favor of Cascade Acoustics Inc., Claimant, in the amount of $100,764.00, plus interest, by instrument Recorded November 14,2008, Reception No. 2008- 061738, Lane County Oregon Records. 37. Construction Lien in favor of Cascade Acoustics Inc., Claimant, in the anlount of $625,883.75, plus interest, by instrwnent Recorded November 14, 2008, Reception No, 2008- 061739, Lane County Oregon Records. 38. Construction Lien in favor of Johnson Controls, Inc., Claimant, in the amount of $30,398.00 including costs, by instrument Recorded January 8,2009, Reception No. 2009- 000904, Lane County Oregon,Records. 39. Construction Lien in favor of Johnson Controls, Inc" Claimant, in the amount of $1,740,656.67 including costs, by instrument Recorded January 8, 2009, Reception No. 2009- 000905, Lane County Oregon Records. 40. Construction Lien in favor of RFI Electronics, Inc. - Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amowlt of $607,670.47 including costs, by instrument Recorded January 16,2009, Reception No. 2009- 002260, Lane County Oregon Records. 41. Umecorded Lease, including the terms and provisions thereof, between NSC Properties, LLC, an Oregon limited liability company, Landlord, and RiverBend Ambulatory Surgery Center, LLC, an Oregon limited liability company, Tenant, as disclosed by Memorandum of Lease Recorded January 21, 2009, Reception No. 2009-002736, Lane County Oregon Records. (Affects Tax Lot 902) 42. Claim of Lien in favor ofRFI Electronics, Inc. - Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amount of$8,180.20, by instrument Recorded February 4,2009, Reception No. 2009-005566, Lane County Oregon Records. 43. Claim of Lien in favor of RFI Electronics, Inc. - Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amount of $19, 199.55, by instrument Recorded February 4,2009, Reception No. 2009-005567, Lane County Oregon Records. 44. Claim of Lien in favor ofRFI Electronics, Inc. - Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amount of$II,373.12, by instrument Recorded February 4, 2009, Reception No. 2009-005568, Lane County Oregon Records. Date R . ecelved: . MAY I 8 2009 CONTINUED Original SUbmittal ~.::-::--:-:-. ELT - 55927 Page 7 45. Claim of Lien in favor ofRFI Electronics, Inc. - .Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amount of $19,3 71.91, by instrument Recorded February 4,2009, Reception No. 2009-005569, Lane County Oregon Records. 46. Claim of Lien in favor of RFI Electronics, Inc. - Oregon d/b/a RFI Communications & Security Systems and d/b/a RFI Building Technologies, Claimant, in the amount of$13,126.98, by instrument Recorded February 4, 2009, Reception No. 2009-005570, Lane County Oregon Records. NOTE: Taxes, Map No. 17-03-23-22-00500, Code 04-78, Account No. 0193787, 2008-2009, $1,989.51, paid in full. Taxes, Map No. 17-03-23-22-00600, Code 04-78, Account No. 0193761, 2008-2009, $2,468.91, paid in full. Taxes, Map No. 17-03-23-22-00700, Code 04-78, Account No. 0193803, 2008-2009, $4,148.88, paid in full. Taxes, Map No. 17-03-22-00-00300, Code 04-78, Account No. 0187821, 2008-2009, $39,095.64, paid in full. Taxes, Map No. 17-03-22-00-00700, Code 04-78, Account No. 0187862, 2008-2009, $11,286.26, paid in full. (Includes Additional Property) Taxes, Map No. 17-03-22-00-00902, Code 04-78, AccountNo. 1193141,2008-2009, $315,950.16, paid in full. Taxes, Map No. 17-03-22-00-01000, Code 04-78, Account No: 0187938, 2008-2009, $30,037.86, paid in full. Taxes, Map No. 17-03-22-00-01001, Code 04-78, Account No. 1052545,2008-2009, $2,821.61, paid in full. Taxes, Map No. 17-03-22-00-01001, Code 04-30, Account No. 1696564,2008-2009, $219.23, paid in full. Taxes, Map No. 17-03-22-00-01201, Code 04-78, Account No. 1167020,2008-2009, $5,077.40, paid in full. Taxes, Map No. 17-03-22-00-01203, Code 04-78, AccountNo. 1467958, 2008-2009, $199,768.06, paid in full. Taxes, Map No. 17-03-22-00-01400, Code 04-78, Account No. 0187961, 2008-2009, $4,818.16, paid in full. (Includes Additional Property) Taxes, Map No. 17-03-22-00-01400, Code 19-00, Account No. 0187987, 2008-2009, $3,386.51, paid in full. Taxes for 2009-2010 tax year wi!1 be assessed to Map No. 17-03-22-00-04100, Code 04-78, Account No. 1823070. Date Received: MAY 1 8 2009 CONTINUED Original Submittal "- ,) . EL T - 55927 Page 8 NOTE: The addressees) of the property to be insured herein is: NOT KNOWN. (17-03-23-22-00500) 3351 AND 3353 BALDY VIEW LANE, SPRINGFIELD, OREGON 97477. (17-03-23-22- 00600) 3387 GAME FARM ROAD, SPRINGFIELD, OREGON 97477. (17-03-22-00-00700) 3311,3333,3355,3363,3377 AND 3383 RIVERBEND DRIVE, SPRINGFIELD, OREGON 97477. (17-03-22-00-00902) 3333 GAME FARM ROAD, SPRINGFIELD, OREGON 97477. (17-03-22-00-01000) 3420 BALDY VIEW LANE, SPRINGFIELD, OREGON 97477. (17-03-22-00-01000) 3306 BALDY VIEW LANE, SPRINGFIELD, OREGON 97477. (17-03-22-00-01001) 3125 GAME FARM ROAD, SPRINGFIELD, OREGON 97477. (17-03-22-00-01201) NOT KNOWN. (17-03-22-00-01203) 3113 GAME FARM ROAD, SPRINGFIELD, OREGON 97477. (17-03-22-00-01400) NOTE: As of February 23,2009, there are no liens for the City of Springfield. INFORMATIONAL NOTE: EVERGREEN LAND TITLE COMPANY FINDS NO NOTICE OF RESCISSION RECORDED IN THE LAST 24 MONTHS. NOTE: SUPPLEMENTED TO UPDATE REPORT. Very truly yours, EVERGREEN LAND TITLE COMPANY HOME OFFICE By. /~ ..J/, /wk/:"_ _. /~.- - ~.. r '-__-\.,........ Joseph M. Silence Ti tIe Officer CC: KPFF Consulting Engineers Attn: Tod Kelso (email: tod.kelso@kpffcivilpdx.com) NO LIABILITY IS ASSUMED HEREUNDER UNTIL POLICY IS ISSUED AND PREMIUM PAID. IF FOR ANY REASON THE REPORT IS CANCELLED, A MINIMUM CANCELLATION FEE OF $200.00 WILL BE CHARGED. Date Received: MAY I 8 2009 Original Submittal 00 H 17-03-22-2 ,-I -' i ~ y)- f /~// /7_ c ? _ Z. Z -CG COURTESY Of EVERGREEN LAND TITLE CO, 741;1981 ._~-........, ..., u '. =- '1 G04-78 0000000000 '" ~-"e-.f1.".' (VAC.Pe;R Y',? utI'(V," 004.- 23 17 03 22 I 2 0'" 0 00000-00000 ~ f ~21 /91005ftt I o ';EE ~p 004-78 000 0 0 0 GOO 000 0 5l03' ll! '---------e;t-~ II 004":'62 .,,, ~Q'~'~Q:r.: ( 22 - 2c --~ il 2+eT ~\J~\:)U , , 004-78 -c.:-- c c C f::._, C C c- ---,------ (~ I lMW I C I ~_ I c:- ) f ._~+ -----.. 'H)5 1 2+96 ( I 1 1 - 0i3 1 I --IJ. I I I I -- I 1 1 .. W <oJ r: ., ........~. ""......,f-4l!..';) g(C.......~ r, SEE TINA,MOU ,., N ,., o " €lO 8 G 000000 0 G 0 004-23 Cl. ~ "J - . A r.^ . , " :Trl ~- ': .~TJ' .,"'""..#...,b-......~9' I Date 'Received: 00.4}- 310 w w Ul ~ ~ ~ ~ - "-'" ri...A}<E"'U~ ~. - -. '!m. t'T - I1VHg.~fA" ~ MAY 1 8 2009 Original Submittal 191 19' 19' 19' 19! 19' 19! 19! 19' 19' 19' 19' 19' 19' 19' 19' 19' 19' 19: 19: 20. 20' 20' 200 20' 20' 20' 20' 20' 21' 21' 21' 21' 21' 21' 21' 21' 21' 21 21 21 21 21 21 21 21 21 21 22' 22. 22. 22 22 . / Division or Chier Deputy Cle~k Lane County Deeds and Reco~ds AFTER RECORDING RETURN TO: 1111111111 111111111111111111111111111111111 0105J469..<l0J0J0SS. '0020021 02 2 0 7 M 1041 009 1:0 :45 P RPR-LIEN Cnt=l Stn=1 CASHIER OS $10.00 $11,00 " l~~g.~~5566 $21. 00 Bryan A. Kelley, Esq. Oles Morrison Rinker & Baker LLP 70 I Pike Street, Suite 1700 Seattle, Washington 98101-3930 QLr" V\. e.C P-C<LL e. It ett l-K CLAIM OF LIEN (ORS 87.035) Claimant (Grantee): RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES Person or Company Indebted To Claimant (Grantor): TURNER CONSTRUCTION COMPANY Legal Description: LOT 8, RlVERBEND PHASE 2, RECORDED JUNE 3, 2008 UNDER LANE COUNTY RECORDS AND DEEDS RECORDING NUMBER 2008-300895 NOTICE IS HEREBY GIVEN THAT THE UNDERSIGNED CLAIMS A LIEN PURSUANT TO ORS CHAPTER 87, In support of this Lien, the foilowing information is submitted: 1. Name of Lien Claimant: RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE. E WILSONVILLE, OR 97070 (503) 682_9900 2. Date on which the Claimant began to perrorm labor, provide professional services, supply materials or equipment, or the date on which employee benefit contrihutions became due: OCTOBER 27,2007 3. Name or person who requested labor, materials and equipment and who is indehted to the Claimant: TURNER CONSTRUCTION COMPANY CLAlMOFUEN PAGE 1 on Date Received: MAY 1 8 2009 Original Submittal ...,' 111111 II II ~I I "' 4. Description of the property against which a lien is claimed: 3333 RNERBEND DRIVE (FORMERLY 3333 GAME FARM ROAD) SPRINGFIELD, OR 97477 5. Name of owner or reputed owner: PEACEHEAL TH 6, Last date on which labor was performed, professional services were furnished, contributions to an employee benefit plan were due, or material or equipment was furnisbed: NOVEMBER 21,2008 7. Principal amonnt for which the lien is claimed, after deducting all just credits and offsets: $8,180.20 If the Claimant is the assignee of trrm so DE!\NREEC ,.f>RE ENT RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE E WILSONVILLE, OR 97070 (503) 682-9900 8. STATE OF OREGON DEAN REECE, being first duly sworn upon oath, deposes and says: That I am the claimant (or attorney of the claimant, or administrator, representative, or agent of the trustees of an employee benefit plan) above named; I have read or heard the foregoing claim, read and know the contents thereof, and believe the same to be true and correct and that the7ftl claim of lien is t frivolous and is made with reasonable cause, and is not clearly excessive under the pe , of perj , , - . i'- Claimant SUBSCRIBED and SWORN TO before me this ~ day of February, 2009. ~ll~ ~ . Printed Name: f:(iV/lnYlP. e Har~ N~T ARY PUBLIC i,n and f97 the. State of OREGON, resldmg at: P1tlS.~~ ~_' . Commission expires~ q /'1 /2NO.J . County of Lane CLAIM OF LIEN PAGE20F2 ..,. ) ) ) ss. ~ -...,-----~_. OFFICIAi. SEAL - ROXANNE E MARTIN NOTARYPUBUC-OREGON , COMMISSION NO. 409604 MMISS'9'!. ~PIR~ ~~"!.B'jIl_ 1 Date Received: MAY t 8 2009 Original Submittal I I. III II~III 110 .... O.M.",. ........,1 . , "- l~~~.~~~D1 III " " 11111111111111 11111111111111111111 $21.00 011514,a20090~a556,002J0~~ 02/04/2009 01:07:45 PM RPR-LIEN CnL=l SLn=l CASHIER 05 $10.00 $11.00 Division 0' Chle' Deputy Clerk Lane CounLy Deeds and Records AFTER RECORDING RETURN TO: Bryan A. Kelley, Esq. Oles Morrison Rinker & Baker LLP 70 I Pike Street, Suile 1700 Seattle, Washington 98101-3930 QL,0V\.e..r: PeA..c..e..l+~\K CLAIM OF LIEN (ORS 87.035) Claimant (Grantee): RFI ELECTRONICS, INe. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES ,I Person or Company Indebted To Claimant (Grantor): E C COMPANY Legal Description: LOT 8, RIVERBEND PHASE 2, RECORDED JUNE 3, 2008 UNDER LANE COUNTY RECORDS AND DEEDS RECORDING NUMBER 2008-300895 NOTICE IS HEREBY GIVEN THAT THE UNDERSIGNED CLAIMS A LIEN PURSUANT TO ORS CHAPTER 87. In support of this Lien, the following infonnalion is submitted: I. Name of Lien Claimant: RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE. E WILSONVILLE, OR 97070 (503) 682-9900 2. Date on wbicb the Claimant began to perform labor, provide professional services, supply materials or equipment, or the date on which employee benefit contributions became due: MAY 16, 2007 3. Name of person who requested labor, materials and equipment and who is indebted to the Claimant: E C COMPANY CLAlMOFLIEN Date Received: PAGE I OF2 MAY 1 8 2009 Original Submittal . 4. Description of tbe property against whicb a lien is claimed: 3333 RIVERBEND DRIVE (FORMERLY 3333 GAME FARM ROAD) SPRINGFIELD, OR 97477 5. Name of owner or reputed owner: PEACEHEAL TH . 6. Last date on wbich labor was performed, professional services were furnisbed, contributions to an employee benefit plan were due, or material or equipment was furnisbed: NOVEMBER 21,2008 7. Principal amount for which the lien is claimed, after deducting all just credits and offsets: $19,199.55 U~. CI._, b ~'-'~""'1!J: 4N/A .. DEAN REEUl-ENT RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE E WILSONVILLE, OR 97070 (503) 682-9900 8. STATE OF OREGON ) ) ) ss. County of Lane DEAN REECE, being first duly sworn upon oath, deposes and says: That I am the claimant (or attorney of the claimant, or administrator, representative, or agent of the trustees of an employee benefit plan) above named; I have read or heard the foregoing claim, read ~J1 know the contents thereof, and believe the same to be true and correct and that the cl' of lien' not frivolous and is made with reasonable cause, and is not clearly excessive under the en ty of-p JUl)'. .0 '--------.. ~.~'-- '=>-"OFFICiAt..;Et---, i 't: ' j,. ROXANNE E MARTIN I I \~',," ,.// NOTARY PUBUC.. OREGON I , ",\"" " COMMISSION NO 409604 I .:"~~N.~PIR~~~ CLAIM OF LIEN PAGE20F2 SUBSCRIBED and SWORN TO before me this LfJ- day of February, 2009. 1411m~ f. ~ Printed Name: 012/MP- E Harkn NOTARY p~~JC jn and tp,r the State of OREGON, residing at: ~f1y, U':J;'j[ Commission expires. CYt{, . Date Received: MAY 1 8 2009 Original Submittal ., .... "",. ._". 01. .".. .. ,",lllill.'11 . "I. I II 11,1 ..,11' , DIvIsIon of ChIef Deputy Clerk Lane County Deeds and Records AFTER RECORDING RETURN TO: " lOO~.OO~~~~ 111111111111111111111111111111111111111111111111 $21,00 01050471200901055680020023 02/04/200901:07:45 PM RPR-LIEN Cnt=l Stn=l CASHIER 05 $10,00 $11.00 Bryan A. Kelley, Esq. Oles Morrison Rinker & Baker LLP 701 Pike Street, Suite 1700 Seattle, Washington 98101-3930 OL0 V\. e. (' '. P e.a.. Ce.J-\ e'^- l +'k. CLAIM OF LIEN (ORS 87.035) Claimant (Grantee): RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES Person or Company Indebted To Claimant (Grantor): ECCOMPANY Legal Description: LOT 8, RIVERBEND PHASE 2, RECORDED JUNE 3, 2008 UNDER LANE COUNTY RECORDS AND DEEDS RECORDING NUMBER 2008-300895 NOTICE IS HEREBY GIVEN THAT ,THE UNDERSIGNED CLAIMS A LIEN PURSUANT TO ORS CHAPTER 87. In support of this Lien, the following information is submitted: 1. Name of Lien Claimant: RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE. E WILSONVILLE, OR 97070 (503) 682-9900 2. Date on which the Claimant began to perform labor, provide professional services, supply materials or equipment, or the date on which employee benefit eontribntions became due: AUGUST 4,2008 3. Name of person who requested labor, materials and equipment and wbo is indebted to tbe Claimant: E C COMPANY CLAIM OF LIEN PAGEIOF2 Date Received: MAY 1 8 2009 Original Submittal .' , I, I 1111111 4. Description of the property against which a lien;' claimed: 3333 RIVERBEND DRNE (FORMERLY 3333 GAME FARM ROAD) SPRINGFIELD, OR 97477 5. Name of owner or reputed owner: PEACEHEAL TH 6. Last date on which labor was performed, professional services were furnisbed, contrihntions to an employee henefit plan were due, or material or eqnipment was furnished: NOVEMBER 21, 2008 7. Principal amount for wbicb the lien is claimed, after deducting all just credits and offsets: $11,373.12 If the Claimant is the assignee Ofth#:N/A DEA'N REECE; PRESIDENT RFI ELECTRONICS, INe. - OREGO\,/ d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE E WILSONVILLE, OR 97070 (503) 682-9900 8. STATE OF OREGON ) ) ) ss. County of Lane DEAN REECE, being first duly sworn 'upon oath, deposes and say., That I am the claimant (or attorney of the claimant, or administrator, representative, or agent of the trustees of an employee benefit plan) above named; I have read or heard the foregoing elai read know the contents thereof, and believe the same to be true and correct and that the clai f lie 1 not frivolous and is made with reasonable eause"and is not clearly excessive under the p of Claimant SUBSCRIBED and SWORN TO before me this 1ft day of February, 2009. ._~-=- =~=~~~'I ' ~''''J1''IR c.. ~ OFFICIAL SEAL If ~J(U, .". 1 ROXANNE E MARTIN Printed Name: fJ~nf/ne.. t/ MLV+z,y; . Iol0TARYPUBUC.OREGON . ~ "" ~ COMMISSION NO. 409604 . NOTARY PtmLIf:: in and for the Sta, te of OREGON, MY OMMISS~~E>:P~~F,?~MJll'I1~.:W1! residinga!: ~ ~. Commission expires:" / . CLAIM OF LIEN PAGE'2 OF 2 Date Received: MAY 1 8 2009 Original Submittal -'f I 11..11 III I '" II / Division of Chief Depuly Clerk Lane Counly Deeds and Records '\ lOO~.~~~~O~ AFTER RECORDING RETURN TO: 11111111111 11111111111111111"1111111111 III $21.00 1105147320'9000~~~a0020029 02/04/2009 01:07:45 pn RPR-LIEN Cnl=1 Sln=1 CASHIER OS $10.00 $11.00 Bryan A. Kelley, Esq. Oles Morrison Rinker & Baker LLP 70 I Pike Street, Suite 1700 Seattle, Washington 98101-3930 Dl>>I\,,"-(; r~c-.e lteAU--t.,., CLAIM OF LIEN (ORS 87.035) Claimant (Grantee): RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES Person or Company Indebted To Claimant (Grantor): E CCOMPANY Legal Description: LOT 8, RIVERBEND PHASE 2, RECORDED JUNE 3, 2008 UNDER LANE COUNTY RECORDS AND DEEDS RECORDING NUMBER 2008-300895 NOTICE IS HEREBY GIVEN THAT THE UNDERSIGNED CLAIMS A LIEN PURSUANT TO ORS CHAPTER 87. In support of this Lien, the following infonnation is submitted: I. Name of Lien Claimant: RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE. E WILSONVILLE, OR 97070 (503) 682-9900 2. Date on which the Claimant began to perform labor, provide professional services, supply materials or equipment, or the date on which employee benefit contributions became due: AUGUST 27, 2007 3. Name of person who requested labor, materials and eqnipment and who is indebted to the Claimant: E C COMPANY cLAiM OF LIEN PAGE I OF2 Date Received: MAY 1 8 2009 Original Submittal '-, , . ..... .. '''~ .~ " ..I 4. Description of the property again.t which a lien i. claimed: 3333 RlVERBEND DRIVE (FORMERLY 3333 GAME FARM ROAD) SPRINGFIELD, OR 97477 5. Name of owner or reputed owner: PEACEHEAL TH 6. Last date on which labor was performed, professional services were furnished, contributions to an employee benefit plan were due, or material or equipment was furnished: NOVEMBER 21,2008 7. Principal amount for which the Iieni. claimed, after deducting all just credits and offsets: $19,371.91 If", C.;_,. ", ...._0'''. ~'l4N ~ DEA/~~IDENT RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., SYE E WILSONVILLE, OR 97070 (503) 682-9900 8. STATE OF OREGON County of Lane ) ) ) ss. DEAN REECE, being first duly sworn upon oath, deposes and says: That [ am the claimant (or attorney of the claimant, or administrator, representative, or agent of the trustees of an employee benefit plan) above named; [have read or heard the foregoing elai read a know the contents thereof, and believe the same to be true and correct and that the clai f lie i not frivolous and is made with reasonable cause, and is not clearly excessive under the "" of r. Claimabt SUBSCRIBED and SWORN TO befure me this LJ!!> day of February, ~009. . ~f~ Printed Name: KManll"'_ F, Har+-r.,:,_ NOTARY PUBLIC in and fosthe State of OREGON, residing at: 1J.lL4un~p"., (J/LI<.M.. Commission expires:' Cj!Vh'J/b. m~-"""''''''= . OFFICIAL S!:AL . !~ ROXANNE E MARTIN ~'\(i!';;:h NOTARYPUBUC.OREGON ...,:(', COMMISSION NO. 400604 _~~~~_=-~~~~l~~~_ St; 4 1 CLAIM OF LIEN PAGE20F2 ~,. Date Received: MAY 1 8 2009 Original Submittal II I I . / Division of Chief Deputy Clerk Lane County Deeds end Records 1~~~.~~~~1~ , AFTER RECORDING RETURN TO: 111111'111111111111111111111 1111111111111111111 $21,00 01051474200901055700120026 02/04/200901:07:45 PM RPR-LIEN Cntcl Stncl CASHIER 05 $10.00 $11.00 Bryan A. Kelley, Esq. Oles Morrison Rinker & Baker LLP 701 Pike Street, Suite 1700 Seattle, Washington 98101-3930 OWV\e.f: Pc:.a.c:.e \-\e<\.l+l." CLAIM OF LIEN (ORS 87.035) Claimant (Grantee): RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES Person or Company Indebted To Claimant (Grantor): ECCOMPANY Legal Description: LOT8,RIVERBENDPHASE2,RECORDED JUNEJ, 2008 UNDER LANE COUNTY RECORDS AND DEEDS RECORDING NUMBER 2008-300895 NOTICE IS HEREBY GIVEN THAT THE UNDERSIGNED CLAIMS A LIEN PURSUANT TO ORS CHAPTER 87. In support of this Lien, the following information is submitted: 1. Name of Lien Claimant: RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICATIONS & SECURITY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE. E WILSONVILLE, OR 97070 (503) 682-9900 2. Date on wbicb the Claimant began to perform labor, provide professional services, supply materials or eq uipment, or tbe date on which employee benefit contributions became due: SEPTEMBER 10, 2007 3. Name of person who requested labor, materials and equipment and wbo is indebted to tbe Claimsnt: E C COMPANY CLAIM OF LIEN PAGE I on Date Received: MAY I 8 2009 Original Submitt..' .' ".,1 II" ,1.1111"" .' , , .,,, ""L.. ,..._.. ,.. a .' 4. Description of tbe property against wbicb a lien is claimed: 3333 RIVERBEND DRIVE (FORMERLY 3333 GAME FARM ROAD) SPRINGFIELD, OR 97477 5. Name of owner or reputed owner: PEACEHEALTH 6. Last date on wbich labor was performed, professional services were furnisbed, contributions to an employee benefit plan were due, or material or equipment was furnished: NOVEMBER 21, 2008 7. Principal amount for wbicb tbe lien is claimed, after deducting all just credits and offsets: $13,126.98 ,,,.. C,.....".... ""''''' .rili~ 1: ~.ff)~ " DEAN~~CE, ;!;/f{IDENT RFI ELECTRONICS, INC. - OREGON d/b/a RFI COMMUNICA nONS & SECURiTY SYSTEMS and d/b/a RFI BUILDING TECHNOLOGIES 25977 SW CANYON CREEK RD., STE E WILSONVILLE, OR 97070 (503) 682-9900 8. STATE OF OREGON County of Lane ) ) ) ss. DEAN REECE, being first duly sworn upon oath, deposes and says: That I am the claimant (or attorney of the claimant, or administrator, representative, or agent of the trustees of an employee benefit plan) above named; I have read or heard the foregoing claim, re d and kn e contents thereof, and believe the same to be true and correct and that the C~~~f j;{n is t lvolous and is made with reasonable cause, and is not clearly excessive under the Pfi) 0 perj . Claimant - ,. CLAIM OF LIEN PAGE20F2 .' ------~~, 7 7....,.-.1 ' OFFICIAL SEAL : ROXANNE E MARTIN NGTARYPUBUC-OREGON ". . COMMISSION NO, 409604 MY. MM~I~N_~X~~MJl<f11..~ ~-~_._~- - ..' .., - Lji1> day of February, 2009. ~f: /J7~ Printed Name: KMaJ1nl'_ k Marl-,;;' NOTARY PUBLIC iQ and for the State of OREGON, residing at: f.U:ahV1t?l1vYI {,,~ Commission expires: '9fi1l1o .J SUBSCRIBED and SWORN TO before me this Date Received: MAY I 8 2009 Original Submittal I. ,'. ..1. .,. 111110;........ I" II. . I... .. ,1.1,. .", .,. 1111 Drinking Water Protection Overlay District Development Application Walgreens Clinical Pharmacy Mav 13 2009 ATTACHMENT 3 LOCATION MAP WITH TOTZ Date Received: MAY 1 8 2009 'riginal :>ubrnittal ~"""'-. .~-. ".:c-T"O'="~.'~ ~ L c" l, ---- ~ !, i' l -' o TRAVEL N ~ ~rRA~'f j ~O~NDWATER TIME \ '\ ~ .~ ~ ~M"~ ~J!III!1 -Ift'!l~l ~ ;f!: " '" I~ , ! ;;. Date Received: MAY \ 8 2009 ~I --- ill I~ ...- Original submittal_ \ 11 ~i \ il I NORTH ~ ~ SHEET NO. - SCAlf eto ~ "'" "" ~ , 'CH__""'" OF' an"""",,t:TlOO._" KTA Assockl......:.i, Inc. KTAAssoclates, Inc. Phone206.447.145Q 800 Fifth Avenue, Suite 4100 Fax 206.374.2279 Seattle, WA 98104 www.KTAinc.net Hazardous Material Management Plan Walgreens Clinical Pharmacy Located in the Peace Health Riverbend Medical Pavilion Springfield, Oregon May 2009 Date Received: MAY 1 8 2009 KTA Original Submittal A Professional Environmental Service Corporation TABLE OF CONTENTS 1.0 HAZARDOUS MATERIAL MANAGEMENT PLAN PURPOSE AND OBJECTiVES.............,..... 1 2.0 PLAN REVIEW AND REVISIONS .,....................,....,..,....,....,....."....."....."..."....,....,....,................. 2 3.0 HAZARDOUS MATERIAL INVENTORY STATEMENT AND STORAGE..........,................,........ 3 4.0 HAZARDOUS MATERIAL SECONDARY CONTAINMENT AND SPILL PREVENTION ,..........5 5,0 CHEMICAL EMERGENCY I SPILL RESPONSE......................,......................................"...,........ 7 6,0 PERSONNEL TRAINING FOR HAZARDOUS MATERIAL MANAGEMENT....,....,..................... 9 7.0 MONTHLY INSPECTIONS OF HAZARDOUS MATERIAL MANAGEMENT AND CORRECTIVE ACTION SYSTEM ......, ,.... ,...,..........,...., ,...,...., ,.........., ......, ...., ,...,....'...........,.....,.. 10 8.0 RECORDKEEPING .. ,....., ,.....,. ,....,....,........, ,......... ,..., ,..., ,....,..., ,................, ,..., '........, ..........., ,....... 11 LIST OF APPENDICES APPENDIX A HAZARDOUS MATERIAL INVENTORY STATEMENT APPENDIX B MATERIAL SAFETY DATA SHEETS FOR PRODUCTS IDENTIFIED IN HMIS APPENDIX C HAZARDOUS MATERIAL STORAGE LOCATION DRAWiNG APPENDIX D DNAPL LIST APPENDIX E HAZARDOUS MATERIAL STORAGE MONTHLY INSPECTION FORM Date Received: MAY 1 8 2009 Original Submittal 1.0 HAZARDOUS MATERIAL MANAGEMENT PLAN PURPOSE AND OBJEGTIVES The Hazardous Material Management Plan ("Plan") for the Walgreens Clinical Pharmacy ("Facility") located in the Peace Health Riverbend Medical Pavilion in Springfield, Oregon selVes several objectives, The Plan establishes responsibilities, policies, prevention measures, and procedures for the storage and usage of hazardous materials at the Faciiity. Requirements for hazardous materials have been established by the City of Springfield Drinking Water Protection (DWP) Overlay District and rely on the Springfield Fire Code. One purpose of the Plan is to meet DWP requirements and protect the groundwater used as a city drinking water supply from contamination by discharges of hazardous material or other materials that pose a risk to groundwater. The Plan addresses the following hazardous material management processes (the applicable section of the Plan is identified in parentheses): . Allowable hazardous materials to be stored and used at the Facility (Section 3.0); . Hazardous material storage locations (Section 3.0); . Secondary containment for hazardous material containers and spill prevention measures (Section 4.0); . Spill control, collection, and disposal procedures (Section 5.0); . Personnel training for hazardous material management (Section 6.0); . Inspection and maintenance of containment devices and emergency equipment (Section 7.0); . Recordkeeping (Section 8.0); and . Hazardous Material Inventory Statement (Appendix A), This Plan addresses requirements for the environmental regulation areas described above. Although there are several hazardous material safety and use guidelines included within this Plan, Health and Safety and Hazard Communications are covered by a separate program at the Facility.. , Additionally, this Facility is unlikely to generate regulated hazardous waste at this time; therefore, hazardous waste management is not addressed within this Plan, Date Received: MAY 1 8 2009 Original Submittal WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, 2:0 PLAN REVIEW AND REVISIONS I The Facility will ensure the Plan is kept current and updated as necessary to reflect any change in the storage of hazardous matenals. It is anticipated that the list of hazardous materials submitted to the City of Springfield is comprehensive and would only occasionally require updating for additional materials. Hazardous material storage, management, and spill response procedures in this Plan will be reviewed periodically and updated as necessary. Date Received: MAY I 8 2009 Original Submittal WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, 2 The hazardous material management requirements include maintaining an inventory of hazardous materials used at the Facility and identification of the storage locations. The hazardous materials covered by this Plan are a unique subset of the broad classification of "hazardous material", it is important to understand the definition of hazardous material as it applies to this Plan, 3.1 Definition of Hazardous Material Hazardous materials are substances, as defined in City of Springfield Land Use Development Code, Chapter 3,3-200 for the Drinking Water Protection (DWP) Overlay District, which may be stored, handled, treated, used, or produced at the Facility. As the Facility is located in an area specified to be a drinking water wellhead Time of Travel Zone (TOTZ) of 1-5 years, restrictions apply to hazardous materials to protect groundwater. The Springfield Development Code defines hazardous materials as those substances (liquid or solid) which pose a risk to groundwater quality (Chapter 3.3-205 A.1.). The class of hazardous materials is based on the Springfield Fire Code, which has been as adopted and amended by the City, including materials in both usable or waste conditions. City of Springfield Land Use Development Code, Chapter 3,3-230 exempts several types of Springfield Fire Code hazardous materials, these exemptions include: (1) Hazardous materials in fuel tanks and fluid reservoirs attached to (i) a private or commercial motor vehicle and used directly in the motoring operation of that vehicle, or (ii) machinery, including but not limited to fuel, engine oil and coolant; (2) Fuel oil used in existing heating systems; (3) Hazardous materials contained in properly operating sealed units (transformers, refrigeration units, etc.) that are not opened as part of routine use; (4) Local natural gas distribution lines; (5) Fuel for emergency generators located at facilities that provide essential community services (hospitals, fireMe safety, police, public shelters, telephone systems, etc.); and (6) Any commoniy used office supply - such as correcting fluid for typewriters, toner for computer printers or cleaners for windows and bathrooms - where the supplies are purchased off-site for use on-site. 3.2 Hazardous Material Inventory Statement The Facility has developed a comprehensive Hazardous Material Inventory Statement (HMIS) that lists all hazardous materials used at the Facility, maximum quantity, and storage location. This list accompanies the Plan and is located in Appendix A. The Material Safety Data Sheets (MSDSs) for all products identified in the HMISare located in Appendix B. 3.3 Hazardous Material Storage Locations The hazardous material storage locations are listed in the Hazardous Material Inventory Statement in Appendix A. Additionally, locations most likely to store hazardous material and pharmaceutical items within the Facility are identified and outlined in red on the detailed floor plan drawing in Appendix C. The HMMP with the HMIS and facility drawing identifying hazardous material and pharmaceutical item storage locations are to be submitted to the City of Springfield along with the DWP Overlay Development Application, WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, Date Received: MAY 1 8 2009 3 Original Submittal 3.4 Hazardous Material Management All hazardous materials defined above will be stored, handled, treated, used, or produced at the Facility according to the guidelines outlined in this Plan. Hazardous materials will be purchased only where necessary and used only for the intended purpose. Hazardous materials will only be stored indoors with appropriate secondary containment. Hazardous materials will not be stored outdoors, Hazardous materials will only be used outdoors with precautions to prevent hazardous material from entering stormwater or infiltrating into the ground. Facility personnel will take precautions to prevent releases of hazardous materials during storage and use, and any releases that do occur will be controlled, cleaned up promptly, and disposed of appropriately. Individual containers of products that are not highly hazardous or toxic, and which are frequently used may be kept at the use location without secondary containment. Examples would be household products such as dish detergent or hand soap placed beside the Facility sink or under the sink within the sink cabinet. Pharmaceutical items may be hazardous materials and will be managed appropriately. The Facility will not purchase, store, use, or sell any products containing Dense Non,Aqueous Phase Liquids (DNAPLs). A DNAPL is one of a group of hazardous materials that is denser than water, has a low solubility rate, and degrades slowly to other compounds that are even more of a health hazard. A list of DNAPLs regulated within the City of Springfield's DWP Overlay District is maintained by the Springfield Utility Board (SUB) and included in Appendix D. Examples of DNAPLs are Perchlorethylene and 1,1,1- Trichloroethane. Material Safety Data Sheets (MSDSs) for new hazardous materials proposed to be stbred, handled, treated, used, produced, or soid at the Facility must be reviewed by the SUB before purchase to ensure the product does not contain any DNAPLs. The Facility will maintain a log of all products reviewed for potential DNAPLs. The HMIS will be updated with new products as they are approved, The Facility will submit an updated HMIS to the SUB in electronic format, when new hazardous materials are added or removed from the HMIS or upon request by the SUB. Date Received: MAY 1 8 2009 Original Submittal WALGREENS CliNICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES, INC. 4 . Hazardous materials will be stored, handled, and used with precautjons to avoid spills. 4.1 Secondary Containment The City of Springfield requires that all hazardous material containers must have secondary containment regardless of type, quantity, or size. Secondary containment for hazardous materials that pose a risk to the groundwater will be provided in accordance with the applicable regulatory requirements (Chapter 3.3-235 B.2. of the DWP Program). This requirement specifically states that: "Unless exempted, all hazardous materials or other materials that pose a risk to groundwater shall be stored in areas with approved secondary containment in place (Springfield Fire Code 2702,1 and 2704,2.2)". Secondary containment may be provided by one of the following means: . Liquid-tight sloped or recessed floors; . Liquid-tight floors with raised or recessed sills or dikes; . Sumps and collection systems; . Drainage systems leading to a controlled location; or . Secondary containment devices, such as spill pallets, decks, tubs, or trays for containers, Secondary containment systems will be sized to accommodate a spill from the largest container. In addition, the sizing needs to accommodate fire-protection water (20-minute discharge volume). The materials of construction of the secondary containment system must be compatible with the hazardous materials to be stored. Incompatible hazardous materials will be separated from each other in the secondary containment system. The secondary containment system will have a monitoring method, such as visual observation. Materials should be stored away from doorways and drains to prevent spills or leaks from leaving the secondary containment area. Most of the hazardous materials to be stored and used at this Facility are alcohols, alcohol-based products, and cleansers and disinfectants in iess than one quart plastic containers. All liquid hazardous materials and hazardous materials that could be dissolved in water (e.g., powdered products) will be stored in secondary containment. The secondary containment devices, such as plastic tubs, will allow easy access and quick inspection to determine if any release of hazardous materials has occurred. The secondary containment tubs or trays will have sufficient depth to contain the at least 110% volume of the largest container. In hazardous material use areas where products are used frequentiy and easily visible, individual containers of products that are not highly hazardous or toxic do not need to be kept in secondary containment. Examples would inciude a small container of dish detergent or hand soap placed beside the Facility sink or under the sink within the sink cabinet. Materials not in current use should be retumed to storage in secondary containment. Date Received: WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTA ASSOCIATES, INC. MAY I 8 2009 5 Original Submittal Hazardous materials that are individually packaged in sealed foil or plastic packets will not require storage in secondary containment, unless the material poses a high risk to groundwater. Storage devices such as Pixis medication dispensing units and drawer carts, such as a crash cart provide adequate secondary containment. 4.2 Spill Prevention In addition to secondary containment, Facility personnel will follow precautions in hazardous material storage and use to prevent spills. The following measures will be used for spill prevention: . Containers of hazardous materials will be stored in designated areas within the Facility. Safe storage and use of hazardous materials will only occur in conjunction with Facility safety procedures. . Hazardous materials should not be left in doorways, hallways, bathrooms, beside drains, outside areas, or any other unrestricted or unprotected locations. . All containers of hazardous materials will be labeled with the identity of contents and chemicai components. . Hazardous material containers must be in good condition, compatible with the material stored therein, and not in danger of leaking. Containers should be kept closed except when the material is in use, Non-compatible materials should not be stored next to each other. . Containers stored in cabinets, closets and on shelves should be at eye"level or below. . Storage areas should be well-lit. Hazardous material storage areas should be secured or locked, if appropriate, to protect against unauthorized access, . Hazardous material storage areas should have signs to provide safety information and spill cleanup procedures. . Spill cleanup kits should be readily available near hazardous material storage areas. . Floor drain mats should be maintained in all hazardous material storage areas with floor drains to prevent accidental spills from reaching the sanitary sewer system. . Hazardous material containers must not be opened, handled, or stored in a manner that may rupture the container or cause them to leak. . Proper handling and storage information, is explained in MSDSs, available for all hazardous materials stored and used at the Facility. . Empty containers previously used for storage of hazardous materials will be free of residual material before appropriate disposal. Date Received: MAY 1 8 2009 WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, 6 Original Submittal' 5.1 General Personnel who work with or around chemicals will be trained in these procedures. Hazardous material container storage areas will be managed to minimize the possibility of fire, explosion, or any unplanned release of chemicals to the environment. 5.2 Emergency Requirements The Facility maintains an emergency plan, which includes the following elements required for hazardous material management: . Communications and fire control equipment, including periodic testing to ensure equipment will operate properly in time of emergency. . Arrangements with local authorities, . An Emergency Coordinator for the Facility has been designated with the responsibility for coordinating all emergency response measures. . Spill response procedures: the level of response to a hazardous material spill wiil depend upon the physical characteristics and volume of material being handled, its potential hazards, and the potential for release to the environment. The following are general guidelines to be followed for a hazardous material spill: o The individual who caused or discovers the spill is responsible for immediate response and containment until the Emergency Coordinator arrives. o Immediately alert area occupants and supervisor, and evacuate the area, if necessary. o If a volatile, fiammable material is spilled, immediately wam everyone, control sources of ignition and ventilate the area. o If there is a fire that cannot be extinguished with a portable fire extinguisher, call the local Fire Department at 911. o Attempt to contain the spill (with absorbent material) to the smallest practical area. o As appropriate, spills should be cleaned up by chemical treatment, absorption, or neutralization. If the spill is too large for the responsible individual or Emergency Coordinator to handle, or may pose a risk to groundwater: . Call 911 to contact: . Fire Department Hazardous Material Unit, . Poiice Department, and . Springfield Utility Board (SUB). Date Received: WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, f'1AY 1 8 2009 Original Submittal . Contact the Peace Health Riverbend Medical Pavilion Emergency Coordinator, o Wear personal protective equipment, as appropriate to the hazards. Refer to the Material Safety Data Sheet (MSDS) for appropriate personal protective equipment. o Protect floor drains or other means of environmental release. Floor drain mats, spill socks, and absorbents may be placed around drains. o Bulk absorbents and multiple spill pillows do not work with acids. POWERSORB (3M) products and their equivalent will handle acid. Acids should be neutralized if possible, o When spilled materials have been absorbed, use brush and scoop to place materials in an appropriate container. Polyethylene bags may be used for small spills. Five-gallon pails with polyethylene liners may be appropriate for larger quantities. o For spills of hazardous material, the waste product and spill control materials might be classified as a hazardous waste, For a spill of hazardous material, label the container to identify the material as Spill Material Involving "'XiZ Chemical", Contact the Emergency Coordinator for advice on storage and packaging for disposal. o Decontaminate the surface where the spill occurred using a mild detergent and water, when appropriate. . The Emergency Coordinator will complete or assign necessary reporting to authorities and agencies, The Emergency Coordinator will assess the need for any required environmental reporting. The Emergency Coordinator may contact or coordinate with the Peace Health Riverbend Medical Pavilion Emergency Coordinator and Environmental Coordinator for assistance. , Date Received: MAY 1 8 2009 WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, Original Submittal Q . In general, Facility personnel will receive direction or training from their supervisors, as necessary for each position, in hazardous material management. General training given to all employees in their group does not need to be documented. Facility personnel who handle hazardous materials may need basic training and direction if their position has responsibility for: . Awareness of the sensitive area that the Facility occupies and special precautions needed to protect the drinking water. . General hazardous material storage and use guidelines, . Responding to spills or other hazardous material related emergencies. At a minimum, all Facility staff will be trained on the following: HMMP requirements, ~mergency Plan procedures, and DWP awareness. Date Received: MAY 1 8 2009 Original Submittal WALGREENS CUNICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES, INC. 9 . . . - , AND G0RRECTIVE ACTION SYSTEM Monthly inspections of hazardous material storage areas will be conducted, This Facility is unlikely to generate regulated hazardous waste at this time, therefore, only the hazardous material monthly inspections would be required. As necessary, documented periodic inspections of storage areas are required for hazardous material management at the Facility. 7.1 Hazardous Material Storage Monthly Inspections Monthly inspections of hazardous material storage areas will be performed using the standard Hazardous Material Storage Monthly Inspection Form. Appendix E includes a copy of this inspection form. The inspection form includes a list of items to be checked at each area. In particular, secondary containment devices (tubs, trays, and cabinets), and emergency equipment must be inspected. The inspector will look for events or practices that could lead to an unintended release of hazardous material. The inspection form must also be reviewed and signed by the Facility Manager. Completed inspection forms will be maintained in a binder or file. When an inspection identifies a compliance issue, a corrective action will be performed, The Faciiity Manager will track both preventative and corrective maintenance activities in a log book. Date Received: MAY 1 8 2009 Original Submittal WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KT A ASSOCIATES, INC, 10 8.0 RECOR~KEEPING 8.1 Recordkeeping The Facility Manager will establish and maintain a hazardous material management file. As a best management practice, all hazardous material management files should be maintained for a minimum of 3 years, As necessary, the filing system should include: . Hazardous Material Management Plan (HMMP), . Hazardous Material Inventory Statement (HMIS) and location drawings, . Correspondence with agencies, consultants, etc. (must maintain for 3 years), . Reports submitted to environmental, fire, and safety agencies, . Personnel training records, and . Completed hazardous material storage monthly inspection forms. 8.2 Reporting Any new hazardous material must be approved by the SUB and added to the HMIS prior to storage within the Facility, The new material's MSDS should be reviewed to ensure that it does not contain any DNAPLs (refer to the DNAPL List located in Appendix D). In addition, the HMMP should be reviewed and updated regularly to reflect current hazardous material management within the Facility. Date Received: MAY 1 8 2009 Original Submittal WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, 11 APPENDIX A - HAZARDOUS MATERIAL INVENTORY STATEMENT Date Received: MAY 1 8 2009 WflJ...GREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, Original Submittal ManLrlactu....$ Produ"lName I Hu.<1louelnlliftlients L;ampnor::;plrlISU::;P IClhylAlconol: Camphor Hydrogen Peroxide Hydrogen Peroxide (<5%) ,. Iodine TinClure 2% Waler: Ethyl Alcohol: Sodium Iodide: Iodine Isopropyl Alcohol 70% Isopropanol Isopropyl Alcohol 91% Isopropyl Alcohol IWinde.originlllGlllSS Waler: Cleaner Isopropanol: Elllyleneglycol Monohexylelher WrtchHazel IEtIlylAlCOhol(200ProofJ: W,lchHazeIE.lracl 0 ., <50 :r 0 ~ C/) :3:: II) - c: )> CD 0' -< 3 - ::u ;:;: CD Iii CO 0 ...., CD = <0 = <0 CD 0.. OFClSFCHazar<l.....' MaletlalName Hazardous Material Inventory Slatement for Walgreens Clinical Pharmacy wllhin RMP May 2009 HC::~$ c'a~=::u2: 'Mn,Q""nllty IAppro:"irn&teRan\le c::~~~s Statlol.' Uat.rbl (CRTI(TablI6) ("nUnoled) .oI'~~:~';,~~s ICRTKTab". Msterial Class . ancl5} flamrnableLiquld N~, I '''mm''''o'' Flammable Liquid Flammable Liquid I Com'",',"""", I ",m=",'LO'. " 3.l 64-17-~,Il4_U%: 76-22-2,10_0% No" NoneSpecmed m2.a4_1,<5% on MSDS 1B 32 7732-18-5,49.77%: 54-17-5,45,85%: 7681--82_5,2,39%: 7553-56-2,1.99% 1"~>-O'7D% 167--63--0,91% 1B " 1B " IliA " 7732-18-5,60-100%: 67-53--0,1,0-5,0%: 112-25-40.t-1.0% 'C 33 54-17-5.14_15%: No CAS # Provided. 85-86% 2boltles 24boltles I'""'"'' 24lJQttles 1bollle 1boltlll 2boltles I"'" 16ftoz 2floz 16fioz 16 fl oz 26ftoz I""" 0_031259allo; PlaSlrCbolll1l N-1-4 39a1lon5 PleSlicboltlel N.1-4 0,031259allor Plasticbollle N'1-4 3gallon$ I 0,'''''''.0 0.20313gallor 0,25 gallon Plaslicboltle N-l-4 PlaslicbotlJe N-l-4 Plastic bottle N_l-4 PlasticboWe N-'~ ^Sl~1'39., ^Opanor Cloud SY5tem ::itorege Healln" Hlgn(J) UIL;~eCllon IFlm " High (3) Rllaclivily" Nonll(O) Liqllid NFPA7Q..! Classiflc>lllon Locations Comments Liq..lid Slorage Health = None (0) orc Section Fire= None (0) Reaclivily " Slighl (1) Uqllid I'"'''' liquid Liqllid L1ql1id Liql1id Hllallll = NOml (0) Fire "High (3) Rllactivity "None (0) Storage Heailh = Slighl (1) Fim"High(3} Rllllctivily"Nona(O) Slorag& Haailh"SIiglll(l) Fim = High (3) Raaclivily" None (0) Storage Heallh" Non& (0) Fire = Moderllla (2) Reoclivily: None (0) Storage Haallh "Slighl (1) Fire = Moderale (2) Reaclivily: Nonll (0) OTCSeclion OTCSedion OTCSection Cabin&l l1ndernllatll sink OTCSection Hazardous Material Inventory Statement Update Form for Walgreens Clinical Pharmacy within RMP I Examples: 1 Belladonna Tincture USP Various 16"oz 3 48f1oz Plastic bottle Liquid aTC Seclion Iodine Tincture 7% Various 2f1oz 2 4" oz Plaslicboltle Liquid aTC Section Lugols Solution 5% USP Medical Chemical Corp. 132"OZ 3 96" oz Plaslicbollle Liquid OTC Section L 0 .... <Ci" 5" 0 !!.!. en S ll) c: CD CT -< 3 - ;;0 ;::;: CD ~ CO ~ 0 ~ CD 55 <" CD a. tJFPA 704 Classification. Name of Hazard Health Flammability InslabilityfReactivity Speci~1 Hazards Code in Word~ None or Minimal or Least Slight Moderate High or Serious Severe Color on Sauare on Point Blue Red Yellow White CorreSDondinQ Numerica' Code o 1 2 3 4 Combustible Liquids !Jnified Fire Code Definitions IFlammable Liauids I I IFiammable Solid I IOxidizer I I PvroDhoric Unstable (reactive) (but not eXDlosivei Water reactive material Toxic Hiqhlv Toxic Use Class 2 Class3A Class3B 1A ,. 1C 4 3 2 1 4 3 2 1 3 2 1 Date Received: MAY 1 8 2009 Original Submittal Soatial Location 9.O'Clock 12-0'Clock 3-0'Clock 6-0'Clock Code o through 4 o through 4 o through 4 On!}' useW (Water rea_ctive) or OX (Oxidizer) 100F < or = FP < l40F 140F<or=FP<200 FP :>0 or = 200F F2 F2 Fl FP < 73F, BP < 100F FP < 73F, BP:>o 100F 73F < FP < 100F F4 F3 F3 lonition temp < 212F Ex?losive reaction from contamination. thermal o~ ,?h'(~ical shock Causes severe increase in bum rate of combustible materials or vioorous decomoosition Causes moderate Increase in burn rate or soontaneous iqnition o(combustible materials Sliqhtlv increases bum rate, does not cause spontaneou's iqnition Soontaneous ionition in air below 130F ICap?ble of detonation or exp,losive decomposition or reaction at normal temp/press ICaoable of detonation or explosive decomposition or reaction from hiflh temp or heatinq I Unsiable and caoable of violent chemical reaction at normaltemoJOft3s'S, bui does not detonate or exolode INormallv stable. but can become unstable at hiqh temo I I Reacts exolosivelv with water without heal or confinement I Potentially exolosi;e when mixed with water I Release enemv when mixed with water, but not violently I ILethal dose to rats LD50 It o\"er lethB' dose to rats LDSO I-"~- .-.'. - IUSE {Material\ is: 1. PlacincJ a material into action, includinq solids. liouids and, 9ases, or 12. Makino a material available lor service by ooeninq or connectinq anythinq utilized lor confinement of material includinq solids, liquids and qases. EPCRA Hazard Codes (Table 6) EPCRA Hazard Codes UFC Hazard Name 1.1 Class A Explosives 1.2 Class B Explosives 1.3 Class C Explosives 1.4 Blasting Agents 1.5 Very Insensitive Explosives 1.6 Extremely Insensitive Explosives 2.1 Flammable Gas 2.1 Flammable Gas 2.2 Non-Flammable Gas 2.2 Non-Flammable Gas 2.3 Poisonous Gas 3.1 Flammable Liquid (FP <: 0 F) 3.2 Flammable Liquid (0 F <: FP <: 73 F) 3.3 Flammable Liquid (73 F <: FP <: 141 F) 3.113.2 Combination Flammable Liquid 4.1 Flammable Solid 4.2 Spontaneously Combustible Material 4.2 Spontaneously Combustible Material 4.3 Dangerous When Wet 4.3 Dangerous When Wet 4.3 Dangerous When Wet 4.4 Reactive Material 4.4 Reactive Material 4.5 Combustible Liquid 4.5 Combustible Liquid 4.5 Combustible Liquid 4.5 Combustible Fiber 4.5 Combustible Fiber 5.1 Oxidizer 5.1 Oxidizer 5.1 Oxidizer 5.1 Oxidizer 5.2 Organic Peroxides 6.1 Poisonous Material 6.2 Etiologic Material 6.3 Acute Health Hazard 6.4 Chronic Health Hazard 6.5 Pesticide 7.3 Radioactive Material 8 Corrosive 9 Miscellaneous Hazardous Material 0 .., <0' S' 0 ll> en ~ Ql ..... c: CD 0- -< 3 - :::0 ;::;: CD - CO !l!. 0 '" (I) = <" ~ (I) c. UFC Hazard Class Div 1.1 Div 1.2 Div 1.3 Div 1.4 Div 1.5 Div 1.6 Gaseous liquefied Gaseous Liquefied Gaseous 1A 1B& 1C 1B& 1C 4 3 3 2 1 2 1 II IliA IIIB Loose Baled 4 3 2 1 u .... cO. S' !!1. en 3:: c: :!'< CT 3 - ;::;: ~ co !!!.. ~ = = <.c ,EPCRA Stora/'Je Conditions (Tables 4 & 5\ TABLE IV - STORAGE CODES ~ TYN of St.orqQi A.n... ........Abowgroundtank 6.... .,......Underground tank c.... . Tank Inside buildln" D,n .StMldrum E.. ...........n... ,Plastic or non-metallic drum F..... ..Can G.. ..Carboy H.....................Silo I...................... Fiber drum J.. ..,.......,Bag K. ..Box L ....m.. .......CVlinder M ....................Glll&G bottios,jugs Of budl:et.6 N ............n...".. Plastic bottle!,'jugs or buckets 0.. ......Tctebin P...... ...._ Tank wagon a.. .....,Railcar R....... ....ClttKlr s....... .......OeMr TABLE V - TEMPERATURE AND PRt~li!1RE Cl)NOITIONS M-JD 'STORAG~ CQOES ~ Storaae C<lnditlone (PRESSURE) 1 . .Normal pressure 2 . .GRlld., than I'lCIfmlIIl ~resIlUf"Q 3 . .Less than normal pl'Msure (TEMPERATURE) 4 . . . .' . . . .Normaltemperaturo 5 ...., .Gre_arttJan normaltomp.rature 6 . . . . . . . .less than normal temperature but not cryogenic 7 . . . . . . . .Cryogenic conditions DNAPL Definina Reouirements Definition Dense Non-aqueous Phase Liquids (DNAPLs) are: Heavier than waler (specific gravity >1) Have a low solubility rate (<10gll or 1%) Degrade to other compounds that are evon more of a health hazard For the purposes of Drinking Water Protection, DNAPL chemicals are defined as "all chemicals displaying the characteristics of a DNAPL chemical or a material containing a substance considered aDNAPL chemical". DNAPL CtlAlTlic::!l~ DNAPL chemicals are commonly used as cleaners, de-greasers, coolants, pesticides, and for treating wood. The following DNAPL chemicals are identified specifically but are not a comprehensive list of chemicals considered DNAPLs. If a chemical meets the Definition above it is regulated anwohibited. . ;:+. CD ;0 CD o CD <" CD 0- o. APPENDIX B - MATERIAL SAFETY DATA SHEETS FOR PRODUCTS IDENTIFIED IN HMIS WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, Date Received: MAY 1 8 2U09 Original Submittal Humco Holding Group, Inc. 7400 Alumax Drive Texarkana. TX 75501 903-831-7808 [tern #0395-0467 CAMPHOR SPIRITS USP DATE PREPARED: 03/14/01 SECTION I PRODUCT IDENTIFICATION PRODUCT NAME: Camphor Spirits USP SECTION II HAZARDOUS COMPONENTS Component Percent CAS No. Ethyl Alcohol Camphor 84.0% 10.0% 64-17-5 76"22-2 SECTION III PHYSICAL DATA Boiling Point: 1700F Specific Gravity: (H20 ~ I) 0.824 Solubility: (In watcr) [nsoluble Vapor Pressure: (mmHg) NA Vapor Density: (Aic=l) NA Evaporation Rate: NA Appearance and Odor: Clear water white Jiquid with campJlOr odor. % Volatiles by Volume: NA SECTION III A DEGREE OF HAZARD Degree of Hazard 4 - Extreme 3 - High 2 - Moderate I - Slight o - Insignificant Flammability Health Reactivity Special Hazard 3 3 o o / Date Received: MAY 1 8 2009 Original Submittal CAMPHOR SPIRITS USP Page 2 SECTION IV FIRE AND EXPLOSION HAZARDS Flash Point: 660F Extinguishing Media: Dry chemical, carbon dioxide, alcohol foam, water spray. Special Firefighting Procedures and p'recautions: When heated, material emits flammable and explosive vapors. If it can be safely done, remove containers from fire area. Unusual Fire and Explosion Hazards: Firefighters should use selkontained breathing apparatus and full protective clothing. SECTION V HEALTH HAZARD DATA First Aid Instructions for Accidental Exposure: If on Skin: Wash with soap and water. Gct medical help if any irritation persists. If in Eyes: Flush with,mIming water for 15 minutes~ Get medical attention immediately. IfInhaled: Remove victim to fresh air. Get immediate medical assistance. If Swallowed: Immediately give 3 to 4 glasses of water. Do Not induce vomiting. Ifvomiting occurs, give fluids again. Have physician determine if patient's condition allows" induction of vomiting or evacuation of stomach. Do not give anything by mouth to an unconscious or convulsing person. SECTION VI REACTIVITY DATA Stability: Stable Hazardous Polymerization: Will not occur. Conditions to a void: Strong oxidizing agents such as Potassium Permanganate & Chromic Anhydride, Decomposition Products: Partial oxidation products and carbon monoxide from thenn~l-oxidation degradation. Date Received: MAY 1 8 2009 Original Submittal CAMPHOR SPIRITS USP Page 3 SECTION VII SPILL AND DISPOSAL PROCEDURES Steps to be taken in the event of a spill or discharge: Provide adequate ventilation. Remove sources of heat or ignition. Protect against inhalation of vapors and skin contact. Cbver spill with dry sand or venniculitc and mix well prior to transferring to a disposal container. Keep container tightly closed, Disposal Procedures: Scrap can be burned in a safe place or approved incinerator. Follow Federal, State and local regulations. SECTION VIII INDUSTRIAL PROTECTIVE EQUIPMENT Ventilation: To meet TLV requirements. Respiratory Protection: Full face chemical cartridge respirator with an organic vapor cartridge to 200 mg/mg) Eye Protection: Chemical safety goggles, eye wash station. Skin Protection: Protective clothing for prolonged or repeated exposure. SECTION IX SPECIAL PRECAUTIONS Precautions to be taken in handling and storing: Store in a cool, dry, well ve ntilated area away from oxidizing agents and sources. of heat or ignition. Date Received: MAY 1 8 2009 Original Submittal (Q5( c5 MSDS for Hydrogen Peroxide, 3% Catalog # 1202E Medical chemical Corp. 19430 Van Ness Ave. Torrance, CA 90501 Customer Service: Phone (310)787-6800 FAX (310)787-4464 CHEMTREC Emergency Response Telephone Number: (800)424-9300 Note: The CHEMTREC phone number is only for emergencies involving spills, leaks, fire, exposure or accident. Please direct all other inquiries to our customer service phone number. Section 1 - Product Identification A stabilized, aqueous solution of hydrogen peroxide. Section II - Composition/Information on Components Ingredients CAS# OSHA Pel 1 ppm TWA (air) ACGIH TLV 1 ppm TWA (air) Other Limits % hydrogen peroxide 7722-84-1 3%w/v Section III - Hazards Identification Overview: May be harmful if swallowed. May be irritating to skin eyes and respiratory tract. Safety Ratings Health: Slight Flammability.' None Reactivity: None Recommended safety equipment: safety goggles, lab coat and proper gloves Storage: General storage NFPA Ratings Health = 0 Flammability = 0 Reactivity = 1 Potential Health Effects Contact: Slight The toxicology of this compound have not been completely examined. It is presumed that the toxicity of this item is similar to other dilute peroxides. 3% hydrogen peroxide is not expected to present health problems under normal circumstances Inhalation: Not likely to be an issue. May be irritating Ingestion: While the toxicity of this compound is low, large doses may cause nausea, vomiting, diarrhea, etc, Skin contact: Not normally a problem Date Received: Eye contact: May be irritating Chronic Exposure: Unknown MAY 1 8 2009 Aggravation of preexisting conditions: Unknown Original Submittal Section IV - First Aid Measures Inhalation: Unlikely to be an issue, Remove from source of exposure and get medical attention for any breathing difficulty. Ingestion: Unlikely to be an issue. Get medical advise for exceptional cases. MSDS for 3% Hydrogen Peroxide, page 1 of 3 Skin Contact: Unlikely to be an Issue. Wash affected area with soap and water. Get medical advice if irritation develops. Eye Contact: Rinse thoroughly with running water. Get medical advice if irritation develops. Section V - Fire Fighting Measures Flash point:: Not applicable. Flammable Limits: Not applicable. Fire: Not normally a fire Hazard, Explosion: Not Normally an explosion hazards. Fire Extinguishing Media: Any means suitable for surrounding fire, Special information: Pyrolysis will release corrosive oxides, Section VI - Accidental Release Measures Absorb with a suitable inert absorbent and store in a suitable container for disposal. Waste disposal is u'sually 110t restricted but local ordinances vary. Insure compliance with all government regulations. Section VII - Handling and Storage , , Store in a closed container, protected from freezing. Section VIII - Exposure Control/Personal Protection Airborne Exposure Limits: See section I I Ventilation System: Usually not required. When required, Refer to the ACGIH document, "Industrial Ventilation, a Manual of Recommended Practices" for details about ventilation. Personal Respirator: Usually not required. In case of emergency, or when exposure levels are unknown, use a positive pressure, full face piece, air supplied respirator. Skin protection: Protective gloves are not required but recommended as part of good laboratory practice. Eye Protection: Laboratory safety goggles or similar products are not required but recommended as part of good laboratory practice. '1 _/ Section IX . Physical and Chemical Properties Boiling Point: 100'C Vapor pressure (mm Hg): 18 @20'C Vapor Density (air = 1): 0.6 VOC: 0 g/I Appearance and Odor: A clear, colorless, odorless liquid. Density: About 1.0 g/ml Evaporation Rate (water = 1): 1 Solubility: Infinitely miscible with water Section X - Stability and Reactivity Stability: Freezes at low temperature. Hazardous Decomposition Products: Will liberate large amounts of oxygen. Hazardous polymerization: Will not occur. Incompatibilities: Nothing unusual. Conditions to avoid: Excessive cold/heat and light. Date Received: MAY 1 8 2009 Section XI - Toxicological Information ~';si:-..c! '3-l"h~;.",t= Cancer lists Ingredient Hydrogen Peroxide Known Carcinogenicity? I No NTP? No Anticipated? No tARC Category 3 MSDS for 3% Hydrogen Peroxide. page 2 of 3 Section XII - Ecological Information Environmental Fate: Biodegradable Environmental Toxicity: None Section XIII - Disposal Not normally restricted but ultimate authority resides with local government agencies. Insure compliance with all government regulation Section XIV - Transportation information Not Regulated Section XV - Regulatory Information Chemical Inventory Status Ingredient Hydrogen Peroxide TSCA Yes EC Yes Federal, State and International RegUlations Ingredient Hydrogen Peroxide SARA 302 RQ TPQ No No SARA 3 13 List Category No No RCRA 26L33 No TSCA SeD) No -', Chemical Weapons Convention: No TSCA 12(b): No CDTA: No SARA 31 1/312: Acute: Yes, Chronic: No, Fire: No, Pressure: No Section XVI - Other Information This information is believed to be correct but is not waranteed as such, nor does it purport to be all inclusive. Revision Date: Feb. 16, 2006 Date Received: MAY 1 8 2009 Original Submittal MSDS for 3% Hydrogen Peroxide, page 3 of 3 httrc'/ /fscimage.fishersci .com/msds/45416.htm Material Safety Data Sheet Iodine Solution, Tincture ACC# 45416 II Section 1 - Chemical Product and Company Identification II MSDS Name: Iodine Solution, Tincture Catalog Numbers: 571951, 571952, 593267' Synonyms: Tincture of Iodine Company Identification: Fisher Scientific 1 Reagent Lane Fair Lawn, NJ 07410 For information, call: 201-796-7100 Emergency Number: 201-796-7100 For CHEMTREC assistance, call: 800-424-9300 For International CHEMTREC assistance, call: 703-527-3887 JI ~ Section 2 - Composition, Information on Ingredients CAS# 7732-18-5 64-17-5 7681-82-5 7553-56-2 Chemical Name Percent 49.77 45.85 2.39 1.99 EINECS/ELINCS 231-791-2 200-578-6 231-679-3 231-442-4 Water Ethyl alcohol Sodium iodide Iodine L Section 3 - Hazards Identification II EMERGENCY OVERVIEW Appearance: amber liquid. Flash Point: 12.8 deg C. Warning! Causes severe eye irritation. Flammable liquid and vapor. Causes respiratory tract irritation. This substance has caused adverse reproductive and fetal effects in humans. May cause central nervous system depression. May cause liver, kidney and heart damage. Causes moderate skin irritation. Possible sensitizer. . Date Received: Target Organs: Blood, kidneys, heart, central nervous system, liver, respiratory system, cardiovascular system, bone marrow, thyroid. MAY 1 8 2009 Potential Health Effects Original Submittal Eye: Causes severe eye irritation. May cause painful sensitization to light. May cause chemical conjunctivitis and corneal damage. Skin: Causes moderate skin irritation. May cause skin sensitization, an allergic reaction, which becomes evident upon re-exposure to this material. May be absorbed through the skin. May cause cyanosis of the extremities. Ingestion: May cause gastrointestinal irritation with nausea, vomiting and diarrhea. May cause systemic toxicity with acidosis. May cause central nervous system depression, characterized by excitement, followed by headache, dizziness, drowsiness, and nausea. Advanced stages may cause collapse, unconsciousness, coma and pOSSible death due to respiratory failure. )f 7 15-Mar-0919:59 httrc' / /fsci mage:fishersci .com/msds/45416.htm Inhalation: Inhalation of high concentrations may cause central nervous system effects characterized by nausea, headache, dizziness, unconsciousness and coma. Causes respiratory tract irritation. May cause narcotic effects in high concentration. Vapors may cause dizziness or suffocation. May cause respiratory sensitization. Chronic: Prolonged or repeated skin contact may cause defatting and dermatitis. Chronic exposure can lead to iodism characterized by headache, excess salivation, nasal discharge, conjunctivitis, laryngitis, bronchitis, stomatitis, enlarged submaxillary glands, and skin rashes. May cause reproductive and fetal effects. Laboratory experiments have resulted in mutagenic effects. Chronic exposure can affect thyroid function. Animal studies have reported the development of tumors. Prolonged exposure may cause liver, kidney, and heart damage. If Section 4 - First Aid Measures JI Eyes: Immediately flush eyes with plenty of water for at least 15 minutes, occasionally lifting the upper and lower eyelids. Get medical aid. Skin: Get medical aid. Flush skin with plenty of water for at least 15 minutes while removing contaminated clothing and shoes. Wash clothing before reuse. Ingestion: Call a poison control center. If swallowed, do not induce vomiting unless directed to do so by medical personnel. Never give anything by mouth to an unconscious person. Get medical aid. Inhalation: Remove from exposure and move to fresh air immediately. If not breathing, give artificial respiration. If breathing is difficult, give oxygen. Get medical aid. Notes to Physician: Treat symptomatically and supportively. Persons with skin or eye disorders or liver, kidney, chronic respiratory diseases, or central and peripheral nervous sytem diseases may be at increased risk from exposure to this substance. Activated charcoal does not reduce ethanol absorption. Antidote: Ethanol may inhibit methanol metabolism. II Section 5 - Fire Fighting Measures General Information: Ethanol may inhibit methanol metabolism. As in any fire, wear a self-contained breathing apparatus in pressure-demand, MSHA/NIOSH (approved or equivalent), and full protective gear. Vapors may form an explosive mixture with air. Vapors can travel to a source of ignition and flash back. Will burn if involved in a fire. Flammable Liquid. Can release vapors that form explosive mixtures at temperatures above the flash point. Use water spray to keep fire-exposed containers cool. Wear appropriate protective clothing to prevent contact with skin and eyes. Wear a self-contained breathing apparatus (SCBA) to prevent contact with thermal decomposition products. Containers may explode in the heat of a fire. Extinguishing Media: For small fires, use dry chemical, carbon dioxide, water spray or alcohol- resistant foam. For large fires, use water spray, fog, or alcohol-resistant foam. Use water spray to cool fire-exposed containers. Water may be ineffective. Do NOT use straight streams of water. Flash Point: 12.8 deg C ( 55.04 deg F) Autoignition Temperature: 362.8 deg C ( 685.04 deg F) Date Received: Explosion Limits, Lower:3.3 vol % Upper: 19 vol % M NFPA Rating: (estimated) Health: 0; Flammability: 3; Instability: O' AY 1 8 2009 ~ Section 6 - Accidental Release M ungmal '=lUDmlllal IJ easures ----~~I General Information: Use proper personal protective equipment as indicated in Section 8. Spills/Leaks: Absorb spill with inert material (e.g. vermiculite, sand or earth), then place in suitable container. Remove all sources of ignition. Use a spark-proof tool. Provide ventilation. A vapor )f 7 15-Mar-09 19:59 http<://fscimage.fishersci.com/msds/45416.htm suppressing foam may be used to reduce vapors. II Section 7 - Handling and Storage Handling: Wash thoroughly after handling. Remove contaminat'Cd clothing and wash before reuse. Use only in a well-ventilated area. Ground and bond containers when transferring material. Use spark-proof tools and explosion proof equipment. Avoid contact with eyes, skin, and clothing. Empty containers retain product residue, (liquid and/or vapor), and can be dangerous. Keep container tightly closed. Keep away from heat, sparks and flame. Do not ingest or inhale. Do not pressurize, cut, weld, braze, solder, drill, grind, or expose empty containers to heat, sparks or open flames. Storage: Keep away from heat, sparks, and flame. Keep away from sources of ignition. Store in a cool place in the original container and protect from sunlight. Store in a tightly closed container. Keep from contact with oxidizing materials. Store in a cool, dry, well-ventilated area away from incompatible substances. Flammables-area. Keep away from reducing agents. Do not store near perchlorates, peroxides, chromic acid or nitric acid. II IL Section 8 - Exposure Controls, Personal Protection Engineering Controls: Use explosion-proof ventilation equipment. Facilities storing or utilizing this material should be equipped with an eyewash facility and a safety shower. Use adequate general or local exhaust ventilation to keep airborne concentrations below the permissible exposure limits. Exoosure Limits Chemical Name Water ACGIH NIOSH OSHA - Final PELs none listed none listed none listed Ethyl alcohol 1000 ppm TWA 1000 ppm TWA; 1900 mg/m3 TWA 3300 ppm IDLH none listed 1000 ppm TWA; 1900 mg/m3 TWA Sodium iodide none listed Iodine 0.1 ppm Ceiling 2 ppm IDLH none listed 0.1 ppm Ceiling; 1 mg/m3 Ceiling OSHA Vacated PELs: Water: No OSHA Vacated PELs are listed for this chemical. Ethyl alcohol: 1000 ppm TWA; 1900 mg/m3 TWA Sodium iodide: No OSHA Vacated PELs are listed for this chemical. Iodine: No OSHA Vacated PELs are listed for this chemical. Personal Protective Equipment Eyes: Wear appropriate protective eyeglasses or chemical safety goggles as described by OSHA's eye and face protection regulations in 29 CFR 1910.133 or European Standard EN166. Skin: Wear appropriate protective gloves to prevent skin exposure. Clothing: Wear appropriate protective clothing to prevent skin exposure. Respirators: A respiratory protection program that meets OSHA's 29 CFR 1910.134 and ANSI Z88.2 requirements or European Standard EN 149 must be followed whenever workplace conditions warrant respirator use. II 11___. Section 9 - Physical and Chemical Properties Date Received: Physical State: Liquid Appearance: amber Odor: alcohol-like pH: Not available. Vapor Pressure: 40 mm Hg MAY I 8 2009 Original Submittal 1f 7 15-Mar-0919:59 http~:/ /fsci mage. fishersci .com/msds/ 45416. htm Vapor Density: 1.6 Evaporation Rate: > 1 Viscosity: Not available. Boiling Point: 73-79 deg C Freezing/Melting Point:-80 deg C Decomposition Temperature:Not available. Solubility: Soluble in water. Specific Gravity / Density:O. 79 Molecular Formula:Mixture Molecular Weight:Not available. II Section 10 - Stability and Reactivity J Chemical Stability: Stable under normal temperatures and pressures. Conditions to Avoid: Stable under normal temperatures and pressures., incompatible materials, light, ignition sources, excess heat, oxidizers. Incompatibilities with Other Materials: Strong oxidizing agents, peroxides, acids, acid chlorides, acid anhydrides, alkali metals, ammonia, permanganic acid, ruthenium (VIII) oxide, bromine pentafluoride, nitrosyl perchlorate, chromyl chloride, uranium hexafluoride, iodine heptafluoride, uranyl perchlorate, acetyl bromide, silver nitrate, disulfuryl difluoride, magnesium perchlorate, platinum, potassium-tert-butoxide, silver oxide, hydrazine, tetrachlorosilane + water, acetyl chloride, calcium hypochlorite, mercuric nitrate, perchloric acid, potassium dioxide, sodium, magnesium, zinc, aluminum, steel, antimony, acetaldehyde, bromine trifluoride, reducing agents. Hazardous Decomposition Products: Carbon monoxide, irritating and toxic fumes and gases, carbon dioxiqe, toxic fumes of sodium oxide, hydrogen iodide, iodine. Hazardous Polymerization: Will not occur. II Section 11 - Toxicological Information II I RTECS#: CAS# 7732-18-5: ZCOllOOOO CAS# 64-17-5: KQ6300000 CAS# 7681-82-5: WB6475000 CAS# 7553-56-2: NN1575000 LDSO/LCSO: CAS# 7732-18-5: Oral, rat: LD50 = >90 mL/kg; CAS# 64-17-5: Draize test, rabbit, eye: 500 mg Severe; Draize test, rabbit, eye: 500 mg/24H Mild; Draize test, rabbit, skin: 20 mg/24H Moderate; Inhalation, mouse: LC50 = 39 gm/m3/4H; Inhalation, rat: LC50 = 20000 ppm/10H; Oral, mouse: LD50 = 3450 mg/kg; Oral, rabbit: LD50 = 6300 mg/kg; Oral, rat: LD50 = 7060 mg/kg; Oral, rat: LD50 = 9000 mg/kg; Date Received: MAY 1 8 2009 Original Submittal_ CAS# 7681-82-5: Draize test, rabbit, eye: 100 mg/24H Moderate; 1f 7 15-Mar-0919:59 https://fscimage.fishersci.com/msds/45416.htm Draize test, rabbit, skin: 500 mg/24H Moderate; Oral, mouse: LD50 = 1000 mg/kg; Oral, rat: LD50 = 4340 mg/kg; CAS# 7553-56-2: Oral, mouse: LD50 = 22 gm/kg; Oral, mouse: LD50 = 1000 mg/kg; Oral, rabbit: LD50 = 10 gm/kg; Oral, rat: LD50 = 14 gm/kg; Carcinogenicity: CAS# 7732-18-5: Not listed by ACGIH, IARC, NTP, or CA Prop 65. CAS# 64-17-5: Not listed by ACGIH, IARC, NTP, or CA Prop 65. CAS# 7681-82-5: Not listed by ACGIH, IARC, NTP, or CA Prop 65. CAS# 7553-56-2: Not listed by ACGIH, IARC, NTP, or CA Prop 65. Epidemiology: Ethanol has been shown to produce fetotoxici.ty in th'e embryo or fetus of laboratory animals. Prenatal exposure to ethanol is associated with a distinct pattern of congenital malformations that have collectively been termed the "fetal alcohol syndrome". Teratogenicity: CAS# 64-17-5: Oral, Human - woman: TDLo = 41 gm/kg (femaie 41 weekes) after conception) Effects on Newborn - Apgar score (human only) and Effects on Newborn - other neonatal measures or effects and Effects on Newborn - drug dependence. Reproductive Effects: CAS# 64-17-5: Intrauterine, Human - woman: TDLo = 200 mg/kg (female 5 day(s) pre-mating) Fertility - female fertility index (e.g. # females pregnant per # sperm positive females; # females pregnant per # females mated). Mutagenicity: CAS# 64-17-5: DNA Inhibition: Human, Lymphocyte = 220 mmol/L.; Cytogenetic Analysis: Human, Lymphocyte = 1160 gm/L.; Cytogenetic Analysis: Human, Fibroblast = 12000 ppm.; Cytogenetic Analysis: Human, Leukocyte = 1 pph/72H (Continuous).; Sister Chromatid Exchange: Human, Lymphocyte = 500 ppm/72H (Continuous). Neurotoxicity: No information found Other Studies: II Section 12 - Ecological Information ~I Ecotoxicity: Fish: Rainbow trout: LC50 = 12900-15300 mg/L; 96 Hr; Flow-through @ 24-24.30CFish: Rainbow trout: LC50 = 11200 mg/L; 24 Hr; Fingerling (Unspecified)Bacteria: Phytobacterium phosphoreum: EC50 = 34900 mg/L; 5-30 min; Microtox test CAS# 64-17-5: When spilled on land it is apt to volatilize, biodegrade, and leach into the ground water, but no data on the rates of these processes could be found. Its fate in ground water is unknown. When released into water it will volatilize and probably biodeg'rade. It would not be expected to adsorb to sediment or bioconcentrate in fish. Environmental: CAS# 64-17-5: When released to the atmosphere it will photodegrade in hours (polluted urban atmosphere) to an estimated range of 4 to 6 days in less polluted areas. Rainout should be significant. Date Received: Physical: No information available. Other: No information available. MAY 1 8 2009 Considerations . . . JI -nngtn~I.Sllbmltt~1 II Section 13 - Disposal Chemical waste generators must determine whether a discarded chemical is classified as a hazardous waste. US EPA guidelines for the classification determination are listed in 40 CFR Parts 261.3. Additionally, waste generators must consult state and local hazardous waste regulations to ensure )f 7 15-Mar-09 19:59 hUfl<:/ /fsci mage. fishersci .com/msds/ 45416. htm complete and accurate classification. RCRA P-Series: None listed. RCRA U-Series: None listed. II Section 14 - Transport Information Shipping Name: Hazard Class: UN Number: Packing Group: Additional Info: . US DOT ETHANOL SOLUTION 3 UN1170 II Canada TDG FLAMMABLE LIQUID NOS (ETHANOL) 3 UN1993 II FLASH POI NT 8 C II~, - _.'._._ Section 15 - Regulatory Information JI US FEDERAL TSCA CAS# 7732-18-5 is listed on the TSCA inventory. CAS# 64-17-5 is listed on the TSCA inventory. CAS# 7681-82-5 is listed on the TSCA inventory. CAS# 7553-56-2 is listed on the TSCA inventory. Health & Safety Reporting List None of the chemicals are on the Health & Safety Reporting List. Chemical Test Rules None of the chemicals in this product are under a Chemical Test Rule. Section 12b None of the chemicals are listed under TSCA Section 12b. TSCA Significant New Use Rule None of the chemicals in this material have a SNUR under TSCA. CERCLA Hazardous Substances and corresponding RQs None of the chemicals in this material have an RQ. SARA Section 302 Extremely Hazardous Substances None of the chemicals in this product have a TPQ. SARA Codes CAS # 64-17-5: immediate, delayed, fire. CAS # 7681-82-5: immediate. CAS # 7553-56-2: immediate, delayed, fire. Section 313 No chemicals are reportable under Section 313. Clean Air Act: This material does not contain any hazardous air pollutants. This material does not contain any Class 1 Ozone depletors. This material does not contain any Class 2 Ozone depletors. Clean Water Act: None of the chemicals in this product are listed as Hazardous Substances under the CWA. None of the chemicals in this product are listed as Priority Pollutants under the CWA".. None of the chemicais in this product are listed as Toxic Pollutants under the CWA. uate Received: OSHA: None of the chemicals in this product are considered highly hazardous by OSHA. MAY I 8 2009 STATE CAS# 7732-18-5 is not present on state lists from CA, PA, MN, MA, FL, or NJ. .. . CAS# 64-17-5 can be found on the following state right to know lists: CalifornQ)'I61l!WI~H!"ef1!ttal Pennsylvania, Minnesota, Massachusetts. )f 7 15-Mar-09 19:59 http"://fscimage.fishersci.com/msds/45416.htm CAS# 7681-82-5 is not present on state lists from CA, PA, MN, MA, FL, or NJ. CAS# 7553-56-2 can be found on the following state right to know lists: California, New Jersey, Pennsylvania, Minnesota, Massachusetts. California Prop 65 WARNING: This product contains Ethyl alcohol, a chemical known to the state of California to cause developmental reproductive toxicity. California No Significant Risk Level: None of the chemicals in this product are listed. European/International Regulations European Labeling in Accordance with EC Directives Hazard Symbols: F Risk Phrases: R 11 Highly flammable. Safety Phrases: S 16 Keep away from sources of ignition - No smoking. S 33 Take precautionary measures against static discharges. S 7 Keep container tightly closed. S 9 Keep container in a well-ventilated place. WGK (Water Danger/Protection) CAS# 7732-18-5: No information available. CAS# 64-17-5: 0 CAS# 7681-82-5: 1 CAS# 7553-56-2: 1 Canada - DSL/NDSL CAS# 7732-18-5 is listed on Canada's DSL List. CAS# 64-17-5 is listed on Canada's DSL List. CAS# 7681-82-5 is listed on Canada's DSL List. CAS# 7553-56-2 is listed on Canada's DSL List. Canada - WHMIS This product has a WHMIS classification of B2, D2B. This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations and the MSDS contains all of the information required by those regulations. Canadian Ingredient Disclosure List CAS# 64-17-5 is listed on the Canadian Ingredient Disclosure List. CAS# 7681-82-5 is listed on the Canadian Ingredient Disclosure List. CAS# 7553-56-2 is listed on the Canadian Ingredient Disclosure List. -- -- - ~~_...~.~---.--..- II 11_ Section 16 - Additional Information MSDS Creation Date: 9/02/1997 Revision #7 Date: 10/30/2007 The information above is believed to be accurate and represents the best information currently available to us. However, we make no warranty of merchantability or any other warranty, express or implied, with respect to such information, and we assume no liabifity resulting from its use. Users should make their own investigations to determine the suitability of the information for their particular purposes. In no event shall Fisher be liable for any claims, losses, or damages of any third party or for lost profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even if Fisher has been advised of the possibility of.such damages. Date Received: MAY 1 8 2009 Original Submittal )f 7 15-Mar-0919:59 httn: / /fscimage.fishersci .com/msds/89530, htm Material Safety Data Sheet Isopropyl alcohol 70% in water ACC# 89530 l Section 1 - C~E:ll11ical Product and_Co_mpanLldentification II MSDS Name: Isopropyl alcohol 70% in water Catalog Numbers: AC613190040, AC613245000, A459-1, A459-20, A459-4, A459-500, NC9290641, NC9405257, NC9524653, NC9761180 Synonyms: Isopropanol; Dimethylcarbinol; sec-Propyl alcohol; Rubbing alcohol; Petrohol; 1-Methylethanol; 1-Methylethyl alcohol; 2-Hydroxypropane; 2-Propyl alcohol; Isopropyl alcohol; Propan-2-ol; IPA; 2-Propanol. Company Identification: Fisher Scientific 1 Reagent Lane Fair Lawn, NJ 07410 For information, call: 201-796-7100 Emergency Number: 201-796-7100 For CHEMTREC assistance, call: 800-424-9300 For International CHEMTREC assistance, call: 703-527-3887 II II Section 2 - Composition, I nformation on Ingredients CAS# 67-63-0 7732-18-5 I Chemical Name !Isopropyl alcohol IWater Percent 70 30 EINECS/ELINCS 200-661- 7 231-791-2 II l Section 3 - Hazards Identification EMERGENCY OVERVIEW Appearance: colorless liquid. Flash Point: 18 deg C, Warning! Flammable liquid and vapor. Breathing vapors may cause drowsiness and dizziness. Causes eye and respiratory tract irritation, Aspiration hazard if swallowed. Can enter lungs and cause damage. Prolonged or repeated contact causes defatting of the skin with irritation, dryness, and cracking, May cause central nervous system depression, . Target Organs: Central nervous system, respiratory system, eyes, skin. Potential Health Effects Eye: Produces irritation, characterized by a burning sensation, redness, tearing, inflammation, and possible corneal injury. May cause transient corneal injury, In the eyes of a rabbit. 0.1 ml of 70% isopropyl alcohol caused conjunctivitis, iritis, and corneal opacity, Skin: May cause irritation with pain and stinging, especially if the skin is abraded, Isopropanol has a low potential to cause allergic skin reactions; however, rare cases of allergic contact dermatitis have been reported. May be absorbed through intact skin. Dermal absorption has been considered toxicologically insignificant, The cases of deep coma associated with skin contact are tholJjgatc:.{)Il?~eeived' consequence of gross isopropanol vapor inhalation in rooms with inadequate ventilation, rather t~n ' being attributable to percutaneous absorption of isopropanol per se. MAY I 8 2009 )f 7 Original SubOlitltlk.o.R 1 q : 52 httn: //fscimage. fishersci .com/msds/89530.htm Ingestion: Causes gastrointestinal irritation with nausea, vomiting and diarrhea, May cause kidney damage, May cause central nervous system depression, characterized by excitement. followed by headache, dizziness, drowsiness. and nausea. Advanced stages may cause collapse. unconsciousness, coma and possible death due to respiratory failure, Aspiration of material into the lungs may cause chemical pneumonitis, which may be fatal, The probable oral lethal dose in humans is 240 ml (2696 mg/kg), but ingestion of only 20 ml (224 mg/kg) has caused poisoning. Inhalation: Inhalation of high concentrations may cause central nervous system effects characterized by nausea, headache, dizziness, unconsciousness and coma, May cause narcotic effects in high concentration. Causes upper respiratory tract irritation. Inhalation of vapors may cause drowsiness and dizziness. Chronic: Prolonged or repeated skin contact may cause defatting and dermatitis, L Section 4 - First Aid Measures JI Eyes: In case of contact, immediately flush eyes with plenty of water for a t least 15 minutes. Get medical aid. Skin: In case of contact, flush skin with plenty of water, Remove contaminated clothing and shoes, Get medical aid if irritation develops and persists, Wash clothing before reuse, Ingestion: Potential for aspiration if swallowed. Get medical aid immediately. Do not induce vomiting unless directed to do so by medical personnel. Never give anything by mouth to an unconscious person. If vomiting occurs naturally, have victim lean forward, Inhalation: If inhaled, remove to fresh air. If not breathing, give artificial respiration. If breathing is difficult, give oxygen, Get medical aid. Notes to Physician: Urine acetone test may be helpful in diagnosis, Hemodialysis should be considered in severe intoxication, Treat symptomatically and supportively, ~I II Section 5 - Fire Fighting Measures General I nformation: As in any fire, wear a self-contained breathing apparatus in pressure-demand, MSHAlNIOSH (approved or equivalent), and full protective gear, Vapors may form an explosive mixture with air. Use water spray to keep fire-exposed containers cool. Flammable liquid and vapor, Vapors are heavier than air and may travel to a source of ignition and flash back, Vapors can spread along the ground and collect in low or confined areas. Extinguishing Media: Water may be ineffective. Do NOT use straight streams of water. For large fires, use dry chemical, carbon dioxide, alcohol-resistant foam, or water spray, For smail fires, use carbon dioxide, dry chemical. dry sand, or alcohol-resistant foam. Cool containers with flooding quantities of water until well after fire is out. Flash Point: 18 deg C ( 64.40 deg F) Autoignition Temperature: 399 deg C ( 750,20 deg F) Explosion Limits, Lower:2.0 vol % Upper: 12.7 @ 93,30C NFPA Rating: (estimated) Health: 1; Flammability: 3; Instability: 0 Jl 11- Section 6 - Accidental Release Measures General Information: Use proper personal protective equipment as indicated in Section 8, Spills/Leaks: Absorb spill with inert material (e.g. vermiculite, sand or earth), then place in suitable container, Use water spray to dilute spill to a non-flammable mixture. Clean up spills immediat~ly, observing precautions in the Protective Equipment section, Remove all sources of~~rRe~ved: spark-proof tool. Provide ventilation, A vapor suppressing foam may be used to reduce vapors. MAY 1 8 2009 ')f 7 Original submittalQJhDe~ 9: 52 httn: / /fscimage,fishersci .com/msds/89530.htm II~_ .....~___.._=__~ection.?_~_':!"!.n~ling and Storage u . _ ___--.J Handling: Wash thoroughly after handling. Remove contaminated clothing and wash before reuse. Ground and bond containers when transferring material. Use spark-proof tools and explosion proof equipment. Avoid contact with eyes, skin, and clothing, Empty containers retain product residue, (liquid and/or vapor), and can be dangerous. Take precautionary measures against static discharges. Keep container tightly closed. Do not pressurize, cut, weld, braze, solder, drill, grind, or expose empty containers to heat. sparks or open flames. Use only with adequate ventilation, Avoid breathing vapor or mist, Storage: Keep away from sources of ignition. Store in a tightly closed container. Keep from contact with oxidizing materials. Store in a cool. dry, well-ventilated area away from incompatible substances. ~~- Sectio~~_E)(po~~~~ Controls, Personal protection________..JI Engineering Controls: Use explosion-proof ventilation equipment. Facilities storing or utilizing this material should be equipped with an eyewash facility and a safety shower. Use adequate general or local exhaust ventilation to keep airborne concentrations below the permissible exposure limits. EXDosure Limits I Chemical Name ACGIH I NIOSH 400 ppm TWA; 980 mg/m3 TWA 2000 ppm IDLH (10% LEL) none listed OSHA - Final PELs Water 200 ppm TWA; 400 ppm STEL Inane listed 400 ppm TWA; 980 mg/m3 TWA Isopropyl alcohol none listed OSHA Vacated PELs: Isopropyl alcohol; 400 ppm TWA; 980 mg/m3 TWA Water; No OSHA Vacated PE Ls are I isted for this chemica I, Personal Protective Equipment Eyes: Wear chemical splash goggles, Skin: Wear appropriate protective gloves to prevent skin exposure. Clothing: Wear appropriate protective clothing to prevent skin exposure. Respirators: A respiratory protection program that meets OSHA's 29 CFR 1910,134 and ANSI Z88,2 requirements or European Standard EN 149 must be followed whenever workplace conditions warrant respirator use. II l Section 9 - Physical and Chemical Properties Physical State: Liquid Appearance: colorless Odor: alcohol-like pH: Not available. Vapor Pressure: 33 mm Hg @ 20 deg C Vapor Density: 2.1 (Air=1) Evaporation Rate:1,7 (n-butyl acetate=1) Viscosity: 2,27 mPas @ 20 deg C Boiling Point: 82 deg C @ 760 mm Hg Freezing/Melting Point:-88 deg C Decomposition Temperature: Not available, Solubility: Miscible. Specific Gravity/Density:O,7850 (water=1) Molecular Formula:C3H80 Date Received: MAY 1 8 2009 Original Submittal )f 7 09-Dec-0819:52 httn: / /fscimage, fishersci .com/msds/89530, htm Molecular Weight:50.09 ,~--~I II Section 10 Stability and Reactivity Chemical Stability: Stable. Conditions to Avoid: Ignition sources, excess heat. Incompatibilities with Other Materials: Strong oxidizing agents, strong acids, strong bases, amines, ammonia, ethylene oxide, isocyanates, acetaldehyde, chlorine, phosgene, Attacks some forms of plastics, rubbers, and coatings" aluminum at high temperatures, Hazardous Decomposition Products: Carbon monoxide, carbon dioxide. Hazardous Polymerization: Will not occur. J II Section 11 - Toxicological Information RTECS#: CAS# 57-53-0: NT8050000 CAS# 7732-18-5: ZC0110000 LDSO/LCSO: CAS# 57-53-0: Draize test. rabbit, eye: 100 mg Severe; Draize test. rabbit, eye: 1Q'mg Moderate; Draize test. rabbit, eye: 100 mg/24 H Moderate: Draize test. rabbit, skin: 500 mg Mild; Inhalation, mouse: LC50 = 53000 mg/m3: Inhalation, rat: LC50 = 15000 ppm/8H; Inhalation, rat: LC50 ~ 72500 mg/m3: Oral, mouse: LD50 ~ 3500 mg/kg; Oral, mouse: LD50 = 3500 mg/kg; Oral, rabbit: LD50 = 5410 mg/kg: Oral, rat: LD50 ~ 5045 mg/kg; Oral, rat: LD50 ~ 5000 mg/kg; Skin, rabbit: LD50 ~ 12800 CAS# 7732-18-5: Oral, rat: LD50 ~ >90 mL/kg; Date Received: Carcinogenicity: CAS# 57-53-0: Not listed by ACGIH, IARC, NTP, or CA Prop 55. CAS# 7732-18-5: Not listed by ACGIH, IARC, NTP, or CA Prop 55. MAY 1 8 2009 Epidemiology: No information'found Teratogenicity: A rat & rabbit developmental toxicity study showed no teratogenic effects at doses that were clearly maternally toxic, In a separate rat study, no evidence of developmental neurotoxicity was associated with gestational exposures to IPA up to 1200 mg/kg/d. Reproductive Effects: See actual entry in RTECS for complete information, Mutagenicity: See actual entry in RTECS for complete information, Neurotoxicity: In rats exposed to isopropanol by inhalation, acute neurotoxicity was noted at 1 and 5 hours at 5000 ppm, but only minimal effects were seen at 1500 ppm and the animais recovered within 5 hours, No toxicity was noted at 500 ppm, Other Studies: Original Submittal t.... Sec!i()n~ 2~- Eco.log!cal Information - II )f 7 09-Dec-08 19: 52 httn: / /fsci mage. fi shersci .com/msds/895 30, htm I: -- --, ----] Ecotoxicity: Fish: Fathead Minnow: >1000 ppm; 95h; LC50Daphnia: >1000 ppm; 95h; LC50Fish: Gold orfe: 8970,9280 ppm; 48h; LC50 IPA has a high biochemical oxygen demand and a potential to cause oxygen depletion in aqueous systems, a low potential to affect aquatic organisms, a low potential to affect secondary waste treatment microbial metabolism, a low potential to affect the germination of some plants, a high potential to biodegrade <low persistence) with unacclimated microorganisms from activated sl udge. Environmental: No information available. Physical: THOD: 2.40 g oxygen/gCOD: 2,23 g oxygen/gBOD-5: 1.19-1.72 g oxygen/g Other: No information available, l Section 13 - Disposal Consi'derations II Chemical waste generators must determine whether a discarded chemical is classified as a hazardous waste, US EPA guidelines for the classification determination are listed in 40 CFR Parts 251,3, Additionally, waste generators must consult state and local hazardous waste regulations to ensure complete and accurate classification. RCRA P-Series: None listed. RCRA U-Series: None listed. Shipping Name: Hazard Class: UN Number: Packing Group: US DOT ISOPROPANOL 3 UN1219 II Canada TOG ISOPROPANOL 3 UN1219 II ~l I I I I II Section 14 - Transport Information II Section 15 - Regulatory Information JI US FEDERAL TSCA CAS# 57-53-0 is listed on the TSCA inventory. CAS# 7732-18-5 is listed on the TSCA inventory, Health & Safety Reporting List CAS# 57 -53-0: Effective 12/15/86, Sunset 12/15/95 Chemical Test Rules CAS# 67-63-0: 40 CFR 799.2325 Section 12b None of the chemicals are listed under TSCA Section 12b, TSCA Significant New Use Rule None of the chemicals in this material have a SNUR under TSCA, CERCLA Hazardous Substances and corresponding RQs None of the chemicals in this material have an RQ. SARA Section 302 Extremely Hazardous Substances None of the chemicals in this product have a TPQ. SARA Codes CAS # 67-53-0: immediate, delayed, fire. Section 313 Date Received: MAY I 8 2009 Original Submill~1 )f 7 09-Dec-0819:52 . httn: //fscimage, fishersci ,com/msds/89530.htm This material contains Isopropyl alcohol (CAS# 67-63-0, 70%),which is suqject to the reporting requirements of Section 313 of SARA Title III and 40 CFR Part 373. Clean Air Act: This material does not contain any hazardous air' pollutants, This material does not contain any Class 1 Ozone depletors. This material does not contain any Class 2 Ozone depletors. Clean Water Act: None of the chemicals in this product are listed as Hazardous Substances under the CWA. None of the chemicals in this product are listed as Priority Pollutants under the CWA, None of the chemicals in this product are listed as Toxic Pollutants under the CWA, OSHA: ' None of the chemicals in this product are considered highly hazardous by OSHA. STATE CAS# 67-63-0 can be found on the following state right to know lists: California, New Jersey, Pennsylvania, Minnesota, Massachusetts, CAS# 7732-18-5 is not present on state lists from CA, PA, MN, MA, FL, or NJ. California Prop 65 California No Significant Risk Level: None of the chemicals in this product are listed, European/ I nternational Regulations European Labeling in Accordance with EC Directives Hazard Symbols: XI F Risk Phrases: R 11 Highly flammable, R 36 Irritating to eyes. R 67 Va pours may cause drowsiness and dizziness. Safety Phrases: S 16 Keep away from sources of ignition - No smoking. S 24/25 Avoid contact with skin and eyes, S 26 In case of contact with eyes, rinse immediately with plenty of water and seek medical advice. S 7 Keep container tightly closed. WGK (Water Danger/Protection) CAS# 67-63-0: 1 CAS# 7732-18-5: No information available, Canada - DSL/NDSL CAS# 67-63-0 is listed on Canada's DSL List, CAS# 7732-18-5 is listed on Canada's DSL List, Canada - WHMIS This product has a WHMIS classification of B2, D2A. This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations and the MSDS contains all of the information required by those regulations, Canadian Ingredient Disclosure List . CAS# 67-63-0 is listed on the Canadian Ingredient Disclosure List, II Il;:ltf! RpCAjy ~d: ._ -----n.-.1 HNH-g-~g€J Section 16 - Additional Information MSDS Creation Date: 7/27/1999 Revision #11 Date: 2/18/2008 Original SubmittaJ The information above is believed to be accurate and represents the best information currently available to us. However, we make no )f 7 09-Dec-0819:52 " httn: / /fscimage. fishersci .com/msds/89530.htm warranty of merchantability or any ottler warranty express or implied, with respect to such information, and we assume no liability resulting from its use. Users should make their own investigations to determine the suitability of.the information for their particular purposes. In no event shall Fisher be liable for any claims, losses, or damages of any tf7ird party or for lost profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even if Fisher has been advised of the possibility of such damages. Date Received: MAY 1 8 2009 Original Submittal )f 7 09-Dec-0819:52 . Item Number: 804 04/2912008 Page I of 5 Material$afet~(Dc:,lta Sheet J -~\ 111\ i' ! , Section 1: PRODUCT AND COMPANY IDENTIFICATION. Vi-Jon Incorporated 8515 Page Avenue Saint Louis, MO 63114 Phone: 314-427-1000 In Case of Spill Emergency Contact: Chemtrec: 1-800-424-9300 Product Name: 91% WG Isopropyl Alcohol Product Code: 804 Product Use: Various Issue Date: 04/29/2008 Supersedes Date: None Section 2: HAZARDS IDENTIFICATION EMERGENCY OVERVIEW: Keep out of reach of children. Appearance/Odor: Clear, colorless, mobile liquid with a characteristic odor. WARNING: Flammable (isopropyl alcohol) Target (isopropyl alcohol) respiratory system, skin, eyes, CNS, liver, blood and reproductive system. Potential Health Effects: See Section 11 for more information. Symptoms of Exposure: Inhalation: May cause irritation of the respiratory tract. Ingestion: May cause nausea, vomiting and diarrhea, Eyes: May cause irritation to the eyes. Skin: May cause irritation to the skin. This product does not contain any carcinogens or potential carcinogens as listed by OSHA, IARC orNTP. This material contains a component that is considered hazardous by the OSHA Hazard Communication Standard (29 CFR 1910.1200). Potential Environmental Effects: See Section 12 for more information. Date Received: MAY 1 8 2009 Original Submittl'I Item Number: 804 04/29/2008 Page 2 of 5 Section 3: COMPOSITION/INFORMATION ON INGREDIENTS Comoonent Isopropyl Alcohol CAS# 67-63-0 %bvWl. 91% Section 4: FIRST AID MEASURES Emergency first aid procedures by route of exposure: Inhalation: If symptoms are experience, remove source of contamination or move victim to fresh air. If affected person is not breathing, apply artificial respiration. If breathing is difficult, give oxygen. Get medical attention. Do not induce vomiting. If the material is swallowed, get medical attention or advice. If irritation is experienced, fiush with water. If irritation persists, get medical attention, Immediately flush eyes with water for at least 15 minutes while holding eyelids open. If symptoms persist, get medical attention. Ingestion: Skin: Eyes: Section 5: FIRE FIGHTING MEASURES Flash Point: 140C (57.2'F) Auto Ignition: (Isopropyl Alcohol) 3990C Flammability Classification: Flammable Liquid IB Extinguishing Media: Use methods appropriate for the surrounding fire. Consider water spray or fog, carbon dioxide, dry chemical powder, or alcohol resistant foam. Products of Combustion: Upon decomposition this product may emit carbon dioxide, carbon monoxide and/or low molecular weight hydrocarbons. Fire Fighting Equipment/Instructions: Wear protective clothing and equipment suitable for the surrounding fire, including helmet, facemask, and self contained breathing apparatus. NFPA Rating: Health:1 Fire: 3 Reactivity:O Hazard Scale: 0 = Minimal 1 = Slight 2 = Moderate 3 = Serious 4 = Severe 'Section 6: ACCIDENTAL RELEASE MEASURES Personal Precautions: For large spills wear gloves, safety glasses and when levels exceed OSHA PEL use appropriate NIOSH approved respiratory protection. Keep unnecessary personnel away. Eliminate all sources of ignition or flammables that may come into contact with a spill of this material. Environmental Precautions: Prevent discharge to open waters. Method for Containment: Absorb spilled liquid in suitable non-flammable inert material such as clay, vermiculite or diatomaceous earth. Methods for Clean-Up: Ventilate area of leak or spill. Use spark-proof tools to sweep or scrape up and containerize in approved chemical waste container. Wash spill area with water. Date Received: MAY 1 8 2009 Original Submittal . Item Number: 804 04/29/2008 Page 3 of 5 'Section 7: HANDLING AND STORAGE ~. " Handling: Keep away from heat, sparks and flame. Prevent contact with eyes. Avoid inhalation. Storage: Keep the container tightly closed and in a cool, well ventilated place. Section 8: EXPOSURE CONTROLS/PERSONAL PROTECTION Exposure Guidelines Isopropyl Alcohol (67.-63-0) ACGIH: 200 ppm TWA OSHA: 400 ppm TWA; 980 mg/m3 TWA Engineering Controls: Normal room ventilation is usually adequate under normal use. Personal Protective Equipment (PPE) Eye/Face Protection: None needed under normal use. Skin Protection: None needed under normal use. Respiratory Protection: None needed under normal use. General Hygiene Considerations: None needed under normal use. Section 9: PHYSICAL.AND CHEMICAL PROPERTIES Appearance/Color: Clear, colorless, mobile liquid Odor: Alcohol Physical State:Liquid pH: Not Available. Vapor Density: (Isopropyl Alcohol) 2,07 (air = 1) Boiling Point: (Isopropyl Alcohol) 82.50C [DIN 43171] Vapor Pressure: (Isopropyl Alcohol) 42 hPa at 200C Melting Point: (Isopropyl Alcohol) -900C Freezing Point: Not Available Flash Point (see section 5) Flammability Properties (see section 5) Solubility (in water): Soluble Density @ 20oC: 0.784-0.786 g/cm3 Evaporation Rate: Not Available OctanollWater partition coefficient (Kow): (Isopropyl Alcohol): 0,05 at 250C Auto-ignition temperature: (Isopropyl Alcohol) 3990C Decomposition temperature: Not Available 'Section 10: STABILITY AND REACTIVITY Stability: Stable under normal ambient temperatures 700C (210C) Condition to Avoid: Avoid excessive heat or sources of ignition. Incompatible Materials: This product reacts with strong acid, strong bases, and oxidizing agents. Hazardous Decomposition: upon decomposition,'this product evolves carbon monoxide, carbon dioxide, and/or low weight hydrocarbons. Date Received: Hazardous Reactions: Hazardous polymerization will not occur, MAY 1 8 2009 Original Submittal . Item Number: 804 04/29/2008 Page 4 of 5 .Section 11: TOXICOLOGY INFORMATION. ACUTE EFFECTS: A: General Product information Product contains isopropyl alcohol. B: Component Analysis LD50 Isopropyl Alcohol (67-63-0) Inhalation LC50 Rat: 72.6 mg/L/4H Oral LD50 Rat: 4396 mg/kg Dermal LD50 Rat: 12800 mg/kg Dermal LD50 Rabbit: 12870 mg/kg CHRONIC EFFECTS: Component Isopropyl Alcohol (67-63-0) Carcinogenicity: ACGIH A4 - Not Classifiable as a Human Carcinogen Neurotoxicity: This product contains isopropyl alcohol, a central nervous system target. Mutagenicity: No information available for product. Reproductive: No information available for product. Developmental: This product contains isopropyl alcohol, a developmental hazard. Target Organs: skin, eyes, CNS, Kidney, Developmental and respiratory system, Section 12: ECOLOGICAL INFORMATION Ecotoxicity: Isopropyl Alcohol (67-63-0) 96 Hr EC50 Scenedesmus Subspicatus: >1000 mg/L 72 Hr EC50 Scenedesmus subspicatus:>1000 mg/L 96 Hr LC50 Pimephales promelas: 9640 mg/L [flow through] 96 Hr LC50 Pimephales promelas: 94900 mg/L [flow through] (29 days old) 96 Hr LC50 Pimephales promelas: 61200 mg/L [flow through] (31 days old) 5 min EC50 Photobacterium phosphoreum: 35390 mg/L 48 Hr EC50 Daphnia magna: 13299 mg/L 'Section 13: DISPOSAL CONSIDERATIONS Dispose of in accordance with federal, state, and local regu'latlons. 'Section 14: TRANSPORTATION INFORMATION Shipping Name: Consumer Commodity ORM-D Proper Shipping Name for Non-Consumer Commodity: Isopropanol, 3, UN1219, PGII. Section 15: REGULATORY INFORMATION Isopropyl alcohol, a component of this product, is on the TSCA inventory. The following components appear on one or more of the following state hazardous substance lists: I Component I Isopropyl Alcohol CAS# 67-63-0 I CA I YES MA YES MN YES NJ YES PA YES Date Received: MAY I 8 2009 Original Submitt;:ol Item Number: 804 04/29/2008 Page 5 of 5 Section 16: Other Information Prepared by: Vi-Jon Inc. Disclaimer: The information and recommendations contained in the Material Safety Data Sheet (MSDS) are supplied pursuant to 29 CFR 1910.1200 of the Occupational Safety and Health Standards Hazard Communication Rule. The information and recommendations set forth herein are presented in good faith and believed to be correct as of this date hereof, Vi-Jon, however, makes no representation as to the completeness or accuracy thereof, and information is supplied upon the express condition that the persons receiving the information will be required to make their own determination as to its suitability for their purposes prior to use, In no event will Vi-Jon be responsible for any damages of any nature whatsoever resulting from the use of, reliance upon, or the misuse of this information. User assumes all risk of use. storaae and handlina of the oroduct in comoliance with aoolicable federal. state and local laws and reaulations. NO REPRESENTATIONS OR WARRANTIES, EITHER EXPRESSED OR IMPLIED, OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR OF ANY OTHER NATURE, ARE MADE BY VI-JON HEREUNDER WITH RESPECT TO INFORMATION OR THE PRODUCT TO WHICH THE INFORMATION REFERS. The informatian as supplied herein is simply to be informative and intended solely to alert the user af the substance which is the subject matter af this MSDS. The ultimate compliance with federal, state ar local regulations concerning the use of this compound, or compliance with respect.ta product liability, rests solely upon the purchaser thereof. This information relates to the material desianated and mav not be valid for such material used in cambination with anv other materials nor in anv orocess. Date Received: MAY 1 8 2009 Original Submitt;>1 Material Safety Data Sheet according to ANSI Z400.1- 2004 and 29 CFR 1910.1200 djohnson A FAMILY COMPANY Version 1. WINDEX@ ORIGINAL GLASS CLEANER Print Date 01/22/2009 Revision Date 01/16/2009 MSDS Number 350000004274 1. PRODUCT AND COMPANY IDENTIFICATION Product information Trade name Use of the Substance/Preparation Company Emergency telephone 2. HAZARDS IDENTIFICATION Emergency Overview. Appearance / Odor Immediate Concerns Potential Health Effects Routes of exposure Eyes Skin Inhalation Ingestion Aggravated Medical Condition WINDEX@ORIGINAL GLASS CLEANER Hard Surface Cleaner S.C, Johnson & Son, Inc. 1525 Howe Street Racine WI 53403-2236 24 Hour Transport & Medical Emergency Phone (866) 231- 5406 24 Hour International Emergency Phone (952) 8524647 blue /Iiquid / characteristic Avoid contact with skin, eyes and clothing. Eye, Skin, Inhalation, Ingestion. None known. None known. None known. None known. None known. 3. COMPOSITION/INFORMATION ON INGREDIENTS I Chemical Name I Water I Isopropanol I Ethyleneglycol Monohexvlether 4. FIRST AID MEASURES Eye contact . CAS-No. 7732-18-5 67-63-0 112-25-4 % 60.00 - 100.00 1.00 - 5,00 0.10 - 1.00 I I I D~te Re!~eived: ~IA'i I f 2009 Rinse with plenty of water. Get medical attentio'b\-i!lil'l~~~ubmitt II 1/7 Material Safety Data Sheet according to ANSI 2400.1- 2004 and 29 CFR 1910.1200 d)ohnson A FAMILY COMPANY WINDEX@ ORIGINAL GLASS CLEANER Version 1. Print Date 01/22/2009 Revision Date 01/16/2009 MSDS Number 350000004274 develops and persists. Skin contact Wash off with soap and water. Get medical attention if irritation develops and persists. Inhalation Remove to fresh air. Ingestion Never give anything by mouth to an unconscious person. Get medical attention immediately. 5. FIRE-FIGHTING MEASURES Suitable extinguishing media Alcohol foam, carbon dioxide, dry chemical, water fog Specific hazards during fire fighting Container may melt and leak in heat of fire. Further information Although this product has a flash point below 200 Deg F, it is an aqueous solution containing an alcohol and does not sustain combustion. Standard procedure for chemical fires. Wear full protective clothing and positive pressure self- contained breathing apparatus. Flash point 130 'F Method: Tag Closed Cup (TCC) Flash point 54 'C Method: Tag Closed Cup (TCC) Lower explosion limit Note: no data available Upper explosion limit Note: no data available 6. ACCIDENTAL RELEASE, MEASURES Personal precautions Remove all sources of ignition. Methods for cleaning up Soak up with inert absorbent material. Sweep up and shovel into suitable containers for disposal. Dike large spills. Date Rece ived: 7. HANDLING AND STORAGE MAT J 11 i,an9 Handling Advice on safe handling Original Submittal. KEEP OUT OF REACH OF CHILDREN AND PETS, 2/7 Material Safety Data Sheet according 10 ANSI Z400.1- 2004 and 29 CFR 1910.1200 mohnson A FAMILY COMPANY Version 1. WINDEX@ ORIGINAL GLASS CLEANER Print Date 01/22/2009 Revision Date 01/16/2009 Advice on protection against fire and explosion Storage Requiremenls for storage areas and containers' MSDS Number 350000004274 Use only as directed. Keep away from heat and sources of ignition. Keep container closed when not in use. Keep in a dry, cool and well-ventilated place. Do not freeze. Occupational Exposure Limits 8. EXPOSURE CONTROLS/PERSONAL PROTECTION mg/m3 Isopropanol 67-63-0 400 ppm ACGIH STEL /Isopropanol 67-63-0 200 ppm ACGIH TWA I Isopropanol 67-63-0 980 mg/m3 400 ppm OSHA TWA Personal protective equipment Respiratory protection Industrial setting Household setting Hand protection Industrial setting Household setting Eye protection Industrial setting Household setting Hygiene measures No personal respiratory protective equipment normally required, No personal respiratory protective equipment normally required. not required under normal use not required urider normal use No special requirements, Date RE ,ceived: No special requirements. MAY 1 '8 2009 Use only with adequate ventilation. Wash thoroughly after handling. S~bstantial amounts of mist/vapors ca?-!;lfbinal Subrni tal controlled With local exhaust ventilation or resp,,~ory protection. Wear suitable protective clothing. 3/7 Material Safety Data Sheet according to ANSI 2400.1- 2004 and 29 CFR 1910.1200 mohnson A FAMILY COMPANY WINDEX@ ORIGINAL GLASS CLEANER Version 1. Print Date 01/22/2009 Revision Date 01/16/2009 MSDS Number 350000004274 9. PHYSICAL AND CHEMICAL PROPERTIES Form liquid Color blue Odor characteristic pH 10.5 -11,0 Melting point no data available Boiling point no data available Freezing point . no data available Flash point 130 of Method: Tag Closed Cup (TCC) Flash pOint 54 oC Method: Tag Closed Cup (TCC) Evaporation rate no data available Autoignition temperature no data available Lower explosion limit no data available Upper explosion limit no data available Vapour pressure similar to water Water solubility completely soluble Partition coefficient: n- octanol/water no data available Specific Gravity 1.0 estimated Date Re ceived: 10. STABILITY AND REACTIVITY ~.A.Y 1 3 2009 Conditions to avoid None known. Original Submil tal Materials to avoid Strong oxidizing agents Hazardous decomposition products When exposed to fire. produces normal products of combustion. 4/7 Material Safety Data Sheet according to ANSI Z400.1- 2004 and 29 CFR 1910.1200 dJohnson A FAMILY COMPANY WINDEX@ ORIGINAL GLASS CLEANER Version 1. Print Date 01/22/2009 Revision Date 0111612009 MSDS Number 350000004274 Hazardous reactions Stable 11. TOXICOLOGICALlNFORMATION Acute oral toxicity LD50 Dose: eslimated > 5,000 mglkg Acute inhalation toxicity LC50 rat Dose: ;. 2.5 mg/l Acute dermal toxicity LD50 rabbit Dose: estimated> 2,000 mg/kg Chronic effects Carcinogenicity no data available Mutagenicity no data available Reprod uctive effects no data available Teratogenicity no data available Sensitisalion : Not known to be a sensitizer, 12. ECOLOGICAL INFORMATION Ecotoxicity effects Not Available 13. DISPOSAL CONSIDERATIONS Industrial setting Observe all applicable Federal, Provincial and State regulations and Local/Municipal ordinances regarding disposal. Household setting Consumer may discard empty container in trash, or recycle where facilities exist. Date Rel~eived: 14. TRANSPORT INFORMATION MAY 11 2009 Land transport 5/7 Original Submitl al I Material Safety Data Sheet ,,!if I wohnson according to ANSI Z400.1- 2004 and 29 CFR 1910.1200 A FAMILY COMPANY WINDEX@ ORIGINAL GLASS CLEANER Version 1. Print Date 01/22/2009 Revision Date 01/16/2009 MSDS Number 350000004274 U.S. DOT and Canadian TOG Surface Transportation: NA number 1993 Proper shipping name Combustibie Liquid, N,O,S. Class: Combustible liquid Packaging group: III Note: SC Johnson ships this product as "Non-Regulated" per DOT exception for Combustible Liquids. (49 CFR 173.150) Sea transport /MDG: UN-Number: Packagin9 group: Proper shipping name Class: None. None. not regulated None. Air transport /CAO//A TA: Class: Packaging group: Proper shipping name UNIID No.: None. None. not regulated None. '15. REGULATORY INFORMATION Global Chemical Inventories Notification status All ingredients of this product are listed or are excluded from listing on the U.S. Toxic Substances Control Act (TSCA) Chemical Substance Inventory. All ingredients of this product comply with the New Substances Notification requirements under the Canadian Environmental Protection Act (CEPA). California Prop, 65 This product is not subject to the reporting requirements under California's Proposition 65. This product has been classified in accordance with hazard criteria of the Controlled Products Regulations and the MSDS contains all the information required by the Controlled Products Regulations. Date Feceived: 6/7 ~':1Y 1 8 2009 Original Submittal Material Safety Data Sheet ....~I wohnson according to ANSI Z400.1- 2004 and 29 CFR 1910.1200 A FAMILY COMPANY WINDEX@ORIGINAL GLASS CLEANER Version 1. Print Date 01/22/2009 Revision Date 01/16/2009 MSDS Number 350000004274 16. OTHER INFORMATION HMIS Ratings Health o Flammability 2 Reactivity o NFPA Ratings Health o Fire 2 Reactivity o Special Further information This document has been prepared using data from sources considered to be technically reliable. It does not constitute a warranty, expressed or implied, as to the accuracy of the information contained herein. Actual conditions of use are beyond the seller's control. User is responsible to evaluate all available information when using product for any particular use and to comply with all Federal, State, Provincial and Local laws and regulations. I Prepared by: I SC Johnson Global Safety Assessment & Reaulatorv Affairs (GSARA) Date Re ~eived: MAY 11 2009 Original Submit a/ 7/7 . ((i. Science; ~ab.eom ~ ) Chemi~als&L~~ofa~ory ~q~ipli1~nt Health,' 2 F!re . 2 I Reactivity 0 I Personal J Protection Material Safety Data Sheet Witch Hazel MSDS Section 1: Chemical Product l!nd COmpany Identificl!tion Product Name: Witch Hazel Contact Information: Catalog Codes: SLW1105 Sciencelab.com, Inc. 14025 Smith Rd. Houston, Texas 77396 US Sales: 1-600-901-7247 I nternational Sales: 1-261-441-4400 CAS#: Mixture, RTECS: Not applicable. TSCA: TSCA 8(b) inventory: Ethyl alcohol 200 Proof CI#: Not applicable. Order Online: ScienceLab.com Synonym: Witch Hazel, double distilled extract CHEMTREC (24HR Emergency Telephone), call: 1-800-424-9300 Chemical Name: Not applicable, International CHEMTREC, call: 1-703-527-3887 Chemical Formula: Not applicable. For non-emergency assistance, call: 1-281-441-4400 Section 2: Composition and Information on Ingredients Composition: I Name I Ethyl alcohol 200 Proof I Witch Hazel Extract I CAS # 64-17-5 % by Weight 14-15 85-86 Toxicological Data on Ingredients: Ethyl alcohol 200 Proof: ORAL (LD50): Acute: 7060 mg/kg [Rat.]. 3450 mg/kg [Mouse]. VAPOR (LC50): Acute: 20000 ppm 8 hours [Rat]. 39000 mg/m 4 hours [Mouse]. Section 3: Hazards Identification Potential Acute Health Effects: Hazardous in case of eye contact (irritant), of ingestion, of inhalation. Slightly hazardous in case of skin contact (irritant, permeator). Potential Chronic Health Effects: CARCINOGENIC EFFECTS: Classified PROVEN by State of California Proposition 65 [Ethyl alcohol 200 Proof]. Classified A4 (Not classifiable for human or animaL) by ACGIH [Ethyl alcohol 200 Proof], MUTAGENIC EFFECTS: Mutagenic for mammalian somatic cells. [Ethyl alcohol 200 Proof]. Mutagenic for bacteria and/or yeast. [Ethyl alcohol 200 Proof]. TERATOGENIC EFFECTS: Classified PROVEN for human [Ethyl alcohol 200 Proof]. DEVELOPMENTAL TOXICITY: Classified Development toxin [PROVEN] [Ethyl alcohol 200 Proof], C1a!i~!Le<:h 'v d' Reproductive system/toxin/male [POSSIBLE] [Ethyl alcohol 200 Proof], UC:ll~ ~ecel e . MAY 1 8 2009 p.1 Original Submitt;:ol The substance is toxic to blood, the reproductive system, liver, upper respiratory tract, skin, central nervous system (CNS). Repeated or prolonged exposure to the substance can produce target organs damage. Section 4: First Aid Measures Eye Contact: Check for and remove any contact lenses. Immediateiy flush eyes with running water for at least 15 minutes, keeping eyelids open. Cold water may be used. Get medical attention. Skin Contact: Wash with soap and water. Cover the irritated skin with an emollient. Get medical attention if irritation develops. Cold water may be used. Serious Skin Contact: Not available. Inhalation: If inhaled, remove to fresh air. If not breathing, give artificial respiration. If breathing is difficult, give oxygen, Get medical attention if symptoms appear. Serious Inhatation: Evacuate the victim to a safe area as soon as possible. Loosen tight clothing such as a collar, tie, belt or waistband. Seek medical attention. Ingestion: Do NOT induce vomiting unless directed to do so by medical personnel. Never give anything by mouth to an unconscious person. Loosen tight clothing such as a collar, tie, belt or waistband, Get medical attention if symptoms appear. Serious Ingestion: Not available. Section 5: Fire and Explosion Data Flammability of the Product: Flammable. Auto-Ignition Temperature: The lowest known value is 363'C (685.4'F) (Ethyl alcohol 200 Proof). Flash Points: OPEN CUP: 43.333'C (110'F). Flammable Limits: The greatest known range is LOWER: 3.3% UPPER: 19% (Ethyl aicohol 200 Proof) Products of Combustion: These products are carbon oxides (CO, C02). Fire Hazards in Presence of Various Substances: Flammable in presence of open flames and sparks, of heat. Slightly flammable to flammable in presence of oxidizing materials. Non-flammable in presence of shocks. Explosion Hazards in Presence of Yarious Substances: Risks of explosion of the product in presen'ce of mechanical impact: Not available. Risks of explosion of the product in presence of static discharge: Not available. Slightly explosive In presence of acids. Date Received: MAY 1 8 2009 Fire Fighting Media and Instructions: Flammable liquid, soluble or dispersed in water. SMALL FIRE: Use DRY chemical powder. LARGE FIRE: Use alcohol foam, water spray or fog. Cool containing vessels with water jet in order to prevent pressure build-up, autoignition or explosion. Original Submittal Special Remarks on Fire Hazards: Containers should be grounded. CAUTION: MAY BURN WITH NEAR INVISIBLE FLAME Vapor may travel p. 2 considerable distance to source of ignition and flash back, (Ethyl alcohol 200 Proof) Special Remarks on Explosion Hazards: Ethanol has an explosive reaction with the oxidized coating around potassium metal. Ethanol ignites and then explodes on contact with acetic anhydride + sodium hydrosulfate (ignites and may explode), disulfuric acid + nitric acid, phosphorous(lll) oxide platinum, potassium-tert-butoxide+ acids, Ethanol forms explosive products in reaction with the following compound: ammonia + silver nitrate (forms silver nitride and silver fulminate), iodine + phosphorus (forms ethane iodide), magnesium perchlorate (forms ethyl perchlorate), mercuric nitrate, nitric acid + silver (forms silver fulminate) silver nitrate (forms ethyl nitrate) silver(l) oxide + ammonia or hydrazine (forms silver nitride and silver fulminate), sodium (evolves hydrogen gas). (Ethyl alcohol 200 Proof) Section 6: AccidentalRelease Measures Small Spill: Dilute with water and mop up, or absorb with an inert dry material and place in an appropriate waste disposal container. Large Spill: Flammable liquid. Keep away from heat. Keep away from sources of ignition. Stop leak if without risk. Absorb with DRY earth, sand or other non-combustible material. Do not touch spilled material. Prevent entry into sewers, basements or confined areas; dike if needed. Be careful that the product is not present at a concentration level above TL V, Check TL V on the MSDS and with local authorities. Section' 7: Handling and Storage Precautions: . Keep locked up.. Keep away from heat. Keep away from sources of ignition. Ground all equipment containing material. Do not ingest. Do not breathe gas/fumes/ vapor/spray, Avoid contact with eyes. Wear suitable protective clothing. In case of insufficient ventilation, wear suitable respiratory equipment. If ingested, seek medical advice immediately and show the container or the label. Storage: Store in a segregated and approved area. Keep container in a cool, well-ventilated area. Keep container tightly closed and sealed until ready for use. Avoid all possible sources of ignition (spark or flame). Section 8: Exposure Controls/Personal PrQtection Engineering Controls: Provide exhaust ventilation or other engineering controls to keep the airborne concentrations of vapors below their respective threshold limit value. Ensure that eyewash stations and safety showers are proximal to the work-station location. Personal Protection: Splash goggles, Lab coat. Vapor respirator, Be sure to use an approved/certified respirator or equivalent. Gloves (impervious). Personal Protection in Case of a Large Spill: Splash 'goggles. Full suit. Vapor respirator, Boots. Gloves. A self contained breathing apparatus should be used to avoid inhalation of the product. Suggested protective clothing might not be sufficient; consult a specialist BEFORE handling this product. Exposure Limits: Ethyl alcohol 200 Proof TWA: 1000 (ppm) from ACGIH (TL V) [United States] [1999] TWA: 1000 (ppm) from OSHA (PEL) [United States] Date Received: MAY 1 8 2009 Original Submittal p. 3 . TWA: 1900 (mg/m3) from OSHA (PEL) [United States] TWA: 1000 (ppm) from NIOSH TWA: 1000 (ppm) [United Kingdom (UK)] TWA: 1920 (mg/m3) [United Kingdom (UK)] TWA: 1000 STEL: 1250 (ppm) [Canada] Consult local authorities for acceptable exposure limits. Section 9: Physical and Chemical Properties Physical state and appearance: Liquid. Odor: Characteristic Witch Hazel (Strong.) Taste: Not available. Molecular Weight: Not applicable. Color: Clear Colorless. pH (1% soln/water): Not available. Boiling Point: 880C (190.40F) Melting Point: _80C (17.60F) Critical Temperature: The lowest known value is 2430C (469.4 OF) (Ethyl alcohol 200 Proof). Specific Gravity: 0.979 - 0.983 @ 25 C(Water = 1) Vapor Pressure: 2.5 kPa (@ 20oC) Vapor Density: 1.03 (Air = 1) Volatility: Not available. Odor Threshold: The highest known value is 100 ppm (Ethyl alcohol 200 Proof) Water/Oil Dis!. Coeff.: Not available. lonicity (in Water): Not available. Dispersion Properties: See solubility in water, methanol, diethyl ether, acetone. Solubility: Easily soluble in cold water, hot water. Soluble in methanol, diethyl ether, acetone. Section 10: Stability and Reactivity Data Stability: The product is stable. Instability Temperature: Not available. Conditions of Instability: Heat, ignition sources (sparks, fiames), incompatible materials Incompatibility with various substances: Slightly reactive to reactive with oxidizing agents, acids, alkalis. Corrosivity: Non-corrosive in presence of glass. Date Received: Special Remarks on Reactivity: t~l\ Y 1 8 2~~9 Original Submittal . p. 4 . Ethanol rapidly absorbs moisture from the air. Can react vigorously with oxiders. The following oxidants have been demonstrated to undergo vigorous/explosive reaction with ethanol: barium perchlorate, bromine pentaftuoride, calcium hypochlorite, chloryl perchlorate, chromium trioxide, chromyl chloride, dioxygen difluoride, disulfuryl difluoride, fluorine nitrate, hydrogen peroxide, iodine heptafluoride, nitric acid nitrosyl perchlorate, perchloric acid permanganic acid, peroxodisulfuric acid, potassium dioxide, potassium perchlorate, potassium permanganate, ruthenium(VIII) oxide, silver perchlorate, silver peroxide, uranium hexaftuoride, uranyl perchlorate. Ethanol reacts violently/expodes with the following compounds: acetyl bromide (evolves hydrogen bromide) acetyl chloride, aluminum, sesquibromide ethylate, ammonium hydroxide & silver oxide, chlorate, chromic anhydride, cyanuric acid + water, dichloromethane + sulfuric acid + nitrate (or) nitrite, hydrogen peroxide + sulfuric acid, iodine + methanol + mercuric oxide, manganese perchlorate + 2,2-dimethoxy propane, perchlorates, permanganates + sulfuric acid, potassium superoxide, potassium tert-butoxide, silver & nitric acid, silver perchlorate, sodium hydrazide, sulfuric acid + sodium dichromate, tetrachlorisilane + water. Ethanol is also incompatible with platinium, and sodium. (Ethyl alcohol 200 Proof) Special Remarks on Corrosivity: Not available. Polymerization: Will not occur. Section 11: Toxicological Information Routes of Entry: Absorbed through skin. Eye contact. Inhalation. Toxicity to Animals: Acute oral toxicity (LD50): 23793 mg/kg (Mouse) (Calculated value for the mixture). Chronic Effects on Humans: CARCINOGENIC EFFECTS: Classified PROVEN by State of California Proposition 65 [Ethyl alcohol 200 Proof]. Classified A4 (Not Classifiable for human or animaL) by ACGIH [Ethyl alcohol 200 Proof]. ' MUTAGENIC EFFECTS: Mutagenic for mammalian somatic cells. [Ethyl alcohol 200 Proof]. Mutagenic for bacteria and/or yeast. [Ethyl alcohol 200 Proof]. TERATOGENIC EFFECTS: Classified PROVEN for human [Ethyi alcohol 200 Proof]. DEVELOPMENTAL TOXICITY: Classified Development toxin [PROVEN] [Ethyl alcohol 200 Proof]. Classified Reproductive system/toxin/male [POSSIBLE] [Ethyl alcohol 200 Proof]. ' Other Toxic Effects on Humans: Hazardous in case of ingestion, of inhalation, Slightly hazardous in case of skin contact (irritant, permeator), Special Remarks on Toxicity to Animals: Not available. Special Remarks on Chronic Effects on Humans: May affect genetic material (mutagenic) Causes adverse reproductive effects and birth defects (teratogenic) , based on moderate to heavy consumption, May cause cancer based on animal data. Human: passes through the placenta, excreted in maternal milk. (Ethyl alcohol 200 Proof) Special Remarks on other Toxic Effects on Humans: n~..o. C.o.,...oi"o'rI. Section 12: Ecological Information Ecotoxicity: Not available. MAY 1 8 2009 BOD5 and COD: Not available, Original Submittf,1 Products of Biodegradation: Possibly hazardous short term degradation products are not likely. arise. However, long term degradation products may Toxicity of the Products of Biodegradation: The product itself and its products of degradation are not toxic. p. 5 Special Remarks on the Products of Biodegradation: Not available. Section 13: Disposal Considerations Waste Disposal: Waste must be disposed of in accordance with federal, state and local environmental control regulations. Section 14: Transport Information DOT Classification: CLASS 3: Flammable liquid. Identification: : Ethanol solution (Ethyl alcohol 200 Proof) UNNA: 1170 PG: III Special Provisions for Transport: Not available. Section 15: Other Regulatory Information Federal and State Regulations: California prop. 65: This product contains the following ingredients for which the State of California has found to cause cancer, birth defects or other reproductive harm, which would require a warning under the statute: Ethyl alcohol 200 Proof California prop, 65: This product contains the following ingredients for which the State of California has found to cause birth defects which would require a warning under the statute: Ethyl alcohol 200 Proof California prop. 65: This product contains the following ingredientsror which the State of California has found to cause cancer which would require a warning under the statute: Ethyl alcohol 200 Proof Rhode Island RTK hazardous substances: Ethyl alcohol 200 Proof Pennsylvania RTK: Ethyl alcohol 200 Proof Florida: Ethyl alcohol 200 Proof Massachusetts RTK: Ethyl alcohol 200 Proof New Jersey: Ethyl alcohol 200 Proof TSCA 8(b) inventory: Ethyl alcohol 200 Proof Other Regulations: OSHA: Hazardous by definition of Hazard Communication Standard (29 CFR 1910.1200). Other Classifications: WHMIS (Canada): Not controlled under WHMIS (Canada). DSCL (EEC): R10- Flammable. S2- Keep out of the reach of children. HMIS (U.S.A.): Health Hazard: 2 Fire Hazard: 2 Reactivity: 0 Personal Protection: j Date Received: MAY 1 8 2009 National Fire Protection Association (U.S.A.): Health: 1 Original Submittal Flammability: 2 p, 6 Reactivity: 0 Specific hazard: Protective Equipment: Gloves (impervious). Lab coat. Vapor respirator. Be sure to use an approvedlcertified respirator or equivalent. Splash goggles. Section 16: Other Information References: Not available. Other Special Considerations: Not available. Created: 10/10/200512:16 AM Last Updated: 11/06/200812:00 PM The information above is believed to be accurate and represents the best information currently available to us. However, we make no warranty of merchantability or any other warranty, express or implied, with respect to such information, and we assume no liability resulting from its use, Users should make their own investigations to determine the suitability of the information for their particular purposes. In no event shall ScienceLab. com be liable for any claims, losses, or damages of any third party or for lost profits or any special, indirect, incidental, consequential or exemplary damages, howsoever arising, even if ScienceLab.com has been advised of the possibility of such damages. Date Received: MAY 1 8 2009 Original Submittal p. 7 APPENDIX C - HAZARDOUS MATERIAL STORAGE LOCA 1l0N DRAWING Date Received: . MAY 1 8 2009 WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES,INC, Original Submittal ..r"I........... ~:' ~ & ;Jl;rr; '"Tj:jrr' :J g /~ I , . DgoGJ I '" 1 lfi m OvJ o ;,[ DIP[CnON or VlN'f\.PlANK nOORING J i~ IUI ~ I Fj ,19 J ~ , .~: ~ ~cw",~~1 ~~) :C .~ , - -... . IJJ 'I 1 lEI ' " . , ~ J --....... I I I I :~ ...-/ ~ ----, " --....... Q ~ u . \ ~I ') ] -;) , -......./ ....,-......., .......-........ --~, ~-.._-- it;~__ :-;;=:=..:=,~ r .1..._........._ , ~- ::::':'\ ----............ ~ .. ::-:f;;=::: . ~-=-~ \. ...---.--....--- \.. ==.......,----J .:.- ___J ~:=.;~== ~=..:..-- 1IlTJ;1UJIII....".;)H3_ ~"'=-- ~i~~~;... - .--"'-"'-- -...----,-- -..-...-- - --.....-,- -- - -- 0IEMI!_~1I ~'t!:- L=-"""3~C_ ~-"'-_._- ---...--- - ~~~:=~ ==...~::.:....::: ._~--,-- .. =~":- =:E?''='';:'''-..---.,.. Date R 3ceived: MAY I 8 2009 Origin,,' ~'1brn llal ONSITEf>HARM.'.CY . OPTION A FINISH AND FiXTURES o OPTION B FINISH ANO FIXTURES ~",' ,- '. , I I Q___vnuoo.'._Loc..._ ....,..~-,... -----..- ~"''''''-I ~""'~"'" -"""'7';:1 i:i.: 1--- 1L 'I 1_.... ~ -=:_--1-- ~- A"f"ll"- :" ; ~ s:"E:-:-. : "I=- ,: ----..---- ----. 'Ula..itIftDDN.... '.oa.tllQ~Df_.~~ __""'I000O ~^LIDD1_" ~'TCII\.T'" ~-"';. ~-T--'; :..-....- d~ n ..---- ..Q - ~N<U~ q -;;;-.. "1'1 ....,:;om~~ ~..... I I .. ........ - - -- -~ -- -...- ~ ~-n. ~ ~ r~ --" .-" , , , , , , , I : c:...1 _--6 ct",~_ ,---'... .....--- ___....coo --- _coo_. ---'"'- .......-.. _.........,- ...".-","",. .........- WAlGREENS ClINIC PHARMACY ""- -~ -- ~~~ c;...,..... "-.iU'.~ __.____ .--- -. -~ ----- ,- D1 DOTI. ____ - .......DO>8>_... ~~'''''-;:.:,:::...,--:~-'''=--- ) ) ) ) ) APPENDIX D - DNAPL UST .. 41. .. ft 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. .t .. .. .. " 41. 41. 41. 41. WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTA ASSOCIATES. INC. Date Received: MAY 1 B 2009 Original Submittal Dense Non-Aqueous Phase Liquids (DNAPLs) Prohibited From Use in the Time-or-Travel Zones Identified in Springfield City Code 41. 41. .. 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. 41. f. .. f. .. f. .. .. .. .. f. .. .. .. .. .. .. .. .. .. .. .. .. Adopted by the Springfield Utility Board March 28, 2005 Definition Dense Non-aqueous Phase Liquids (DNAPLs) are: . Heavier than water (specific gravity >1) . Have a low solubility rate (<lOg/lor 1%) . Degrade to other compounds that are even more of a health hazard For the purposes of Drinking Water Protection, DNAPL chemicals are defined as "all chemicals displaying the characteristics of a DNAPL chemical or a material containing a substance considered a DNAPL chemical". DNAPL Chemicals DNAPL chemicals are commonly used as cleaners, de-greasers, coolants, pesticides, and for treating wood. The following DNAPL chemicals are identified specifically but are not a comprehensive list of chemicals considered DNAPLs. If a chemical meets the Definition above it is regulated and prohibited. Common DNAPL chemicals are listed below. Chemical Name. I, I ,2,2-tetrachloroethane Alternative Name Acetylene tetrachloride; Symmetrial tetrachloroethane Ethane trichloride; B-trichloroethane; Vinyl trichloride 1,1- DCE; I,I-Dichloroethene; asym-Dichloroethylene; NCI- C54262; RCA waste number U078; Sconatex; VC; VDC; Vinylidene chloride; Vinylidene chloride (II); Vinylidene dichloride; Vinylidene chloride; I, I ,2-trichloroethane I,I-dichloroethylene CAS Number 79-34-5 79-00-5 75-35-4 Date Received: MAY 1 8 2009 Original Submittal SUB DNAPL chemical list Page 2 of5 1,I-Dichloroethane Chlorinated hydrochloric ether; 75-34-3 I, I-Dichloroethane; asym- ) Dichloroethane; Ethylidene chloride; Ethylidenedichloride; I,I-Ethylidene dichloride; NCI- C04535; RCRA waste number U076; UN 2362; Asymmetrical 41. dichloroethane 11,2-Dichloropropane I Propylene dichloride; Dichloro- 178-87-5 41. 1,2-propane 41. I, 1,1- Trichloroethane 1,1,1- TCA; Aerothene; Aerothene 71-55-6 41. TT; Baltana; Chloroethene; .. Chloroethene NU; Chlorothane NU; Chloroethene; Chloroethene 41. NU; Chloroethene VG; Chlorten; 41. Genklene; Inhibisol; Methyl 41. chloroforn1; Methyltrichloro- methane; NCI-C04626; RCRA 41. waste number U226; Solvent lll; 41. - T; I, 1,1- TCE; Trichloroethane; f. Tri-ethane; UN 2831 1;2,3- Trichloropropane Allyl trichloride; Glycerol 96-18-4 f. trichlorohydrin; Glyceryl .. trichlorohydrin; Trichlorohydrin .. 11,2,4-trichlorobenzene I Unsym-Trichlorobenzene; I 120-82-1 1,2,4- Trichlorobenzol .. 1,2-dichloroethylene Acetylene dichloride; 540-59-0 f. cis-Acetylene dichloride; f. trans-Acetylene dichloride; sym-Dichloroethylene .. Carbon tetrachloride Carbon chloride; Carbon tet; 56-23-5 .. Freon@ 10; Halon@ 104; .. T etrachloromethane I Chlorodiphenyl Aroclor@ 1254; PCB; 111097-69-1 .. Polychlorinated biphenyl .. I Chloroform Methane trichloride; 167-66-3 .. Trichloromethane .. Dichloroethyl ether bis (2-Chloroethyl)ether; 2,2- 111-44-4 Dichlorodiethyl ether; 2,2- f. Dichloroethyl ether f. I Ethylene dibromide 11,2-Dibromoethane; Ethylene 1106-93-4 f. bromide; Glycol dibromide; EDB I Ethylene dichloride 11,2-Dichloroethane; Ethylene 1107-06-2 .. chloride; Glycol dichloride .. Date Received: .. MAY 1 8 2009 .. .. Original Submittal .. .. ) SUB DNAPL chemical list Page 3 of5 Methylene chloride Aerothene MM; DCM; Dichloromethane; Freon 30; Methane dichloride; Methylene bichloride; Methylene dichloride; Narcotil; NCI-C50102; RCRA waste number U080; Solaesthin; Somethine; UN 1593 o-DCB; 1,2-Dichlorobenzene; ortho- Di c hi orobenzene; o-Dichlorobenzol Ethane pentachloride; Pentalin Halowax@ 1013; 1,2,3,4,5- Pentac hI oronaphthal ene PCP; Penta; 2,3,4,5,6- Pentachlorophenol PCM; PMM; Trichloromethane sulfenyl chloride; Trichloromethyl sulfur chloride PCE; PERC; Perchlorethylene; Ankilostin; Antisol I; Carbon bichloride; Carbon dichloride; Dee-Solv; Didakene; Dow-per; ENT 1,860; Ethylene tetrachloride; Fedal-UN; NCI- C04580; Nema; PER; Perawin; Perchlor; Perchloroethylene; Perclene; Perclene D; Percosolv; Perk; Perklone; Persec; RCRA waste number U21 0; Tetlen; Tetracap; Tetrachlorethylene; Tetrachloroethene; I, I ,2,2- Tetrachloroethylene; Tetraleno; Tetralex; Tetravec; Tetroguer; Tetropil; UN 1897 Acetylene dicloride; trans- Acetylene dichloride; 1,2- Dichloroethyene; (E)-I,2- Dichloroethene; trans- Dichloroethylene; 1,2- trans- Dichloroethene; 1,2-trans- dichloroethylene; sym- Dichloroethylene; Dioform o-dichlorobenzene 41. 41. 41. 41. 41. .. 41. 41. .. .. .. 41. 41. 41. f. f. f. f. .. 41. f. f. f. f. f. .. f. .. .. .. .. pentachloroethane pen tachloronaptha I ene pentachlorophenol perchloromethyl mercaptan Tetrachloroethylene Trans-I,2-dichloroethylene 75-09-2 95-50-1 76-01-7 1321-64-8 87-86-5 594-42-3 127-18-4 540-59-0 Date Received: MAY 1 8 2009 Original Submittal SUB DNAPL chemical list Page 4 of 5 Trichloroethylene TCE; Acetylene trichloride; Algylen; Anamenth; benzinol; Blacosolv; Blancosolv; Cecolene; Chlorilen; I-Chloro-2,2- dichloroethylene; Chlorylea; Chlorylen; Circosolv; Crawhaspol; Densinfluat; 1,1- Dichloro-2-chloroethylene; Dow- tri; Dukeron;Ethinyl trichloride; Ethylene trichoride; Fleck-flip; Flock-flip; Fluate; Gemaglene; Germalgene; Lanadin; Lethurin; Narcogen; Narkogen; Narkosoid; NCI-C04546; Nialk; Perm-a- chlor; Penn-a-clor; Petzinol; Philex; RCRA waste number U228; Threthylen; Threthylene; Trethylene; Tri; Triad; Trial; Triasol; Trichloran; Trichloroethene; I, I ,2- Trichlororthene; 1,2,2- Trichloroethene; I, I ,2- Trichloroethylene; 1,2,2- Trichloro-ethylene; Tri-clene; Trielene; Trieline; Triklone; Trilen; Trilene; Triline; Trimar; Triol; Tri-plus; Tri-plus M; UN 1710; Vestrol; Vitran; Westersol 1 Halowax@; Nibren wax; Seekay wax Chlorethene; Chlorethylerie; Chloroethene; l-Chlorethene; Chloroethylene; 1-Chloroetyne; Ethylene monochloride; Monochloroethene; Monochlor- ethylene; MVC; RCRA waste number U043; Trovidur; UN 1086; VC; VCM; Vinyl C monomer; Vinyl chloride monomer t~ trichloronaphthalene Vinyl chloride bromodichloromethane Dibromochloromethane Bromoform T richlorotluoromethane Cis-I,2-dichloroethylene I I I tribromomethane I I 75-27-4 124-48-1 75-25-2 75-69-4 [Jellt:: ~t::vt::ivt::J. 79-01-6 1321-65-9 75-01-4 MAY 1 8 2009 Original Submittal '-.., SUB DNAPL chemical [ist Page 5 of5 Trans-I,3-dichloropropylene bis (chiaro) methylether bis (2-chloroethyl) ether bis (2-chloroisopropyl) ether 2 -ch I oroeth y I vin y lether chlorobenzene bromomethane m-dich]orobenzene dibromomethane chloroethane hexachloroethane tetrach I orona ptha lene Dichlorofluoromethane (in compressed form) ], I, I ,2- Tetrafluoroethane I, I, I ,3,3-Pentafluoropropane S:nancylnvDNAPL2 Ethane; 2-ch]oroethoxy methyl bromide ] ,3-Dichlorobenzene I 1 I Halowax@; Nibren wax; Seekay wax 1 1 ]]12-TFE 1 PFP 1 I] ]-44-4 39638-32-9 110-75-8 108-90- 7 74-83-9 54]-73-] 74-95-3 75-00-3 67-72-1 1335-88-2 175-71-8 1811-97-2 1460-73-1 1 Date Received: MAY 1 8 2009 Original Submittal APPENDIX E - HAZARDOUS MATERIAL STORAGE MONTHLY INSPECTION FORM Date Received: MAY 1 8 2009 WALGREENS CLINICAL PHARMACY HMMP - MAY 2009 KTAASSOCIATES, INC. Original SubOllttW. HAZARDOUS MATERIAL STORAGE MONTHLY INSPECTION FORM Storage Area(s) General Work Area Clinic/storaoe area is maintained f;prllrp' doorS are locked when unattended. No smoking in area is oermitt~. - ..." - Emeroencv Eauinm~nt Fire extinquishers are oresent and full cha ed. Date of last fire extinauisher in~ 'on is noted and CUrrent. Spill control eauioment (soill kit neutralizers. absorbent ds is accessible and available. Communication Systems Phone is access/b/€.. Emerqency phone numbers are oo~t~~ next to phof'1~. Posted safety and waminq sians arp, pvident and ro rI dis la ed. MSDSs are accessible ana availablp. - Protective Eouioment Personnel P;oteCtion Eouipment is readily available. Area Hazardous M~tl"!ri~l!': 0 ::!. ee :i' 0 ID ") CIl :Ji;; - C ~ CD 0' A) 3 - ;::;: CD - 00 0 ~ '" CD ffi <' Comments: J. 0. Inspection Topic General Work Area Emergency Equipment Communications Systems Protective Equipment Secondary Containment Spill Prevention Measures General Work Area Emergency Equipment Communications Systems Protective Equipment Secondary Containment Spill Prevention Measures General Work Area Emergency Equipment Communications Systems Protective Equipment . Secondary Containment Spill Prevention Measures General WorK. Area Emergency Equipment Communications Systems Protective Equipment Secondary Containment Spill Prevention Measures WALGREENS CLINICAL PHARMACY, SPRINGFIELP, OR . Date/time. Name Reviewed by Seconda Containment Hazardous material containers are stored in a ro riate seconda containment. Product containers are not leakin ,.rusted, bul in or dama ed. The base under containers is in ood condition clean, d ,Ii uid-ti ht, and free 01 dl\ CldL:Kl:. ur aelec.~s). Sum s and corrections s stems are in ood condition; an draina e or release flows to controffed location. Containers of stron acids are stored in 01 eth lene Ira s or tubs. fncom atible materials are stored se aratel . I I I. I I S ill Prevention MeaSlJfp's Hazardous material containers are labeled. Hazardous materia! containers are ke t closed. Hazardous material stora e area has si ns With safe and s ill res nse information. All rsons mana in hazardous material have received ro r trainin . Stora e areas are clean, well-lit, and in ood condition. No hazardous materials are stored in ina ro riate locations. Emotv containers are manaqed Drooenv. OK 1_ ~omments MAY 2009