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pdfCSAT Top-Screen
Questions
January 2008
Version 1.4
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
General ................................................................................................................3
Facility Name .............................................................................................................................. 4
Facility Description.................................................................................................................... 4
Facility Location......................................................................................................................... 5
Facility Coordinates................................................................................................................... 5
Facility Owner or Operator........................................................................................................ 6
Facility Regulatory Mandates ................................................................................................... 7
EPA RMP Facility Identifier ....................................................................................................... 8
Collocated Facility ..................................................................................................................... 9
Additional Facility Information ................................................................................................. 9
Security Vulnerability Assessment (SVA) ............................................................................. 10
SVA Methodology .................................................................................................................... 10
Refinery Capacity..................................................................................................................... 11
Refinery Market Share ............................................................................................................. 12
Airport Fuels Supplier ............................................................................................................. 12
Military Installation Supplier ................................................................................................... 13
Liquefied Natural Gas (LNG) Capacity................................................................................... 13
Liquefied Natural Gas Exclusion Zone .................................................................................. 14
Release Toxics..................................................................................................16
Release Toxic Chemicals of Interest ..................................................................................... 16
Release Toxic Chemicals of Interest - Detail ........................................................................ 22
Release Flammables.........................................................................................32
Release Flammable Chemicals of Interest ............................................................................ 32
Release Flammable Chemicals of Interest - Detail ............................................................... 42
Release Explosives ..........................................................................................52
Release Explosive Chemicals of Interest .............................................................................. 52
Release Explosive Chemicals of Interest - Detail ................................................................. 58
Theft/Diversion EXP/IEDP ................................................................................62
Theft/Diversion Explosive/IED Precursor (EXP/IEDP) Chemicals of Interest .................... 62
Theft/Diversion Explosive/IED Precursor Chemicals of Interest - Detail ........................... 69
Theft/Diversion WME ........................................................................................75
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest ............................ 75
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest - Detail ............... 81
Theft/Diversion CW/CWP .................................................................................85
Theft/Diversion of Chemical Weapons/Chemical Weapon Precursors (CW/CWP)
Chemicals of Interest............................................................................................................... 85
Theft/Diversion Chemical Weapons/Chemical Weapon Precursors (CW/CWP) Chemicals
of Interest - Details................................................................................................................... 91
Sabotage/Contamination Chemicals...............................................................96
Sabotage/Contamination Chemicals of Interest ................................................................... 96
Mission Critical Chemicals ............................................................................103
Mission Critical Chemical Production ................................................................................. 103
Economically Critical Chemicals...................................................................107
Economically Critical Chemical Production ....................................................................... 107
Finish ...............................................................................................................113
DHS Form 9007 (6/07)
Page 2 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
General
The Department of Homeland Security will use the information you provide in this TopScreen/Chemical Security Assessment Tool to determine whether particular facilities
present a high level of security risk. Your provision of accurate information in this TopScreen is critical to enabling the Department to make well informed decisions designed to
reduce the Nation's risk.
The Department will base its determinations, in part, upon the information provided in this
Top-Screen/Chemical Security Assessment Tool. The information provided in the TopScreen/Chemical Security Assessment Tool will not, therefore, be the sole or definitive
basis upon which the Department will categorize facilities as presenting a high level of
security risk.
In the first part of the Top-Screen/Chemical Security Assessment Tool, the Department
seeks information concerning the presence and amounts of certain chemicals. The
presence or amount of a particular chemical is not the sole factor in determining whether a
facility presents a high level of security risk. This information informs the subsequent
parts of the Departments assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security
risk.
Paperwork Burden Notice:
The public reporting burden for this form is estimated to be 30.3 hours. The burden
estimate includes time for reviewing instructions, researching existing data sources,
gathering and maintaining the needed data, and completing and submitting the form. Send
comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to: NPPD/OIP/Chemical Security Compliance Division, Attention:
Matthew Bettridge, Project Manager, U.S. Department of Homeland Security, Mail Stop
8100, Washington, DC 20528-8100.
(Paperwork Reduction Project (1670-0007)). Your response is mandatory according to
Public Law 109- 295 Section 550. You are not required to respond to this collection of
information unless a valid OMB control number is displayed in the upper right corner of
this form. NOTE: DO NOT send your completed form to this address.
Submission Statement:
My statements in this submission are true, complete, and correct to the best of my
knowledge and belief and are made in good faith. I understand that a knowing and willful
false statement on this form can be punished by fine or imprisonment or both. (See
section 1001 of title 18, United States Code).
DHS Form 9007 (6/07)
Page 3 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Facility Name
Facility Name
[Q:1.0-66]
Provide the name of the facility. The name must be specific to the
site; if the site is part of a large corporation, the name may be the
corporate name plus the location (for example, 'ABC Oil/Refining Hightown Plant')
Alternative Facility
Name [Q:1.0-62]
Provide alternative names under which the facility may be known.
Facility Description
NAICS Code for the
Facility [Q:1.1-63]
Provide the five- or six-digit NAICS Industry code that corresponds
most closely to the primary activity of this facility as a whole. NAICS
codes are maintained by the U.S. Census Bureau. For a list of the
codes see http://www.census.gov/epcd/naics02/naicod02.htm.
Facility Data
Universal
Numbering System
(DUNS) [Q:1.1-64]
Choose the facility
type that best
describes your
facility [Q:1.1-65]
Enter the nine digit Data Universal Numbering System (DUNS)
identification code for the facility itself. If the facility does not have a
DUNS number, leave this data element blank. Explain: The Data
Universal Numbering System (DUNS) Number is a unique nine
character identification number provided by Duns & Bradstreet (D&B).
The DUNS Number is site-specific and division-specific. Therefore,
each physical location of an entity will have its own DUNS Number. If
the facility doesn't have a DUNS number, leave this field blank.
Chemical manufacturing, usage, storage, and distribution
Petroleum refining
Liquefied natural gas storage
DHS Form 9007 (6/07)
Page 4 of 113
Version 1.3
CSAT Top-Screen Questions
OMB N0. 1670-0007
Expires: 2/29/2008
Facility Location
Facility Location
Address [Q:1.1-68]
Enter the street address of the facility's physical location. [Note: This
may be different from the mailing address.] Use local street and road
designations, not post office or rural box numbers.
Facility Location
Address (continued)
[Q:1.1-69]
Facility Location
Address (continued)
[Q:1.1-70]
Enter any additional street data for the facility's physical location.
[Note: This may be different from the mailing address.] Use local street
and road designations, not post office or rural box numbers.
Facility Location City
[Q:1.1-71]
Enter the city of the facility's physical location.
[Note: This may be different from the mailing address.]
Facility Location
State [Q:1.1-72]
Select the state of the facility's physical location.
[Note: This may be different from the mailing address.]
Facility Location ZIP
Code [Q:1.1-73]
Enter the ZIP Code (including the 4 digit extension, if applicable) of
the facility's physical location. For example, XXXXX or XXXXX-XXXX
are valid ZIP Code formats.
[Note: This may be different from the mailing address.]
Facility Coordinates
Latitude/Longitude Instructions:
1.
2.
3.
4.
5.
Go to The National Map on TerraServer http://terraserver.microsoft.com/, enter your
street, city, and state then click GO.
TerraServer will present one or more “Available Image” links. Click on the most recent.
View the image that will de displayed to verify that your site is at the approximate
latitude/longitude shown.
Copy the Latitude and Longitude from TerraServer into the boxes below.
Click here to verify your coordinates
DHS Form 9007 (6/07)
Page 5 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Facility Latitude
[Q:1.1-591]
Enter the latitudinal coordinate of the approximate center of the
facility in decimal degrees (XX.XXXXXX).
Facility Longitude
[Q:1.1-75]
Enter the longitudinal coordinate of the approximate center of the
facility in decimal degrees. Longitude should begin with a negative
sign with no space before the coordinates (-XX.XXXXXX).
Enter the name of the county or equivalent jurisdiction (borough, parish) in which the
facility is located. If the facility is located in more than one jurisdiction, enter all
appropriate names.
[Q:1.1-76]
Facility Owner or Operator
Who is the Owner of
the facility? [Q:1.2-78]
The Owner is the person or entity that owns a facility. This may be a
person, company, cooperative, state, municipality, etc. This may be
different from the Operator.
Who is the Operator
of the facility?
[Q:1.2-594]
The Operator is the person who has responsibility for the daily
operations of a facility. This may be a person, company, cooperative,
state, municipality, etc. This may be different from the Owner.
DHS Form 9007 (6/07)
Page 6 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Facility Regulatory Mandates
Is the facility regulated pursuant to the Maritime Transportation Security Act of 2002,
Public Law 107-295, as amended?
[Q:1.3-85]
Yes, the facility is regulated pursuant to MTSA.
No, the facility is not regulated pursuant to MTSA
Partially: The site includes both a facility regulated pursuant to MTSA and a facility not
regulated pursuant to MTSA.
If the site includes both a facility regulated pursuant to the Maritime Transportation Security Act
of 2002, Public Law 107-295, as amended, and a facility not regulated pursuant to the Maritime
Transportation Security Act, select "Partially" and continue to fill out the screen for the facility not
subject to the Maritime Transportation Security Act.
Is the facility a Public Water Systems, as defined by section 1401 of the Safe Drinking Act,
Public Law 93-523, as amended?
[Q:1.3-86]
Yes, the facility is a Public Water System.
No, the facility is not a Public Water System.
Partially: the facility contains a Public Water System regulated under the Safe Drinking
Water Act, but also contains components that are not so regulated.
If the facility contains a Public Water System as defined by the Safe Drinking Water Act, but
also contains components that are not covered by that definition, select "Partially" and continue to
fill out the screen for the portion of the facility not so defined under the Safe Drinking Water Act.
Is the facility regulated as a Treatment Works as defined in section 212 of the Federal
Water Pollution Control Act, Public Law 92-500, as amended?
[Q:1.3-87]
Yes, the facility is regulated as a Treatment Works.
No, the facility is not regulated as a Treatment Works.
Partially: the site contains Treatment Works regulated under the Federal Water Pollution
Control Act, but also contains a facility or portion of a facility not so regulated.
If the facility contains a Treatment Works as defined by the Federal Water Pollution Control Act,
but also contains components that are not covered by that definition, select "Partially" and
continue to fill out the screen for the portion of the facility not so defined under the Federal Water
Pollution Control Act.
DHS Form 9007 (6/07)
Page 7 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Is the facility owned or operated by the Department of Defense?
[Q:1.3-88]
Yes
No
For further information or discussion of this type of exemption, please refer to the Interim Final
Rule.
Is the facility owned or operated by the Department of Energy?
[Q:1.3-89]
Yes
No
For further information or discussion of this type of exemption, please refer to the Interim Final
Rule.
Is the facility subject to regulation by the Nuclear Regulatory Commission?
[Q:1.3-90]
Yes
No
For further information or discussion of this type of exemption, please refer to the Interim Final
Rule.
EPA RMP Facility Identifier
Does the facility operate any EPA RMP covered process(es) - Program 1, 2, or 3?
[Q:1.41-395]
Yes
No
Program 1, 2, and 3 processes are those determined under RMP. See 40 CFR 68.10(b), (c),
and (d), or Chapter 2 or EPA's General Guidance for Risk Management Programs (40 CFR 68).
http://yosemite.epa.gov/oswer/ceppoweb.nsf/content/index.html
If Yes, fill in EPA RMP Facility Identifier number
DHS Form 9007 (6/07)
Page 8 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Provide the EPA RMP Facility Identifier, a unique, 12-digit number assigned to the facility
by the RMP Reporting Center after the first RMP submission. The RMP Report Center
included this number in their acknowledgment letter to your facility.
[Q:1.42-396]
EPA RMP Facility
Identifier
Collocated Facility
Specify if the facility is a host to a collocated tenant facility, is a collocated tenant facility
itself, or if this is not applicable.
[Q:1.43-397]
Facility is host to a collocated tenant facility
Facility is a collocated tenant facility
Not applicable
A facility that is collocated shares a site with another company's facility through either a host or
a tenant agreement. If a facility does not share a site with another company's facility it is the sole
tenant.
If facility is host or tenant:
Enter the name of the host or tenant facility and its corresponding EPA RMP Facility
Identifier.
Host/Tenant Facility
Host/Tenant EPA RMP
Facility Identifier
[Q:1.44-398]
[Q:1.44-399]
Additional Facility Information
Enter the number of full-time employees and contractors.
Number of Full Time
Employees
[Q:1.45-400]
The number should represent the typical maximum number of
employees/full-time contractors onsite at any given time. Do not include
occasional times of a higher onsite workforce, such as turnarounds, in
this estimate. Do not use commas when entering data.
DHS Form 9007 (6/07)
Page 9 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Parent Company Name and Data Universal Numbering System (DUNS)
The parent company is the corporation or other business entity that owns at least 50 percent of
the voting stock of the company. If the facility is owned by a joint venture, enter the first of the two
major owners here. If the company does not have a parent company, leave these fields blank.
Parent Company 1
Name [Q:1.45-432]
Parent Company 1
DUNS [Q:1.45-433]
Parent Company 2
Name [Q:1.45-434]
Parent Company 2
DUNS [Q:1.45-435]
Security Vulnerability Assessment (SVA)
Has a security vulnerability assessment been conducted for this facility?
[Q:1.47-436]
Yes
No
A Security Vulnerability Assessment (SVA), enables the identification of security hazards,
threats, and the evaluation of security countermeasures and vulnerabilities.
If Yes, answer SVA Methodology and SVA Date Fields
SVA Methodology
Enter the Name of the SVA Methodology
SVA methodology
[Q:1.482-653]
Enter the date when the most recent security vulnerability assessment of this facility was
completed.
Date of the most recent security
vulnerability assessment
[Q:1.482-654]
The response format is mm/dd/yyyy.
(e.g. May 1, 2006 is entered as
05/01/2006.)
DHS Form 9007 (6/07)
Page 10 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
If the answer to question [Q:1.1-65], "Choose the facility type that best describes your facility" is
Refinery, fill in Refinery Capacity, Refinery Market Share, Airport Fuels Supplier, and Military
Installation Supplier fields.
If the answer to question [Q:1.1-65] , "Choose the facility type that best describes your facility" is
Liquefied Natural Gas Storage, fill in Liquefied Natural Gas Capacity and Liquefied Natural Gas
Exclusion Zone fields
If facility is a chemical facility, go to Release of Toxics (page 16)
Refinery Capacity
Enter the production capacity of the refinery in barrels per day. The production capacity,
also known as the nameplate capacity, is the product output under conditions optimized
for maximum quantity for the production facility, as demonstrated by one or more testruns. Do not use commas when entering the numbers.
Typical Operating
Capacity (bpd)
[Q:1.5-386]
Enter the design capacity, or theoretically calculated product output, of the refinery in
barrels per day. The design capacity of an operable petroleum refinery is expressed in
terms of barrels per day of crude capacity, cracking capacity, desulphurization, or
amounts of products by grade. Do not use commas when entering the numbers.
Maximum Design
Capacity (bpd)
[Q:1.5-387]
For each of the potential refinery crude sources (e.g., ship, pipeline, strategic petroleum
reserve (SPR), rail, and truck) enter the typical contribution as a percentage of the total
barrels per day.
Crude % by Ship/Barge
[Q:1.5-388]
Crude % by Pipeline
[Q:1.5-389]
Crude % by SPR
[Q:1.5-390]
Crude % by Rail
[Q:1.5-391]
Crude % by Truck
[Q:1.5-392]
DHS Form 9007 (6/07)
Page 11 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Refinery Market Share
Enter the regional market shares (%) for each fuel type and description of state/region
supplied. (Gasoline, Diesel, Jet Fuel/Kerosene, LPG, Home Heating Oil). State/region
supplied can include the states or areas of the US where the refinery's products are sold.
Fuel Type
Regional Market
Share (%)
State/Region Supplied
Gasoline
[Q:1.51-655]
Diesel
[Q:1.51-657]
Jet Fuel/Kerosene
[Q:1.51-659]
LPG
[Q:1.51-661]
Home Heating Oil
[Q:1.51-663]
Airport Fuels Supplier
Is the refinery a direct supplier to a major metropolitan airport?
[Q:1.52-374]
Yes
No
If “Yes”, fill in Airport(s)
Enter the name of each airport supplied by this refinery. For each airport, enter the
refinery’s share (0% to 100%) of total deliveries of Aviation Gasoline (Avgas) and jet
Fuel/Kerosene to the airport.
Airport Name
[Q:1.53-375]
DHS Form 9007 (6/07)
% Share of Aviation
Gasoline
% Share of Jet
Fuel/Kerosene
[Q:1.53-376]
[Q:1.53-378]
Page 12 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Military Installation Supplier
Is the refinery a direct supplier to a military installation (products shipped from refinery to
the installation)?
[Q:1.54-380]
Yes
No
If “Yes”, fill in Installation(s) and Product(s)
Military Installation and Products
Enter each military installation supplied by the refinery. Enter the refinery’s share (0% to 100%)
of total deliveries of Gasoline, Diesel, and Aviation Fuel to the installation.
Military Installation
[Q:1.55-381]
% Share of
Gasoline
% Share
of Diesel
% Share of Jet
Fuel/Kerosene
[Q:1.55-382]
[Q:1.55-383]
[Q:1.55-384]
Go to Release Toxics (page 16)
Liquefied Natural Gas (LNG) Capacity
Enter the total LNG storage capacity for the facility (in cubic meters).
[Q:1.6-618]
If there are multiple LNG storage tanks onsite the capacity reported is the total storage capacity
of all LNG tanks.
Enter the regasification rate (billion cubic feet (Bcf) per day).
[Q:1.6-619]
Regasification rate should be the annual average reported in Bcf per day.
DHS Form 9007 (6/07)
Page 13 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
Enter the name of the natural gas pipeline system the facility feeds.
[Q:1.6-620]
The name of the natural gas pipeline system should be the name of the main tie-in point from
this facility.
Liquefied Natural Gas Exclusion Zone
Indicate if this facility was sited according to the 49 CFR 193 exclusion zone requirements
for thermal radiation and flammable vapor dispersion.
[Q:1.92-667]
Yes
No
49 CFR 193 incorporates NFPA 59A by reference. As defined in NFPA 59A, the siting
requirements are provisions to minimize the possibility of the damaging effects of fire reaching
beyond a property line. Refer to the downloadable guidance on the DHS website for the specific
requirements.
If “No”, provide a reason why the facility was exempted.
Liquefied Natural Gas Exclusion Zone Exception
Provide the reason why the facility was exempted from this regulation.
[Q:1.91-669]
Liquefied Natural Gas Exclusion Details
Provide the distance (in feet) of the 5kW/m2 thermal radiation zone using the 49 CFR 193
siting requirements.
[Q:1.93-670]
Feet
DHS Form 9007 (6/07)
Page 14 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
Provide the distance (in feet) to half the Lower Flammability Limit (1/2 LFL) using the 49
CFR 193 siting requirements.
[Q:1.93-671]
Feet
Go to Release Toxics (page 16)
DHS Form 9007 (6/07)
Page 15 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Release Toxics
Release Toxic Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute any of the following release toxic chemicals of interest (COI) at or above the
screening threshold quantity at your facility?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days the COI at or above the screening threshold
quantity.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
If “No” selected for all chemicals, go to Release Flammables (page 32)
DHS Form 9007 (6/07)
Page 16 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
[Q:2.0-121]
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute any of the following
release toxic chemicals of interest (COI)
at or above the screening threshold
quantity at your facility?
Yes
Acrolein
[2-Propenal or Acrylaldehyde]
107-02-8
1.00%
5,000 lbs
Allyl alcohol
[2-Propen-1-ol]
107-18-6
1.00%
15,000 lbs
Ammonia (anhydrous)
7664-41-7
1.00%
10,000 lbs
Ammonia (conc. 20% or greater)
7664-41-7
20.00%
20,000 lbs
Arsenic trichloride
[Arsenous trichloride]
7784-34-1
1.00%
15,000 lbs
Arsine
7784-42-1
1.00%
1,000 lbs
Boron trichloride
[Borane, trichloro]
10294-34-5
1.00%
5,000 lbs
Boron trifluoride
[Borane, trifluoro]
7637-07-2
1.00%
5,000 lbs
Boron trifluoride compound with methyl
ether (1:1)
[Boron, trifluoro [oxybis (methane)]-, T-4-]
353-42-4
1.00%
15,000 lbs
Bromine
7726-95-6
1.00%
10,000 lbs
75-15-0
1.00%
20,000 lbs
Carbon disulfide
DHS Form 9007 (6/07)
Page 17 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute any of the following
release toxic chemicals of interest (COI)
at or above the screening threshold
quantity at your facility?
Yes
Chlorine
7782-50-5
1.00%
2,500 lbs
Chlorine dioxide
[Chlorine oxide, ClO2]
10049-04-4
1.00%
1,000 lbs
Chloroform
[Methane, trichloro-]
67-66-3
1.00%
20,000 lbs
Chloromethyl ether
[Methane, oxybis(chloro-)]
542-88-1
1.00%
1,000 lbs
Chloromethyl methyl ether
[Methane, chloromethoxy-]
107-30-2
1.00%
5,000 lbs
Cyanogen chloride
506-77-4
1.00%
10,000 lbs
Cyclohexylamine
[Cyclohexanamine]
108-91-8
1.00%
15,000 lbs
19287-45-7
1.00%
2,500 lbs
Epichlorohydrin
[Oxirane, (chloromethyl)-]
106-89-8
1.00%
20,000 lbs
Ethylenediamine
[1,2-Ethanediamine]
107-15-3
1.00%
20,000 lbs
Fluorine
7782-41-4
1.00%
1,000 lbs
Diborane
DHS Form 9007 (6/07)
Page 18 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No.1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute any of the following
release toxic chemicals of interest (COI)
at or above the screening threshold
quantity at your facility?
Yes
Formaldehyde (solution)
50-00-0
1.00%
15,000 lbs
7647-01-0
37.00%
15,000 lbs
74-90-8
1.00%
2,500 lbs
Hydrofluoric acid (conc. 50% or greater)
7664-39-3
50.00%
1,000 lbs
Hydrogen chloride (anhydrous)
7647-01-0
1.00%
5,000 lbs
Hydrogen fluoride (anhydrous)
7664-39-3
1.00%
1,000 lbs
Hydrogen sulfide
7783-06-4
1.00%
10,000 lbs
Isobutyronitrile
[Propanenitrile, 2-methyl-]
78-82-0
1.00%
20,000 lbs
Isopropyl chloroformate
[Carbonochloridic acid, 1-methylethyl ester]
108-23-6
1.00%
15,000 lbs
Methacrylonitrile
[2-Propenenitrile, 2-methyl-]
126-98-7
1.00%
10,000 lbs
Methyl hydrazine
[Hydrazine, methyl-]
60-34-4
1.00%
15,000 lbs
Methyl isocyanate
[Methane, isocyanato-]
624-83-9
1.00%
10,000 lbs
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid
DHS Form 9007 (6/07)
Page 19 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute any of the following
release toxic chemicals of interest (COI)
at or above the screening threshold
quantity at your facility?
Yes
Methyl thiocyanate
[Thiocyanic acid, methyl ester]
556-64-9
1.00%
20,000 lbs
Nitric acid
7697-37-2
80.00%
15,000 lbs
Nitric oxide
[Nitrogen oxide (NO)]
10102-43-9
1.00%
10,000 lbs
Oleum (Fuming Sulfuric acid)
[Sulfuric acid, mixture with sulfur trioxide]
8014-95-7
1.00%
10,000 lbs
Perchloromethylmercaptan
[Methanesulfenyl chloride, trichloro-]
594-42-3
1.00%
10,000 lbs
Phosgene
[Carbonic dichloride] or [carbonyl dichloride]
75-44-5
1.00%
500 lbs
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
1.00%
5,000 lbs
Phosphorus trichloride
7719-12-2
1.00%
15,000 lbs
Propionitrile
[Propanenitrile]
107-12-0
1.00%
10,000 lbs
Propyleneimine
[Aziridine, 2-methyl-]
75-55-8
1.00%
10,000 lbs
7446-09-5
1.00%
5,000 lbs
Sulfur dioxide (anhydrous)
DHS Form 9007 (6/07)
Page 20 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute any of the following
release toxic chemicals of interest (COI)
at or above the screening threshold
quantity at your facility?
Yes
Sulfur tetrafluoride
[Sulfur fluoride (SF4), (T-4)-]
7783-60-0
1.00%
2,500 lbs
Sulfur trioxide
7446-11-9
1.00%
10,000 lbs
75-74-1
1.00%
10,000 lbs
7550-45-0
1.00%
2,500 lbs
Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
No
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:2.0-631]
Yes No
DHS Form 9007 (6/07)
Page 21 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Release Toxic Chemicals of Interest - Detail
Indicate the topography used in the RMP*Comp calculation for the area where the facility is located.
[Q:2.1-122]
Urban
Rural
If this facility is covered by EPA RMP, the selection should be the same as that reported to EPA. For all other facilities, if the site is located in an
area with few buildings or other obstructions, select Rural. If the site is in an urban location, or is in an area with many obstructions, select Urban.
Enter the total on-site quantity of the release toxic COI in pounds. Enter the distance of concern reported by RMP*Comp in miles.
The total on-site quantity is the highest amount that the facility either currently possesses or possessed within the past 60 days. Round the
quantity to two significant digits (e.g., round 247500 pounds to 250000 pounds, and round 7625 pounds to 7600 pounds). Do not use commas
when entering data.
The Distance of Concern that should be reported is the downwind distance calculated using RMP*Comp for total on-site quantity of the regulated
chemical, using additional process conditions for this chemical. Report all distances shorter than 0.1 mile as 0.1 mile, and all distances 25 miles or
longer as 25 miles. (RMP*Comp can be downloaded from http://yosemite.epa.gov/oswer/ceppoweb.nsf/content/comp-dwn.htm)
CAS#
Min Conc.
Screening
Threshold
Quantity
Acrolein
[2-Propenal or Acrylaldehyde]
107-02-8
1.00%
5,000 lbs
Allyl alcohol
[2-Propen-1-ol]
107-18-6
1.00%
15,000 lbs
Ammonia (anhydrous)
7664-41-7
1.00%
10,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 22 of 113
Total
On-site
Quantity
(pounds)
Distance of
Concern
(miles)
[Q:2.1-124]
[Q:2.1-126]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min Conc.
Screening
Threshold
Quantity
Ammonia (conc. 20% or greater)
7664-41-7
20.00%
20,000 lbs
Arsenic trichloride
[Arsenous trichloride]
7784-34-1
1.00%
15,000 lbs
Arsine
7784-42-1
1.00%
1,000 lbs
Boron trichloride
[Borane, trichloro]
10294-34-5
1.00%
5,000 lbs
Boron trifluoride
[Borane, trifluoro]
7637-07-2
1.00%
5,000 lbs
Boron trifluoride compound with methyl ether (1:1)
[Boron, trifluoro [oxybis (methane)]-, T-4-]
353-42-4
1.00%
15,000 lbs
Bromine
7726-95-6
1.00%
10,000 lbs
75-15-0
1.00%
20,000 lbs
Chlorine
7782-50-5
1.00%
2,500 lbs
Chlorine dioxide
[Chlorine oxide, ClO2]
10049-04-4
1.00%
1,000 lbs
Chloroform
[Methane, trichloro-]
67-66-3
1.00%
20,000 lbs
Chloromethyl ether
[Methane, oxybis(chloro-)]
542-88-1
1.00%
1,000 lbs
Chemical Name
Carbon disulfide
DHS Form 9007 (6/07)
Page 23 of 113
Total
On-site
Quantity
(pounds)
Distance of
Concern
(miles)
[Q:2.1-124]
[Q:2.1-126]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min Conc.
Screening
Threshold
Quantity
Chloromethyl methyl ether
[Methane, chloromethoxy-]
107-30-2
1.00%
5,000 lbs
Cyanogen chloride
506-77-4
1.00%
10,000 lbs
Cyclohexylamine
[Cyclohexanamine]
108-91-8
1.00%
15,000 lbs
19287-45-7
1.00%
2,500 lbs
Epichlorohydrin
[Oxirane, (chloromethyl)-]
106-89-8
1.00%
20,000 lbs
Ethylenediamine
[1,2-Ethanediamine]
107-15-3
1.00%
20,000 lbs
Fluorine
7782-41-4
1.00%
1,000 lbs
50-00-0
1.00%
15,000 lbs
7647-01-0
37.00%
15,000 lbs
74-90-8
1.00%
2,500 lbs
Hydrofluoric acid (conc. 50% or greater)
7664-39-3
50.00%
1,000 lbs
Hydrogen chloride (anhydrous)
7647-01-0
1.00%
5,000 lbs
Hydrogen fluoride (anhydrous)
7664-39-3
1.00%
1,000 lbs
Hydrogen sulfide
7783-06-4
1.00%
10,000 lbs
Chemical Name
Diborane
Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid
DHS Form 9007 (6/07)
Page 24 of 113
Total
On-site
Quantity
(pounds)
Distance of
Concern
(miles)
[Q:2.1-124]
[Q:2.1-126]
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
CAS#
Min Conc.
Screening
Threshold
Quantity
Isobutyronitrile
[Propanenitrile, 2-methyl-]
78-82-0
1.00%
20,000 lbs
Isopropyl chloroformate
[Carbonochloridic acid, 1-methylethyl ester]
108-23-6
1.00%
15,000 lbs
Methacrylonitrile
[2-Propenenitrile, 2-methyl-]
126-98-7
1.00%
10,000 lbs
Methyl hydrazine
[Hydrazine, methyl-]
60-34-4
1.00%
15,000 lbs
Methyl isocyanate
[Methane, isocyanato-]
624-83-9
1.00%
10,000 lbs
Methyl thiocyanate
[Thiocyanic acid, methyl ester]
556-64-9
1.00%
20,000 lbs
Nitric acid
7697-37-2
80.00%
15,000 lbs
Nitric oxide
[Nitrogen oxide (NO)]
10102-43-9
1.00%
10,000 lbs
Oleum (Fuming Sulfuric acid)
[Sulfuric acid, mixture with sulfur trioxide]
8014-95-7
1.00%
10,000 lbs
Perchloromethylmercaptan
[Methanesulfenyl chloride, trichloro-]
594-42-3
1.00%
10,000 lbs
Phosgene
[Carbonic dichloride] or [carbonyl dichloride]
75-44-5
1.00%
500 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 25 of 113
Total
On-site
Quantity
(pounds)
Distance of
Concern
(miles)
[Q:2.1-124]
[Q:2.1-126]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min Conc.
Screening
Threshold
Quantity
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
1.00%
5,000 lbs
Phosphorus trichloride
7719-12-2
1.00%
15,000 lbs
Propionitrile
[Propanenitrile]
107-12-0
1.00%
10,000 lbs
Propyleneimine
[Aziridine, 2-methyl-]
75-55-8
1.00%
10,000 lbs
Sulfur dioxide (anhydrous)
7446-09-5
1.00%
5,000 lbs
Sulfur tetrafluoride
[Sulfur fluoride (SF4), (T-4)-]
7783-60-0
1.00%
2,500 lbs
Sulfur trioxide
7446-11-9
1.00%
10,000 lbs
75-74-1
1.00%
10,000 lbs
7550-45-0
1.00%
2,500 lbs
Chemical Name
Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
DHS Form 9007 (6/07)
Page 26 of 113
Total
On-site
Quantity
(pounds)
Distance of
Concern
(miles)
[Q:2.1-124]
[Q:2.1-126]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Enter the quantity of the release toxic COI in the Area of Highest Quantity in pounds. Enter the distance of concern reported by
RMP*Comp for each AHQ in miles.
The Area of Highest Quantity (AHQ) is defined as an on-site area, with a radius of 170 feet, where the greatest amount of the release toxic COI is
either currently present or has been present at any one time within the past 60 days. This amount may differ from the total on-site quantity. Round
the quantity to two significant digits (e.g., round 247500 lbs. to 250000 lbs., and round 7625 lbs. to 7600 lbs.) Do not use commas when
entering data.
CAS#
Min. Conc.
Screening
Threshold
Quantity
Acrolein
[2-Propenal or Acrylaldehyde]
107-02-8
1.00%
5,000 lbs
Allyl alcohol
[2-Propen-1-ol]
107-18-6
1.00%
15,000 lbs
Ammonia (anhydrous)
7664-41-7
1.00%
10,000 lbs
Ammonia (conc. 20% or greater)
7664-41-7
20.00%
20,000 lbs
Arsenic trichloride
[Arsenous trichloride]
7784-34-1
1.00%
15,000 lbs
Arsine
7784-42-1
1.00%
1,000 lbs
Boron trichloride
[Borane, trichloro]
10294-34-5
1.00%
5,000 lbs
Boron trifluoride
[Borane, trifluoro]
7637-07-2
1.00%
5,000 lbs
Boron trifluoride compound with methyl ether (1:1)
[Boron, trifluoro [oxybis (methane)]-, T-4-]
353-42-4
1.00%
15,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 27 of 113
Quantity in
AHQ
(pounds)
Distance of
Concern
for AHQ
(miles)
[Q:2.2-2792]
[Q:2.2-2793]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
7726-95-6
1.00%
10,000 lbs
75-15-0
1.00%
20,000 lbs
Chlorine
7782-50-5
1.00%
2,500 lbs
Chlorine dioxide
[Chlorine oxide, ClO2]
10049-04-4
1.00%
1,000 lbs
Chloroform
[Methane, trichloro-]
67-66-3
1.00%
20,000 lbs
Chloromethyl ether
[Methane, oxybis(chloro-)]
542-88-1
1.00%
1,000 lbs
Chloromethyl methyl ether
[Methane, chloromethoxy-]
107-30-2
1.00%
5,000 lbs
Cyanogen chloride
506-77-4
1.00%
10,000 lbs
Cyclohexylamine
[Cyclohexanamine]
108-91-8
1.00%
15,000 lbs
19287-45-7
1.00%
2,500 lbs
Epichlorohydrin
[Oxirane, (chloromethyl)-]
106-89-8
1.00%
20,000 lbs
Ethylenediamine
[1,2-Ethanediamine]
107-15-3
1.00%
20,000 lbs
Fluorine
7782-41-4
1.00%
1,000 lbs
Chemical Name
Bromine
Carbon disulfide
Diborane
DHS Form 9007 (6/07)
Page 28 of 113
Quantity in
AHQ
(pounds)
Distance of
Concern
for AHQ
(miles)
[Q:2.2-2792]
[Q:2.2-2793]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
50-00-0
1.00%
15,000 lbs
7647-01-0
37.00%
15,000 lbs
74-90-8
1.00%
2,500 lbs
Hydrofluoric acid (conc. 50% or greater)
7664-39-3
50.00%
1,000 lbs
Hydrogen chloride (anhydrous)
7647-01-0
1.00%
5,000 lbs
Hydrogen fluoride (anhydrous)
7664-39-3
1.00%
1,000 lbs
Hydrogen sulfide
7783-06-4
1.00%
10,000 lbs
Isobutyronitrile
[Propanenitrile, 2-methyl-]
78-82-0
1.00%
20,000 lbs
Isopropyl chloroformate
[Carbonochloridic acid, 1-methylethyl ester]
108-23-6
1.00%
15,000 lbs
Methacrylonitrile
[2-Propenenitrile, 2-methyl-]
126-98-7
1.00%
10,000 lbs
Methyl hydrazine
[Hydrazine, methyl-]
60-34-4
1.00%
15,000 lbs
Methyl isocyanate
[Methane, isocyanato-]
624-83-9
1.00%
10,000 lbs
Methyl thiocyanate
[Thiocyanic acid, methyl ester]
556-64-9
1.00%
20,000 lbs
Chemical Name
Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid
DHS Form 9007 (6/07)
Page 29 of 113
Quantity in
AHQ
(pounds)
Distance of
Concern
for AHQ
(miles)
[Q:2.2-2792]
[Q:2.2-2793]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Nitric acid
7697-37-2
80.00%
15,000 lbs
Nitric oxide
[Nitrogen oxide (NO)]
10102-43-9
1.00%
10,000 lbs
Oleum (Fuming Sulfuric acid)
[Sulfuric acid, mixture with sulfur trioxide]
8014-95-7
1.00%
10,000 lbs
Perchloromethylmercaptan
[Methanesulfenyl chloride, trichloro-]
594-42-3
1.00%
10,000 lbs
Phosgene
[Carbonic dichloride] or [carbonyl dichloride]
75-44-5
1.00%
500 lbs
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
1.00%
5,000 lbs
Phosphorus trichloride
7719-12-2
1.00%
15,000 lbs
Propionitrile
[Propanenitrile]
107-12-0
1.00%
10,000 lbs
Propyleneimine
[Aziridine, 2-methyl-]
75-55-8
1.00%
10,000 lbs
Sulfur dioxide (anhydrous)
7446-09-5
1.00%
5,000 lbs
Sulfur tetrafluoride
[Sulfur fluoride (SF4), (T-4)-]
7783-60-0
1.00%
2,500 lbs
Sulfur trioxide
7446-11-9
1.00%
10,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 30 of 113
Quantity in
AHQ
(pounds)
Distance of
Concern
for AHQ
(miles)
[Q:2.2-2792]
[Q:2.2-2793]
Version 1.3
CSAT Top-Screen Questions
Chemical Name
Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
DHS Form 9007 (6/07)
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
75-74-1
1.00%
10,000 lbs
7550-45-0
1.00%
2,500 lbs
Page 31 of 113
Quantity in
AHQ
(pounds)
Distance of
Concern
for AHQ
(miles)
[Q:2.2-2792]
[Q:2.2-2793]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Release Flammables
Release Flammable Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute any of the following release flammable chemicals of interest (COI) at or above the
screening threshold quantity at your facility?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days the COI at or above the screening threshold
quantity.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
The following list of release-flammables includes both release-flammable COI and fuel(s). The fuel(s) shown are mixtures of COI or other releaseflammables. If the facility's release-flammable mixture is a fuel(s) from the list below, enter the amount of fuel(s) at the facility consistent with the
release-flammable minimum concentration provision found in § 27.204(a)(2). If a facility counts a release-flammable mixture as a fuel, the facility
should not count its constituent release-flammable COI in the release-flammable COI section of the Top-Screen.
If “No” selected for all chemicals, go to Release Explosives (page 52)
DHS Form 9007 (6/07)
Page 32 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
[Q:3.0-129]
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Acetaldehyde
75-07-0
1.00%
10,000 lbs
Acetylene
[Ethyne]
74-86-2
1.00%
10,000 lbs
Acrylonitrile
[2-Propenenitrile]
107-13-1
1.00%
10,000 lbs
Acrylyl chloride
[2-Propenoyl chloride]
814-68-6
1.00%
10,000 lbs
Allylamine
[2-Propen-1-amine]
107-11-9
1.00%
10,000 lbs
Bromotrifluorethylene
[Ethene, bromotrifluoro-]
598-73-2
1.00%
10,000 lbs
1,3-Butadiene
106-99-0
1.00%
10,000 lbs
Butane
106-97-8
1.00%
10,000 lbs
Butene
25167-67-3
1.00%
10,000 lbs
1-Butene
106-98-9
1.00%
10,000 lbs
2-Butene
107-01-7
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 33 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
2-Butene-cis
590-18-1
1.00%
10,000 lbs
2-Butene-trans
[2-Butene, (E)]
624-64-6
1.00%
10,000 lbs
Carbon oxysulfide
[Carbon oxide sulfide (COS); carbonyl sulfide]
463-58-1
1.00%
10,000 lbs
Chlorine monoxide
[Chlorine oxide]
7791-21-1
1.00%
10,000 lbs
1-Chloropropylene
[1-Propene, 1-chloro-]
590-21-6
1.00%
10,000 lbs
2-Chloropropylene
[1-Propene, 2-chloro-]
557-98-2
1.00%
10,000 lbs
Crotonaldehyde
[2-Butenal]
4170-30-3
1.00%
10,000 lbs
Crotonaldehyde, (E)[2-Butenal], (E)-]
123-73-9
1.00%
10,000 lbs
Cyanogen
[Ethanedinitrile]
460-19-5
1.00%
10,000 lbs
Cyclopropane
75-19-4
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 34 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Dichlorosilane
[Silane, dichloro-]
4109-96-0
1.00%
10,000 lbs
Difluoroethane
[Ethane, 1,1-difluoro-]
75-37-6
1.00%
10,000 lbs
Dimethylamine
[Methanamine, N-methyl-]
124-40-3
1.00%
10,000 lbs
Dimethyldichlorosilane
[Silane, dichlorodimethyl-]
75-78-5
1.00%
10,000 lbs
1,1-Dimethylhydrazine
[Hydrazine, 1, 1-dimethyl-]
57-14-7
1.00%
10,000 lbs
2,2-Dimethylpropane
[Propane, 2,2-dimethyl-]
463-82-1
1.00%
10,000 lbs
Ethane
74-84-0
1.00%
10,000 lbs
Ethyl acetylene
[1-Butyne]
107-00-6
1.00%
10,000 lbs
Ethyl chloride
[Ethane, chloro-]
75-00-3
1.00%
10,000 lbs
Ethyl ether
[Ethane, 1,1-oxybis-]
60-29-7
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 35 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Ethyl mercaptan
[Ethanethiol]
75-08-1
1.00%
10,000 lbs
Ethyl nitrite
[Nitrous acid, ethyl ester]
109-95-5
1.00%
10,000 lbs
Ethylamine
[Ethanamine]
75-04-7
1.00%
10,000 lbs
Ethylene
[Ethene]
74-85-1
1.00%
10,000 lbs
Ethylene oxide
[Oxirane]
75-21-8
1.00%
10,000 lbs
Ethyleneimine
[Aziridine]
151-56-4
1.00%
10,000 lbs
Furan
110-00-9
1.00%
10,000 lbs
Hydrazine
302-01-2
1.00%
10,000 lbs
Hydrogen
1333-74-0
1.00%
10,000 lbs
Hydrogen selenide
7783-07-5
1.00%
10,000 lbs
Iron, pentacarbonyl
[Iron carbonyl (Fe (CO)5), (TB5-11)-]
13463-40-6
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 36 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Isobutane
[Propane, 2-methyl]
75-28-5
1.00%
10,000 lbs
Isopentane
[Butane, 2-methyl-]
78-78-4
1.00%
10,000 lbs
Isoprene
[1,3-Butadiene, 2-methyl-]
78-79-5
1.00%
10,000 lbs
Isopropyl chloride
[Propane, 2-chloro-]
75-29-6
1.00%
10,000 lbs
Isopropylamine
[2-Propanamine]
75-31-0
1.00%
10,000 lbs
Methane
74-82-8
1.00%
10,000 lbs
2-Methyl-1-butene
563-46-2
1.00%
10,000 lbs
3-Methyl-1-butene
563-45-1
1.00%
10,000 lbs
Methyl chloride
[Methane, chloro-]
74-87-3
1.00%
10,000 lbs
Methyl chloroformate
[Carbonochloridic acid, methyl ester]
79-22-1
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 37 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Methyl ether
[Methane, oxybis-]
115-10-6
1.00%
10,000 lbs
Methyl formate
[Formic acid Methyl ester]
107-31-3
1.00%
10,000 lbs
Methyl mercaptan
[Methanethiol]
74-93-1
1.00%
10,000 lbs
Methylamine
[Methanamine]
74-89-5
1.00%
10,000 lbs
2-Methylpropene
[1-Propene, 2-methyl-]
115-11-7
1.00%
10,000 lbs
Methyltrichlorosilane
[Silane, trichloromethyl-]
75-79-6
1.00%
10,000 lbs
Nickel Carbonyl
13463-39-3
1.00%
10,000 lbs
1,3-Pentadiene
504-60-9
1.00%
10,000 lbs
Pentane
109-66-0
1.00%
10,000 lbs
1-Pentene
109-67-1
1.00%
10,000 lbs
2-Pentene,(E)-
646-04-8
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Page 38 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
2-Pentene, (Z)-
627-20-3
1.00%
10,000 lbs
Peracetic acid
[Ethaneperoxic acid]
79-21-0
1.00%
10,000 lbs
Phosphine
7803-51-2
1.00%
10,000 lbs
Piperidine
110-89-4
1.00%
10,000 lbs
Propadiene
[1,2-Propadiene]
463-49-0
1.00%
10,000 lbs
Propane
74-98-6
1.00%
60,000 lbs
Propyl chloroformate
[Carbonchloridic acid, propylester]
109-61-5
1.00%
10,000 lbs
Propylene
[1-Propene]
115-07-1
1.00%
10,000 lbs
Propylene oxide
[Oxirane, methyl-]
75-56-9
1.00%
10,000 lbs
Propyne
[1-Propyne]
74-99-7
1.00%
10,000 lbs
7803-62-5
1.00%
10,000 lbs
Silane
DHS Form 9007 (6/07)
Page 39 of 113
No
Version 1.3
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Tetrafluoroethylene
[Ethene, tetrafluoro-]
116-14-3
1.00%
10,000 lbs
Tetramethylsilane
[Silane, tetramethyl-]
75-76-3
1.00%
10,000 lbs
Tetranitromethane
[Methane, tetranitro-]
509-14-8
1.00%
10,000 lbs
10025-78-2
1.00%
10,000 lbs
Trifluorochloroethylene
[Ethene, chlorotrifluoro]
79-38-9
1.00%
10,000 lbs
Trimethylamine
[Methanamine, N,N-dimethyl-]
75-50-3
1.00%
10,000 lbs
Trimethylchlorosilane
[Silane, chlorotrimethyl-]
75-77-4
1.00%
10,000 lbs
Vinyl acetate monomer
[Acetic acid ethenyl ester]
108-05-4
1.00%
10,000 lbs
Vinyl acetylene
[1-Buten-3-yne]
689-97-4
1.00%
10,000 lbs
Trichlorosilane
[Silane, trichloro-]
DHS Form 9007 (6/07)
Page 40 of 113
No
Version 1.3
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
Vinyl chloride
[Ethene, chloro-]
75-01-4
1.00%
10,000 lbs
Vinyl ethyl ether
[Ethene, ethoxy-]
109-92-2
1.00%
10,000 lbs
Vinyl fluoride
[Ethene, fluoro-]
75-02-5
1.00%
10,000 lbs
Vinyl methyl ether
[Ethene, methoxy-]
107-25-5
1.00%
10,000 lbs
Vinylidene chloride
[Ethene, 1,1-dichloro-]
75-35-4
1.00%
10,000 lbs
Vinylidene fluoride
[Ethene, 1,1-difluoro-]
75-38-7
1.00%
10,000 lbs
No
Fuels: Bunker fuel
Fuels: Diesel
Fuels: Gasoline
Fuels: Home heating oil
Fuels: JP A (jet fuel)
DHS Form 9007 (6/07)
Page 41 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process,
use, store, or distribute any of the
following release flammable
chemicals of interest (COI) at or
above the screening threshold
quantity at your facility?
Yes
No
Fuels: JP 5 (jet fuel)
Fuels: JP 8 (jet fuel)
Fuels: Kerosene
Fuels: LPG
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:3.0-632]
Yes No
Release Flammable Chemicals of Interest - Detail
Enter the total on-site quantity of the release flammable chemical of interest in pounds. Enter the quantity of the release flammable COI
in the Area of Highest Quantity in pounds.
The total on-site quantity is the highest amount that the facility either currently possesses or possessed within the past 60 days. The Area of
Highest Quantity (AHQ) is defined as an on-site area, with a radius of 170 feet, where the greatest amount of the release flammable COI is either
currently present or has been present at any one time within the past 60 days. This amount may differ from the total on-site quantity. For release
flammable COI, AHQ should be reported as an aggregate amount of all release flammable COI located within the AHQ. See the
DHS Form 9007 (6/07)
Page 42 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
downloadable Top-Screen Users Manual for instructions. Round both quantities to two significant digits (e.g., round 247500 pounds to
250000 pounds, and round 7625 pounds to 7600 pounds). Do not use commas when entering data.
CAS#
Min. Conc.
Screening
Threshold
Quantity
Acetaldehyde
75-07-0
1.00%
10,000 lbs
Acetylene
[Ethyne]
74-86-2
1.00%
10,000 lbs
Acrylonitrile
[2-Propenenitrile]
107-13-1
1.00%
10,000 lbs
Acrylyl chloride
[2-Propenoyl chloride]
814-68-6
1.00%
10,000 lbs
Allylamine
[2-Propen-1-amine]
107-11-9
1.00%
10,000 lbs
Bromotrifluorethylene
[Ethene, bromotrifluoro-]
598-73-2
1.00%
10,000 lbs
1,3-Butadiene
106-99-0
1.00%
10,000 lbs
Butane
106-97-8
1.00%
10,000 lbs
Butene
25167-67-3
1.00%
10,000 lbs
1-Butene
106-98-9
1.00%
10,000 lbs
2-Butene
107-01-7
1.00%
10,000 lbs
2-Butene-cis
590-18-1
1.00%
10,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 43 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
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OMB No. 1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
2-Butene-trans
[2-Butene, (E)]
624-64-6
1.00%
10,000 lbs
Carbon oxysulfide
[Carbon oxide sulfide (COS); carbonyl sulfide]
463-58-1
1.00%
10,000 lbs
Chlorine monoxide
[Chlorine oxide]
7791-21-1
1.00%
10,000 lbs
1-Chloropropylene
[1-Propene, 1-chloro-]
590-21-6
1.00%
10,000 lbs
2-Chloropropylene
[1-Propene, 2-chloro-]
557-98-2
1.00%
10,000 lbs
Crotonaldehyde
[2-Butenal]
4170-30-3
1.00%
10,000 lbs
Crotonaldehyde, (E)-
[2-Butenal], (E)-]
123-73-9
1.00%
10,000 lbs
Cyanogen
[Ethanedinitrile]
460-19-5
1.00%
10,000 lbs
Cyclopropane
75-19-4
1.00%
10,000 lbs
Dichlorosilane
[Silane, dichloro-]
4109-96-0
1.00%
10,000 lbs
75-37-6
1.00%
10,000 lbs
Chemical Name
Difluoroethane
[Ethane, 1,1-difluoro-]
DHS Form 9007 (6/07)
Page 44 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
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OMB No. 1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
Dimethylamine
[Methanamine, N-methyl-]
124-40-3
1.00%
10,000 lbs
Dimethyldichlorosilane
[Silane, dichlorodimethyl-]
75-78-5
1.00%
10,000 lbs
1,1-Dimethylhydrazine
[Hydrazine, 1, 1-dimethyl-]
57-14-7
1.00%
10,000 lbs
2,2-Dimethylpropane
[Propane, 2,2-dimethyl-]
463-82-1
1.00%
10,000 lbs
Ethane
74-84-0
1.00%
10,000 lbs
Ethyl acetylene
[1-Butyne]
107-00-6
1.00%
10,000 lbs
Ethyl chloride
[Ethane, chloro-]
75-00-3
1.00%
10,000 lbs
Ethyl ether
[Ethane, 1,1-oxybis-]
60-29-7
1.00%
10,000 lbs
Ethyl mercaptan
[Ethanethiol]
75-08-1
1.00%
10,000 lbs
Ethyl nitrite
[Nitrous acid, ethyl ester]
109-95-5
1.00%
10,000 lbs
Ethylamine
[Ethanamine]
75-04-7
1.00%
10,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 45 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
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OMB No. 1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
Ethylene
[Ethene]
74-85-1
1.00%
10,000 lbs
Ethylene oxide
[Oxirane]
75-21-8
1.00%
10,000 lbs
Ethyleneimine
[Aziridine]
151-56-4
1.00%
10,000 lbs
Furan
110-00-9
1.00%
10,000 lbs
Hydrazine
302-01-2
1.00%
10,000 lbs
Hydrogen
1333-74-0
1.00%
10,000 lbs
Hydrogen selenide
7783-07-5
1.00%
10,000 lbs
Iron, pentacarbonyl
[Iron carbonyl (Fe (CO)5), (TB5-11)-]
13463-40-6
1.00%
10,000 lbs
Isobutane
[Propane, 2-methyl]
75-28-5
1.00%
10,000 lbs
Isopentane
[Butane, 2-methyl-]
78-78-4
1.00%
10,000 lbs
Isoprene
[1,3-Butadiene, 2-methyl-]
78-79-5
1.00%
10,000 lbs
Isopropyl chloride
[Propane, 2-chloro-]
75-29-6
1.00%
10,000 lbs
Chemical Name
DHS Form 9007 (6/07)
Page 46 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
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OMB No. 1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
75-31-0
1.00%
10,000 lbs
Methane
74-82-8
1.00%
10,000 lbs
2-Methyl-1-butene
563-46-2
1.00%
10,000 lbs
3-Methyl-1-butene
563-45-1
1.00%
10,000 lbs
Methyl chloride
[Methane, chloro-]
74-87-3
1.00%
10,000 lbs
Methyl chloroformate
[Carbonochloridic acid, methyl ester]
79-22-1
1.00%
10,000 lbs
Methyl ether
[Methane, oxybis-]
115-10-6
1.00%
10,000 lbs
Methyl formate
[Formic acid Methyl ester]
107-31-3
1.00%
10,000 lbs
Methyl mercaptan
[Methanethiol]
74-93-1
1.00%
10,000 lbs
Methylamine
[Methanamine]
115-11-7
1.00%
10,000 lbs
2-Methylpropene
[1-Propene, 2-methyl-]
74-89-5
1.00%
10,000 lbs
Methyltrichlorosilane
[Silane, trichloromethyl-]
75-79-6
1.00%
10,000 lbs
Chemical Name
Isopropylamine
[2-Propanamine]
DHS Form 9007 (6/07)
Page 47 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
Nickel Carbonyl
13463-39-3
1.00%
10,000 lbs
1,3-Pentadiene
504-60-9
1.00%
10,000 lbs
Pentane
109-66-0
1.00%
10,000 lbs
1-Pentene
109-67-1
1.00%
10,000 lbs
2-Pentene,(E)-
646-04-8
1.00%
10,000 lbs
2-Pentene, (Z)-
627-20-3
Peracetic acid
[Ethaneperoxic acid]
79-21-0
Chemical Name
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
10,000 lbs
1.00%
10,000 lbs
1.00%
Phosphine
7803-51-2
1.00%
10,000 lbs
Piperidine
110-89-4
1.00%
10,000 lbs
Propadiene
[1,2-Propadiene]
463-49-0
1.00%
10,000 lbs
Propane
74-98-6
1.00%
60,000 lbs
Propyl chloroformate
[Carbonchloridic acid, propylester]
109-61-5
1.00%
10,000 lbs
Propylene
[1-Propene]
115-07-1
1.00%
10,000 lbs
Propylene oxide
[Oxirane, methyl-]
75-56-9
1.00%
10,000 lbs
DHS Form 9007 (6/07)
Total On-site
Quantity
(pounds)
Page 48 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
74-99-7
1.00%
10,000 lbs
Silane
7803-62-5
1.00%
10,000 lbs
Tetrafluoroethylene
[Ethene, tetrafluoro-]
116-14-3
1.00%
10,000 lbs
Tetramethylsilane
[Silane, tetramethyl-]
75-76-3
1.00%
10,000 lbs
Tetranitromethane
[Methane, tetranitro-]
509-14-8
1.00%
10,000 lbs
10025-78-2
1.00%
10,000 lbs
Trifluorochloroethylene
[Ethene, chlorotrifluoro]
79-38-9
1.00%
10,000 lbs
Trimethylamine
[Methanamine, N,N-dimethyl-]
75-50-3
1.00%
10,000 lbs
Trimethylchlorosilane
[Silane, chlorotrimethyl-]
75-77-4
1.00%
10,000 lbs
Vinyl acetate monomer
[Acetic acid ethenyl ester]
108-05-4
1.00%
10,000 lbs
Vinyl acetylene
[1-Buten-3-yne]
689-97-4
1.00%
10,000 lbs
Chemical Name
Propyne
[1-Propyne]
Trichlorosilane
[Silane, trichloro-]
DHS Form 9007 (6/07)
Page 49 of 113
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
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CAS#
Min. Conc.
Screening
Threshold
Quantity
Vinyl chloride
[Ethene, chloro-]
75-01-4
1.00%
10,000 lbs
Vinyl ethyl ether
[Ethene, ethoxy-]
109-92-2
1.00%
10,000 lbs
Vinyl fluoride
[Ethene, fluoro-]
75-02-5
1.00%
10,000 lbs
Vinyl methyl ether
[Ethene, methoxy-]
107-25-5
1.00%
10,000 lbs
Vinylidene chloride
[Ethene, 1,1-dichloro-]
75-35-4
1.00%
10,000 lbs
Vinylidene fluoride
[Ethene, 1,1-difluoro-]
75-38-7
1.00%
10,000 lbs
Chemical Name
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Fuels: Bunker fuel
Fuels: Diesel
Fuels: Gasoline
Fuels: Home heating oil
Fuels: JP A (jet fuel)
Fuels: JP 5 (jet fuel)
Fuels: JP 8 (jet fuel)
Fuels: Kerosene
DHS Form 9007 (6/07)
Page 50 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Total On-site
Quantity
(pounds)
Quantity in
AHQ
(pounds)
[Q:3.1-131]
[Q:3.1-2794]
Fuels: LPG
DHS Form 9007 (6/07)
Page 51 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Release Explosives
Release Explosive Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute any of the following release explosive chemicals of interest at or above the
screening threshold quantity at your facility?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days the COI at or above the screening threshold
quantity.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
A Commercial Grade (ACG) refers to any quality or concentration of a COI offered for commercial sale that a facility uses, stores, manufactures or
ships.
If the answer to question [Q:1.1-65], "Choose the facility type that best describes your facility" is Petroleum refinery or Liquefied natural gas storage,
go to Theft/Diversion WME (page 75)
If “No” selected for all chemicals, go to Theft/Diversion EXP/IEDP (page 62)
DHS Form 9007 (6/07)
Page 52 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
[Q:4.0-154]
Chemical Name
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture,
process, use, store, or
distribute any of the
following release explosive
chemicals of interest (COI)
at or above the screening
threshold quantity at your
facility?
Yes
Ammonium nitrate, [with more than 0.2 percent
combustible substances, including any organic
substance calculated as carbon, to the exclusion of any
other added substance]
6484-52-2
ACG
5,000 lbs
Ammonium perchlorate
7790-98-9
ACG
5,000 lbs
Ammonium picrate
131-74-8
ACG
5,000 lbs
18810-58-7
ACG
5,000 lbs
Diazodinitrophenol
87-31-0
ACG
5,000 lbs
Diethyleneglycol dinitrate
693-21-0
ACG
5,000 lbs
Dingu
[Dinitroglycoluril]
55510-04-8
ACG
5,000 lbs
Dinitrophenol
25550-58-7
ACG
5,000 lbs
Dinitroresorcinol
519-44-8
ACG
5,000 lbs
Dipicryl sulfide
2217-06-3
ACG
5,000 lbs
Barium azide
DHS Form 9007 (6/07)
Page 53 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture,
process, use, store, or
distribute any of the
following release explosive
chemicals of interest (COI)
at or above the screening
threshold quantity at your
facility?
Yes
Dipicrylamine [or] Hexyl
[Hexanitrodiphenylamine]
131-73-7
ACG
5,000 lbs
ACG
5,000 lbs
20062-22-0
ACG
5,000 lbs
Hexolite
[Hexotol]
121-82-4
ACG
5,000 lbs
HMX
[Cyclotetramethylenetetranitramine]
2691-41-0
ACG
5,000 lbs
Lead azide
13424-46-9
ACG
5,000 lbs
Lead styphnate
[Lead trinitroresorcinate]
15245-44-0
ACG
5,000 lbs
Mercury fulminate
628-86-4
ACG
5,000 lbs
5-Nitrobenzotriazol
2338-12-7
ACG
5,000 lbs
Nitrocellulose
9004-70-0
ACG
5,000 lbs
Nitroglycerine
55-63-0
ACG
5,000 lbs
Guanyl nitrosaminoguanylidene hydrazine
Hexanitrostilbene
DHS Form 9007 (6/07)
Page 54 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture,
process, use, store, or
distribute any of the
following release explosive
chemicals of interest (COI)
at or above the screening
threshold quantity at your
facility?
Yes
Nitromannite
[Mannitol hexanitrate, wetted]
15825-70-4
ACG
5,000 lbs
Nitrostarch
9056-38-6
ACG
5,000 lbs
Nitrotriazolone
932-64-9
ACG
5,000 lbs
Octolite
57607-37-1
ACG
5,000 lbs
Octonal
78413-87-3
ACG
5,000 lbs
Pentolite
8066-33-9
ACG
5,000 lbs
PETN
[Pentaerythritol tetranitrate]
78-11-5
ACG
5,000 lbs
Picrite
[Nitroguanidine]
556-88-7
ACG
5,000 lbs
RDX
[Cyclotrimethylenetrinitramine]
121-82-4
ACG
5,000 lbs
RDX and HMX mixtures
121-82-4
ACG
5,000 lbs
53014-37-2
ACG
5,000 lbs
Tetranitroaniline
DHS Form 9007 (6/07)
Page 55 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture,
process, use, store, or
distribute any of the
following release explosive
chemicals of interest (COI)
at or above the screening
threshold quantity at your
facility?
Yes
Tetrazene
[Guanyl nitrosaminoguanyltetrazene]
109-27-3
ACG
5,000 lbs
1H-Tetrazole
288-94-8
ACG
5,000 lbs
TNT
[Trinitrotoluene]
118-96-7
ACG
5,000 lbs
Torpex
[Hexotonal]
67713-16-0
ACG
5,000 lbs
Trinitroaniline
26952-42-1
ACG
5,000 lbs
Trinitroanisole
606-35-9
ACG
5,000 lbs
Trinitrobenzene
99-35-4
ACG
5,000 lbs
Trinitrobenzenesulfonic acid
2508-19-2
ACG
5,000 lbs
Trinitrobenzoic acid
129-66-8
ACG
5,000 lbs
Trinitrochlorobenzene
88-88-0
ACG
5,000 lbs
Trinitrofluorenone
129-79-3
ACG
5,000 lbs
Trinitro-meta-cresol
602-99-3
ACG
5,000 lbs
DHS Form 9007 (6/07)
Page 56 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture,
process, use, store, or
distribute any of the
following release explosive
chemicals of interest (COI)
at or above the screening
threshold quantity at your
facility?
Yes
Trinitronaphthalene
55810-17-8
ACG
5,000 lbs
Trinitrophenetole
4732-14-3
ACG
5,000 lbs
Trinitrophenol
88-89-1
ACG
5,000 lbs
Trinitroresorcinol
82-71-3
ACG
5,000 lbs
54413-15-9
ACG
5,000 lbs
Tritonal
No
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:4.0-711]
Yes No
DHS Form 9007 (6/07)
Page 57 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Release Explosive Chemicals of Interest - Detail
Enter the total on-site quantity of the release explosive chemical of interest in pounds. Enter the quantity of the release explosive COI in
the Area of Highest Quantity in pounds.
The total on-site quantity is the highest amount that the facility either currently possesses or possessed within the past 60 days. The Area of
Highest Quantity (AHQ) is defined as an on-site area, with a radius of 170 feet, where the greatest amount of the release explosive COI is either
currently present or has been present at any one time within the past 60 days. This amount may differ from the total on-site quantity. For release
explosive COI, AHQ should be reported as an aggregate amount of all release explosive COI located within the AHQ. See the downloadable
Top-Screen Users Manual for instructions. Round both quantities to two significant digits (e.g., round 247500 pounds to 250000 pounds, and
round 7625 pounds to 7600 pounds). Do not use commas when entering data.
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Ammonium nitrate, [with more than 0.2 percent
combustible substances, including any organic
substance calculated as carbon, to the exclusion of any
other added substance]
6484-52-2
ACG
5,000 lbs
Ammonium perchlorate
7790-98-9
ACG
5,000 lbs
Ammonium picrate
131-74-8
ACG
5,000 lbs
18810-58-7
ACG
5,000 lbs
Diazodinitrophenol
87-31-0
ACG
5,000 lbs
Diethyleneglycol dinitrate
693-21-0
ACG
5,000 lbs
55510-04-8
ACG
5,000 lbs
Chemical Name
Total On-site
Quantity
(pounds)
[Q:4.1-712]
Barium azide
Dingu
[Dinitroglycoluril]
DHS Form 9007 (6/07)
Page 58 of 113
Quantity in
AHQ
(pounds)
[Q:4.1-2795]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
25550-58-7
ACG
5,000 lbs
Dinitroresorcinol
519-44-8
ACG
5,000 lbs
Dipicryl sulfide
2217-06-3
ACG
5,000 lbs
Dipicrylamine [or] Hexyl
[Hexanitrodiphenylamine]
131-73-7
ACG
5,000 lbs
ACG
5,000 lbs
20062-22-0
ACG
5,000 lbs
Hexolite
[Hexotol]
121-82-4
ACG
5,000 lbs
HMX
[Cyclotetramethylenetetranitramine]
2691-41-0
ACG
5,000 lbs
Lead azide
13424-46-9
ACG
5,000 lbs
Lead styphnate
[Lead trinitroresorcinate]
15245-44-0
ACG
5,000 lbs
Mercury fulminate
628-86-4
ACG
5,000 lbs
5-Nitrobenzotriazol
2338-12-7
ACG
5,000 lbs
Nitrocellulose
9004-70-0
ACG
5,000 lbs
Nitroglycerine
55-63-0
ACG
5,000 lbs
Chemical Name
Total On-site
Quantity
(pounds)
[Q:4.1-712]
Dinitrophenol
Guanyl nitrosaminoguanylidene hydrazine
Hexanitrostilbene
DHS Form 9007 (6/07)
Page 59 of 113
Quantity in
AHQ
(pounds)
[Q:4.1-2795]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
15825-70-4
ACG
5,000 lbs
Nitrostarch
9056-38-6
ACG
5,000 lbs
Nitrotriazolone
932-64-9
ACG
5,000 lbs
Octolite
57607-37-1
ACG
5,000 lbs
Octonal
78413-87-3
ACG
5,000 lbs
Pentolite
8066-33-9
ACG
5,000 lbs
PETN
[Pentaerythritol tetranitrate]
78-11-5
ACG
5,000 lbs
Picrite
[Nitroguanidine]
556-88-7
ACG
5,000 lbs
RDX
[Cyclotrimethylenetrinitramine]
121-82-4
ACG
5,000 lbs
RDX and HMX mixtures
121-82-4
ACG
5,000 lbs
Tetranitroaniline
53014-37-2
ACG
5,000 lbs
Tetrazene
[Guanyl nitrosaminoguanyltetrazene]
109-27-3
ACG
5,000 lbs
1H-Tetrazole
288-94-8
ACG
5,000 lbs
TNT
[Trinitrotoluene]
118-96-7
ACG
5,000 lbs
Chemical Name
Total On-site
Quantity
(pounds)
[Q:4.1-712]
Nitromannite
[Mannitol hexanitrate, wetted]
DHS Form 9007 (6/07)
Page 60 of 113
Quantity in
AHQ
(pounds)
[Q:4.1-2795]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Torpex
[Hexotonal]
67713-16-0
ACG
5,000 lbs
Trinitroaniline
26952-42-1
ACG
5,000 lbs
Trinitroanisole
606-35-9
ACG
5,000 lbs
Trinitrobenzene
99-35-4
ACG
5,000 lbs
Trinitrobenzenesulfonic acid
2508-19-2
ACG
5,000 lbs
Trinitrobenzoic acid
129-66-8
ACG
5,000 lbs
Trinitrochlorobenzene
88-88-0
ACG
5,000 lbs
Trinitrofluorenone
129-79-3
ACG
5,000 lbs
Trinitro-meta-cresol
602-99-3
ACG
5,000 lbs
Trinitronaphthalene
55810-17-8
ACG
5,000 lbs
Trinitrophenetole
4732-14-3
ACG
5,000 lbs
Trinitrophenol
88-89-1
ACG
5,000 lbs
Trinitroresorcinol
82-71-3
ACG
5,000 lbs
54413-15-9
ACG
5,000 lbs
Chemical Name
Total On-site
Quantity
(pounds)
[Q:4.1-712]
Tritonal
DHS Form 9007 (6/07)
Page 61 of 113
Quantity in
AHQ
(pounds)
[Q:4.1-2795]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Theft/Diversion EXP/IEDP
Theft/Diversion Explosive/IED Precursor (EXP/IEDP) Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute at the facility A Commercial Grade (including A Commercial Grade at or above
any specified minimum concentration) of any of the following theft/diversion explosive/IED precursor chemicals of interest?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days A Commercial Grade of the COI at or above
the screening threshold quantity in transportation packaging.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
Transportation packaging, as defined by 49 CFR § 171.8 includes, but is not limited to, cylinders, bulk bags, bottles (inside or outside a box),
cargo tanks, and/or tank cars.
A Commercial Grade (ACG) refers to any quality or concentration of a COI offered for commercial sale that a facility uses, stores, manufactures or
ships.
If “No” selected for all chemicals, go to Theft/Diversion WME (page 75)
DHS Form 9007 (6/07)
Page 62 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
[Q:5.0-175]
Chemical Name
CAS#
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Aluminum (powder)
7429-90-5
ACG
100 lbs
Ammonium nitrate, [with more than
0.2 percent combustible substances,
including any organic substance
calculated as carbon, to the
exclusion of any other added
substance]
6484-52-2
ACG
400 lbs
Ammonium nitrate, solid [nitrogen
concentration of 23% nitrogen or
greater]
6484-52-2
33.00%
2000 lbs
Ammonium perchlorate
7790-98-9
ACG
400 lbs
Ammonium picrate
131-74-8
ACG
400 lbs
18810-58-7
ACG
400 lbs
Diazodinitrophenol
87-31-0
ACG
400 lbs
Diethyleneglycol dinitrate
693-21-0
ACG
400 lbs
Barium azide
DHS Form 9007 (6/07)
Page 63 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Dingu
[Dinitroglycoluril]
55510-04-8
ACG
400 lbs
Dinitrophenol
25550-58-7
ACG
400 lbs
Dinitroresorcinol
519-44-8
ACG
400 lbs
Dipicryl sulfide
2217-06-3
ACG
400 lbs
Dipicrylamine [or] Hexyl
[Hexanitrodiphenylamine]
131-73-7
ACG
400 lbs
Guanyl nitrosaminoguanylidene
hydrazine
Hexanitrostilbene
Hexolite
[Hexotol]
HMX
[Cyclotetramethylene-tetranitramine]
DHS Form 9007 (6/07)
No
400 lbs
20062-22-0
ACG
121-82-4
ACG
400 lbs
ACG
400 lbs
2691-41-0
ACG
400 lbs
Page 64 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Hydrogen peroxide (concentration of
at least 35%)
7722-84-1
35.00%
400 lbs
Lead azide
13424-46-9
ACG
400 lbs
Lead styphnate
[Lead trinitroresorcinate]
15245-44-0
ACG
400 lbs
Magnesium (powder)
7439-95-4
ACG
100 lbs
Mercury fulminate
628-86-4
ACG
400 lbs
Nitric acid
7697-37-2
68.00%
400 lbs
98-95-3
ACG
100 lbs
5-Nitrobenzotriazol
2338-12-7
ACG
400 lbs
Nitrocellulose
9004-70-0
ACG
400 lbs
Nitroglycerine
55-63-0
ACG
400 lbs
15825-70-4
ACG
400 lbs
Nitrobenzene
Nitromannite
[Mannitol hexanitrate, wetted]
DHS Form 9007 (6/07)
Page 65 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Nitromethane
75-52-5
ACG
400 lbs
Nitrostarch
9056-38-6
ACG
400 lbs
Nitrotriazolone
932-64-9
ACG
400 lbs
Octolite
57607-37-1
ACG
400 lbs
Octonal
78413-87-3
ACG
400 lbs
Pentolite
8066-33-9
ACG
400 lbs
78-11-5
ACG
400 lbs
Phosphorus
7723-14-0
ACG
400 lbs
Picrite
[Nitroguanidine]
556-88-7
ACG
400 lbs
Potassium chlorate
3811-04-9
ACG
400 lbs
Potassium nitrate
7757-79-1
ACG
400 lbs
PETN
[Pentaerythritol tetranitrate]
DHS Form 9007 (6/07)
Page 66 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Potassium perchlorate
7778-74-7
ACG
400 lbs
Potassium permanganate
7722-64-7
ACG
400 lbs
RDX
[Cyclotrimethylenetrinitramine]
121-82-4
ACG
400 lbs
RDX and HMX mixtures
121-82-4
ACG
400 lbs
Sodium azide
26628-22-8
ACG
400 lbs
Sodium chlorate
7775-09-9
ACG
400 lbs
Sodium nitrate
7631-99-4
ACG
400 lbs
Tetranitroaniline
53014-37-2
ACG
400 lbs
Tetrazene
[Guanyl nitrosaminoguanyltetrazene]
109-27-3
ACG
400 lbs
1H-Tetrazole
288-94-8
ACG
400 lbs
TNT
[Trinitrotoluene]
118-96-7
ACG
400 lbs
DHS Form 9007 (6/07)
Page 67 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Torpex
[Hexotonal]
67713-16-0
ACG
400 lbs
Trinitroaniline
26952-42-1
ACG
400 lbs
Trinitroanisole
606-35-9
ACG
400 lbs
Trinitrobenzene
99-35-4
ACG
400 lbs
Trinitrobenzenesulfonic acid
2508-19-2
ACG
400 lbs
Trinitrobenzoic acid
129-66-8
ACG
400 lbs
Trinitrochlorobenzene
88-88-0
ACG
400 lbs
Trinitrofluorenone
129-79-3
ACG
400 lbs
Trinitro-meta-cresol
602-99-3
ACG
400 lbs
Trinitronaphthalene
55810-17-8
ACG
400 lbs
Trinitrophenetole
4732-14-3
ACG
400 lbs
88-89-1
ACG
400 lbs
Trinitrophenol
DHS Form 9007 (6/07)
Page 68 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min.
Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use, store, or
distribute at the facility A Commercial Grade
(including A Commercial Grade at or above any
specified minimum concentration) of any of the
following theft/diversion explosive/IED precursor
chemicals of interest? Check "Yes" if the facility
either currently possesses or possessed within
the past 60 days A Commercial Grade of the COI
at or above the screening threshold quantity in
transportation packaging.
Yes
Trinitroresorcinol
Tritonal
82-71-3
ACG
400 lbs
54413-15-9
ACG
400 lbs
No
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:5.0-714]
Yes No
Theft/Diversion Explosive/IED Precursor Chemicals of Interest - Detail
Check if the chemical is available in portable, bulk transportation, or bulk storage containers.
A portable package can either be man-portable being movable by 1-3 people without the aid of powered mechanical devices or mechanically
portable with the aid of a fork lift, truck or crane.
Bulk transportation containers include tank cars, rail cars and other large storage containers that could be hitched to a vehicle for removal from a
site.
DHS Form 9007 (6/07)
Page 69 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No.1670-0007
Expires: 2/29/2008
Bulk storage refers to a package or container from which the COI could be safely transferred into a portable package or container.
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Aluminum (powder)
7429-90-5
ACG
100 lbs
Ammonium nitrate, [with more than 0.2 percent
combustible substances, including any organic
substance calculated as carbon, to the exclusion of any
other added substance]
6484-52-2
ACG
400 lbs
Ammonium nitrate, solid [nitrogen concentration of 23%
nitrogen or greater]
6484-52-2
33.00%
2000 lbs
Ammonium perchlorate
7790-98-9
ACG
400 lbs
Ammonium picrate
131-74-8
ACG
400 lbs
18810-58-7
ACG
400 lbs
Diazodinitrophenol
87-31-0
ACG
400 lbs
Diethyleneglycol dinitrate
693-21-0
ACG
400 lbs
Dingu
[Dinitroglycoluril]
55510-04-8
ACG
400 lbs
Dinitrophenol
25550-58-7
ACG
400 lbs
Dinitroresorcinol
519-44-8
ACG
400 lbs
Dipicryl sulfide
2217-06-3
ACG
400 lbs
Dipicrylamine [or] Hexyl
[Hexanitrodiphenylamine]
131-73-7
ACG
400 lbs
Barium azide
DHS Form 9007 (6/07)
Page 70 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:5.1-233]
[Q:5.1-234]
[Q:5.1-235]
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Guanyl nitrosaminoguanylidene hydrazine
Min. Conc.
Screening
Threshold
Quantity
ACG
400 lbs
20062-22-0
ACG
400 lbs
Hexolite
[Hexotol]
121-82-4
ACG
400 lbs
HMX
[Cyclotetramethylene-tetranitramine]
2691-41-0
ACG
400 lbs
Hydrogen peroxide (concentration of at least 35%)
7722-84-1
35.00%
400 lbs
Lead azide
13424-46-9
ACG
400 lbs
Lead styphnate
[Lead trinitroresorcinate]
15245-44-0
ACG
400 lbs
Magnesium (powder)
7439-95-4
ACG
100 lbs
Mercury fulminate
628-86-4
ACG
400 lbs
Nitric acid
7697-37-2
68.00%
400 lbs
98-95-3
ACG
100 lbs
5-Nitrobenzotriazol
2338-12-7
ACG
400 lbs
Nitrocellulose
9004-70-0
ACG
400 lbs
Nitroglycerine
55-63-0
ACG
400 lbs
15825-70-4
ACG
400 lbs
Hexanitrostilbene
Nitrobenzene
Nitromannite
[Mannitol hexanitrate, wetted]
DHS Form 9007 (6/07)
Page 71 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:5.1-233]
[Q:5.1-234]
[Q:5.1-235]
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Chemical Name
Nitromethane
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
75-52-5
ACG
400 lbs
Nitrostarch
9056-38-6
ACG
400 lbs
Nitrotriazolone
932-64-9
ACG
400 lbs
Octolite
57607-37-1
ACG
400 lbs
Octonal
78413-87-3
ACG
400 lbs
Pentolite
8066-33-9
ACG
400 lbs
78-11-5
ACG
400 lbs
Phosphorus
7723-14-0
ACG
400 lbs
Picrite
[Nitroguanidine]
556-88-7
ACG
400 lbs
Potassium chlorate
3811-04-9
ACG
400 lbs
Potassium nitrate
7757-79-1
ACG
400 lbs
Potassium perchlorate
7778-74-7
ACG
400 lbs
Potassium permanganate
7722-64-7
ACG
400 lbs
RDX
[Cyclotrimethylenetrinitramine]
121-82-4
ACG
400 lbs
RDX and HMX mixtures
121-82-4
ACG
400 lbs
26628-22-8
ACG
400 lbs
PETN
[Pentaerythritol tetranitrate]
Sodium azide
DHS Form 9007 (6/07)
Page 72 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:5.1-233]
[Q:5.1-234]
[Q:5.1-235]
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Sodium chlorate
7775-09-9
ACG
400 lbs
Sodium nitrate
7631-99-4
ACG
400 lbs
Tetranitroaniline
53014-37-2
ACG
400 lbs
Tetrazene
[Guanyl nitrosaminoguanyltetrazene]
109-27-3
ACG
400 lbs
1H-Tetrazole
288-94-8
ACG
400 lbs
TNT
[Trinitrotoluene]
118-96-7
ACG
400 lbs
Torpex
[Hexotonal]
67713-16-0
ACG
400 lbs
Trinitroaniline
26952-42-1
ACG
400 lbs
Trinitroanisole
606-35-9
ACG
400 lbs
Trinitrobenzene
99-35-4
ACG
400 lbs
Trinitrobenzenesulfonic acid
2508-19-2
ACG
400 lbs
Trinitrobenzoic acid
129-66-8
ACG
400 lbs
Trinitrochlorobenzene
88-88-0
ACG
400 lbs
Trinitrofluorenone
129-79-3
ACG
400 lbs
Trinitro-meta-cresol
602-99-3
ACG
400 lbs
Trinitronaphthalene
55810-17-8
ACG
400 lbs
DHS Form 9007 (6/07)
Page 73 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:5.1-233]
[Q:5.1-234]
[Q:5.1-235]
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Chemical Name
Trinitrophenetole
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
4732-14-3
ACG
400 lbs
Trinitrophenol
88-89-1
ACG
400 lbs
Trinitroresorcinol
82-71-3
ACG
400 lbs
54413-15-9
ACG
400 lbs
Tritonal
DHS Form 9007 (6/07)
Page 74 of 113
Portable
Bulk
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Bulk
Storage
[Q:5.1-233]
[Q:5.1-234]
[Q:5.1-235]
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OMB No. 1670-0007
Expires: 2/29/2008
Theft/Diversion WME
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute at the facility any of the following theft/diversion WME chemicals of interest?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days the COI at or above the screening threshold
quantity in transportation packaging.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
Transportation packaging, as defined by 49 CFR § 171.8 includes, but is not limited to, cylinders, bulk bags, bottles (inside or outside a box),
cargo tanks, and/or tank cars.
A Commercial Grade (ACG) refers to any quality or concentration of a COI offered for commercial sale that a facility uses, stores, manufactures or
ships.
If “No” selected for all chemicals, go to Theft/Diversion CW/CWP (page 85)
DHS Form 9007 (6/07)
Page 75 of 113
Version 1.3
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OMB No.1670-0007
Expires: 2/29/2008
[Q:6.0-251]
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion WME
chemicals of interest? Check "Yes" if
the facility either currently possesses
or possessed within the past 60 days
the COI at or above the screening
threshold quantity in transportation
packaging.
Yes
Arsine
7784-42-1
0.67%
15 lbs
Boron tribromide
10294-33-4
12.67%
45 lbs
Boron trichloride
[Borane, trichloro]
10294-34-5
84.70%
45 lbs
Boron trifluoride
[Borane, trifluoro]
7637-07-2
26.87%
45 lbs
Bromine chloride
13863-41-7
9.67%
45 lbs
Bromine trifluoride
7787-71-5
6.00%
45 lbs
Carbonyl fluoride
353-50-4
12.00%
45 lbs
Carbonyl sulfide
463-58-1
56.67%
500 lbs
Chlorine
7782-50-5
9.77%
500 lbs
Chlorine pentafluoride
13637-63-3
4.07%
15 lbs
Chlorine trifluoride
7790-91-2
9.97%
45 lbs
DHS Form 9007 (6/07)
Page 76 of 113
No
Version 1.3
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion WME
chemicals of interest? Check "Yes" if
the facility either currently possesses
or possessed within the past 60 days
the COI at or above the screening
threshold quantity in transportation
packaging.
Yes
Cyanogen
[Ethanedinitrile]
460-19-5
11.67%
45 lbs
Cyanogen chloride
506-77-4
2.67%
15 lbs
Diborane
19287-45-7
2.67%
15 lbs
Dichlorosilane
[Silane, dichloro-]
4109-96-0
10.47%
45 lbs
Dinitrogen tetroxide
10544-72-6
3.80%
15 lbs
Fluorine
7782-41-4
6.17%
15 lbs
Germane
7782-65-2
20.73%
45 lbs
Germanium tetrafluoride
7783-58-6
2.11%
15 lbs
Hexaethyl tetraphosphate and
compressed gas mixtures
757-58-4
33.37%
500 lbs
Hexafluoroacetone
684-16-2
15.67%
45 lbs
10035-10-6
95.33%
500 lbs
Hydrogen bromide (anhydrous)
DHS Form 9007 (6/07)
Page 77 of 113
No
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion WME
chemicals of interest? Check "Yes" if
the facility either currently possesses
or possessed within the past 60 days
the COI at or above the screening
threshold quantity in transportation
packaging.
Yes
Hydrogen chloride (anhydrous)
7647-01-0
ACG
500 lbs
74-90-8
4.67%
15 lbs
Hydrogen fluoride (anhydrous)
7664-39-3
42.53%
45 lbs
Hydrogen iodide, anhydrous
10034-85-2
95.33%
500 lbs
Hydrogen selenide
7783-07-5
0.07%
15 lbs
Hydrogen sulfide
7783-06-4
23.73%
45 lbs
Methyl mercaptan
[Methanethiol]
74-93-1
45.00%
500 lbs
Methylchlorosilane
993-00-0
20.00%
45 lbs
Nitric oxide
[Nitrogen oxide (NO)]
10102-43-9
3.83%
15 lbs
Nitrogen trioxide
10544-73-7
3.83%
15 lbs
Nitrosyl chloride
2696-92-6
1.17%
15 lbs
Hydrogen cyanide
[Hydrocyanic acid]
DHS Form 9007 (6/07)
Page 78 of 113
No
Version 1.3
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion WME
chemicals of interest? Check "Yes" if
the facility either currently possesses
or possessed within the past 60 days
the COI at or above the screening
threshold quantity in transportation
packaging.
Yes
Oxygen difluoride
7783-41-7
0.09%
15 lbs
Perchloryl fluoride
7616-94-6
25.67%
45 lbs
75-44-5
0.17%
15 lbs
Phosphine
7803-51-2
0.67%
15 lbs
Phosphorus trichloride
7719-12-2
3.48%
45 lbs
Selenium hexafluoride
7783-79-1
1.67%
15 lbs
Silicon tetrafluoride
7783-61-1
15.00%
45 lbs
Stibine
7803-52-3
0.67%
15 lbs
Sulfur dioxide (anhydrous)
7446-09-5
84.00%
500 lbs
Sulfur tetrafluoride
[Sulfur fluoride (SF4), (T-4)-]
7783-60-0
1.33%
15 lbs
Tellurium hexafluoride
7783-80-4
0.83%
15 lbs
Phosgene
[Carbonic dichloride] or [carbonyl
dichloride]
DHS Form 9007 (6/07)
Page 79 of 113
No
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion WME
chemicals of interest? Check "Yes" if
the facility either currently possesses
or possessed within the past 60 days
the COI at or above the screening
threshold quantity in transportation
packaging.
Yes
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
7550-45-0
13.33%
45 lbs
Trifluoroacetyl chloride
354-32-5
6.93%
45 lbs
Trifluorochloroethylene
[Ethene, chlorotrifluoro]
79-38-9
66.67%
500 lbs
Tungsten hexafluoride
7783-82-6
7.10%
45 lbs
No
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:6.0-715]
Yes No
DHS Form 9007 (6/07)
Page 80 of 113
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OMB No. 1670-0007
Expires: 2/29/2008
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest - Detail
Check if the chemical is available in portable or bulk transportation containers.
A portable package can either be man-portable being movable by 1-3 people without the aid of powered mechanical devices or mechanically
portable with the aid of a fork lift, truck or crane.
Bulk transportation containers include tank cars, rail cars and other large storage containers that could be hitched to a vehicle for removal from a
site.
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Arsine
7784-42-1
0.67%
15 lbs
Boron tribromide
10294-33-4
12.67%
45 lbs
Boron trichloride
[Borane, trichloro]
10294-34-5
84.70%
45 lbs
Boron trifluoride
[Borane, trifluoro]
7637-07-2
26.87%
45 lbs
Bromine chloride
13863-41-7
9.67%
45 lbs
Bromine trifluoride
7787-71-5
6.00%
45 lbs
Carbonyl fluoride
353-50-4
12.00%
45 lbs
Carbonyl sulfide
463-58-1
56.67%
500 lbs
Chlorine
7782-50-5
9.77%
500 lbs
Chlorine pentafluoride
13637-63-3
4.07%
15 lbs
DHS Form 9007 (6/07)
Page 81 of 113
Portable
[Q:6.1-253]
Bulk
Transport
[Q:6.1-254]
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Chlorine trifluoride
7790-91-2
9.97%
45 lbs
Cyanogen
[Ethanedinitrile]
460-19-5
11.67%
45 lbs
Cyanogen chloride
506-77-4
2.67%
15 lbs
Diborane
19287-45-7
2.67%
15 lbs
Dichlorosilane
[Silane, dichloro-]
4109-96-0
10.47%
45 lbs
Dinitrogen tetroxide
10544-72-6
3.80%
15 lbs
Fluorine
7782-41-4
6.17%
15 lbs
Germane
7782-65-2
20.73%
45 lbs
Germanium tetrafluoride
7783-58-6
2.11%
15 lbs
Hexaethyl tetraphosphate and compressed
gas mixtures
757-58-4
33.37%
500 lbs
Hexafluoroacetone
684-16-2
15.67%
45 lbs
Hydrogen bromide (anhydrous)
10035-10-6
95.33%
500 lbs
7647-01-0
ACG
500 lbs
74-90-8
4.67%
15 lbs
7664-39-3
42.53%
45 lbs
Hydrogen chloride (anhydrous)
Hydrogen cyanide
[Hydrocyanic acid]
Hydrogen fluoride (anhydrous)
DHS Form 9007 (6/07)
Page 82 of 113
Portable
[Q:6.1-253]
Bulk
Transport
[Q:6.1-254]
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Hydrogen iodide, anhydrous
10034-85-2
95.33%
500 lbs
Hydrogen selenide
7783-07-5
0.07%
15 lbs
Hydrogen sulfide
7783-06-4
23.73%
45 lbs
Methyl mercaptan
[Methanethiol]
74-93-1
45.00%
500 lbs
Methylchlorosilane
993-00-0
20.00%
45 lbs
Nitric oxide
[Nitrogen oxide (NO)]
10102-43-9
3.83%
15 lbs
Nitrogen trioxide
10544-73-7
3.83%
15 lbs
Nitrosyl chloride
2696-92-6
1.17%
15 lbs
Oxygen difluoride
7783-41-7
0.09%
15 lbs
Perchloryl fluoride
7616-94-6
25.67%
45 lbs
75-44-5
0.17%
15 lbs
Phosphine
7803-51-2
0.67%
15 lbs
Phosphorus trichloride
7719-12-2
3.48%
45 lbs
Selenium hexafluoride
7783-79-1
1.67%
15 lbs
Silicon tetrafluoride
7783-61-1
15.00%
45 lbs
Stibine
7803-52-3
0.67%
15 lbs
Phosgene
[Carbonic dichloride] or [carbonyl dichloride]
DHS Form 9007 (6/07)
Page 83 of 113
Portable
[Q:6.1-253]
Bulk
Transport
[Q:6.1-254]
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Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Sulfur dioxide (anhydrous)
7446-09-5
84.00%
500 lbs
Sulfur tetrafluoride
[Sulfur fluoride (SF4), (T-4)-]
7783-60-0
1.33%
15 lbs
Tellurium hexafluoride
7783-80-4
0.83%
15 lbs
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
7550-45-0
13.33%
45 lbs
Trifluoroacetyl chloride
354-32-5
6.93%
45 lbs
Trifluorochloroethylene
[Ethene, chlorotrifluoro]
79-38-9
66.67%
500 lbs
7783-82-6
7.10%
45 lbs
Tungsten hexafluoride
DHS Form 9007 (6/07)
Page 84 of 113
Portable
[Q:6.1-253]
Bulk
Transport
[Q:6.1-254]
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Theft/Diversion CW/CWP
Theft/Diversion of Chemical Weapons/Chemical Weapon Precursors (CW/CWP) Chemicals of
Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Do you manufacture, process, use, store, or distribute at the facility any of the following theft/diversion CW/CWP chemicals of interest?
Check "Yes" if the facility either currently possesses or possessed within the past 60 days the COI at or above the screening threshold
quantity in transportation packaging.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
NOTE: The STQ for chemical weapons is a cumulative 100 grams (CUM 100g). In order to determine whether or not a facility meets or exceeds
this STQ, a facility must total the amount of any and all chemical weapons it possesses or possessed toward the single STQ of CUM 100 g which
applies to all chemical weapons.
Transportation packaging, as defined by 49 CFR § 171.8 includes, but is not limited to, cylinders, bulk bags, bottles (inside or outside a box),
cargo tanks, and tank cars.
If the answer to question [Q:1.1-65], "Choose the facility type that best describes your facility" is Refinery or Liquefied Natural Gas Storage, or if “No”
selected for all chemicals, go to Sabotage/Contamination Chemicals (page 96)
DHS Form 9007 (6/07)
Page 85 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
[Q:7.0-257]
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion CW/CWP
chemicals of interest? Check "Yes" if the
facility either currently possesses or
possessed within the past 60 days the
COI at or above the screening threshold
quantity in transportation packaging.
Yes
Arsenic trichloride
[Arsenous trichloride]
7784-34-1
30.00%
2.2 lbs
1,4-Bis(2-chloroethylthio)-n-butane
142868-93-7
CUM 100g
Bis(2-chloroethylthio)methane
63869-13-6
CUM 100g
Bis(2-chloroethylthiomethyl)ether
63918-90-1
CUM 100g
1,5-Bis(2-chloroethylthio)-n-pentane
142868-94-8
CUM 100g
1,3-Bis(2-chloroethylthio)-n-propane
63905-10-2
CUM 100g
2-Chloroethylchloro-methylsulfide
2625-76-5
CUM 100g
Chlorosarin
[o-Isopropyl methylphosphonochloridate]
1445-76-7
CUM 100g
Chlorosoman
[o-Pinacolyl methylphosphonochloridate]
7040-57-5
CUM 100g
DF
[Methyl phosphonyl difluoride]
676-98-3
CUM 100g
N,N-(2-diethylamino)ethanethiol
100-38-9
DHS Form 9007 (6/07)
30.00%
No
2.2 lbs
Page 86 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion CW/CWP
chemicals of interest? Check "Yes" if the
facility either currently possesses or
possessed within the past 60 days the
COI at or above the screening threshold
quantity in transportation packaging.
Yes
o,o-Diethyl S-[2-(diethylamino)ethyl]
phosphorothiolate
78-53-5
30.00%
2.2 lbs
Diethyl methylphosphonite
15715-41-0
30.00%
2.2 lbs
N,N-Diethyl phosphoramidic dichloride
1498-54-0
30.00%
2.2 lbs
N,N-(2-diisopropylamino)ethanethiol
[N,N-diisopropyl-β-aminoethane thiol]
5842-07-9
30.00%
2.2 lbs
N,N-Diisopropyl phosphoramidic dichloride
23306-80-1
30.00%
2.2 lbs
N,N-(2-dimethylamino)ethanethiol
108-02-1
30.00%
2.2 lbs
N,N-Dimethyl phosphoramidic dichloride
[Dimethylphosphoramido-dichloridate]
677-43-0
30.00%
2.2 lbs
N,N-(2-dipropylamino)ethanethiol
5842-06-8
30.00%
2.2 lbs
N,N-Dipropyl phosphoramidic dichloride
40881-98-9
30.00%
2.2 lbs
Ethyl phosphonyl difluoride
753-98-0
Ethyldiethanolamine
139-87-7
80.00%
220 lbs
Ethylphosphonothioic dichloride
993-43-1
30.00%
2.2 lbs
DHS Form 9007 (6/07)
No
CUM 100g
Page 87 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion CW/CWP
chemicals of interest? Check "Yes" if the
facility either currently possesses or
possessed within the past 60 days the
COI at or above the screening threshold
quantity in transportation packaging.
Yes
HN1 (Nitrogen Mustard-1)
[Bis(2-chloroethyl)ethylamine]
538-07-8
CUM 100g
HN2 (Nitrogen Mustard-2)
[Bis(2-chloroethyl)methylamine]
51-75-2
CUM 100g
HN3 (Nitrogen Mustard-3)
[Tris(2-chloroethyl)amine]
555-77-1
CUM 100g
Isopropylphosphonothioic dichloride
1498-60-8
Isopropylphosphonyl difluoride
677-42-9
CUM 100g
Lewisite 1
[2-chlorovinyldichloroarsine]
541-25-3
CUM 100g
Lewisite 2
[Bis(2-chlorovinyl)chloroarsine]
40334-69-8
CUM 100g
Lewisite 3
[Tris(2-chlorovinyl)arsine]
40334-70-1
CUM 100g
30.00%
2.2 lbs
MDEA
[Methyldiethanolamine]
105-59-9
80.00%
220 lbs
Methylphosphonothioic dichloride
676-98-2
30.00%
2.2 lbs
DHS Form 9007 (6/07)
No
Page 88 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion CW/CWP
chemicals of interest? Check "Yes" if the
facility either currently possesses or
possessed within the past 60 days the
COI at or above the screening threshold
quantity in transportation packaging.
Yes
O-Mustard (T)
[Bis(2-chloroethylthioethyl)ether]
63918-89-8
Nitrogen mustard hydrochloride
[Bis(2-chloroethyl)methylamine
hydrochloride]
55-86-7
30.00%
2.2 lbs
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
80.00%
220 lbs
Propylphosphonothioic dichloride
2524-01-8
30.00%
2.2 lbs
Propylphosphonyl difluoride
690-14-2
CUM 100g
57856-11-8
CUM 100g
Sarin
[o-Isopropyl methylphosphonofluoridate]
107-44-8
CUM 100g
Sesquimustard
[1,2-Bis(2-chloroethylthio)ethane]
3563-36-8
CUM 100g
96-64-0
CUM 100g
QL
[o-Ethyl-o-2-diisopropylaminoethyl
methylphosphonite]
Soman
[o-Pinacolyl methylphosphonofluoridate]
DHS Form 9007 (6/07)
No
CUM 100g
Page 89 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Do you manufacture, process, use,
store, or distribute at the facility any of
the following theft/diversion CW/CWP
chemicals of interest? Check "Yes" if the
facility either currently possesses or
possessed within the past 60 days the
COI at or above the screening threshold
quantity in transportation packaging.
Yes
Sulfur Mustard (Mustard gas (H))
[Bis(2-chloroethyl)sulfide]
505-60-2
CUM 100g
Tabun
[o-Ethyl-N,N-dimethylphosphoramido
cyanidate]
77-81-6
CUM 100g
Thiodiglycol
[Bis(2-hydroxyethyl)sulfide]
111-48-8
30.00%
2.2 lbs
Triethanolamine
102-71-6
80.00%
220 lbs
Triethanolamine hydrochloride
637-39-8
80.00%
220 lbs
Triethyl phosphite
122-52-1
80.00%
220 lbs
Trimethyl phosphite
121-45-9
80.00%
220 lbs
VX
[o-Ethyl-S-2-diisopropylaminoethyl methyl
phosphonothiolate]
DHS Form 9007 (6/07)
50782-69-9
No
CUM 100g
Page 90 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:7.0-721]
Yes No
Theft/Diversion Chemical Weapons/Chemical Weapon Precursors (CW/CWP) Chemicals of
Interest - Details
Check if the chemical is available in portable, bulk transportation, or bulk storage containers.
A portable package can either be man-portable being movable by 1-3 people without the aid of powered mechanical devices or mechanically
portable with the aid of a fork lift, truck or crane.
Bulk transportation containers include tank cars, rail cars and other large storage containers that could be hitched to a vehicle for removal from a
site.
Bulk storage refers to a package or container from which the COI could be safely transferred into a portable package or container.
Chemical Name
Arsenic trichloride
[Arsenous trichloride]
CAS#
7784-34-1
Min. Conc.
30.00%
Screening
Threshold
Quantity
142868-93-7
CUM 100g
Bis(2-chloroethylthio)methane
63869-13-6
CUM 100g
Bis(2-chloroethylthiomethyl)ether
63918-90-1
CUM 100g
Page 91 of 113
Bulk
Transport
Bulk
Storage
[Q:7.1-260]
[Q:7.1-261]
[Q:7.1-262]
2.2 lbs
1,4-Bis(2-chloroethylthio)-n-butane
DHS Form 9007 (6/07)
Portable
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
1,5-Bis(2-chloroethylthio)-n-pentane
142868-94-8
CUM 100g
1,3-Bis(2-chloroethylthio)-n-propane
63905-10-2
CUM 100g
2-Chloroethylchloro-methylsulfide
2625-76-5
CUM 100g
Chlorosarin
[o-Isopropyl methylphosphonochloridate]
1445-76-7
CUM 100g
Chlorosoman
[o-Pinacolyl methylphosphonochloridate]
7040-57-5
CUM 100g
DF
[Methyl phosphonyl difluoride]
676-98-3
CUM 100g
N,N-(2-diethylamino)ethanethiol
100-38-9
30.00%
2.2 lbs
o,o-Diethyl S-[2-(diethylamino)ethyl] phosphorothiolate
78-53-5
30.00%
2.2 lbs
Diethyl methylphosphonite
15715-41-0
30.00%
2.2 lbs
N,N-Diethyl phosphoramidic dichloride
1498-54-0
30.00%
2.2 lbs
N,N-(2-diisopropylamino)ethanethiol
[N,N-diisopropyl-β-aminoethane thiol]
5842-07-9
30.00%
2.2 lbs
N,N-Diisopropyl phosphoramidic dichloride
23306-80-1
30.00%
2.2 lbs
N,N-(2-dimethylamino)ethanethiol
108-02-1
30.00%
2.2 lbs
N,N-Dimethyl phosphoramidic dichloride
[Dimethylphosphoramido-dichloridate]
677-43-0
30.00%
2.2 lbs
N,N-(2-dipropylamino)ethanethiol
5842-06-8
30.00%
2.2 lbs
DHS Form 9007 (6/07)
Page 92 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:7.1-260]
[Q:7.1-261]
[Q:7.1-262]
Version 1.3
CSAT Top-Screen Questions
Chemical Name
N,N-Dipropyl phosphoramidic dichloride
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
40881-98-9
Min. Conc.
30.00%
Screening
Threshold
Quantity
Bulk
Transport
Bulk
Storage
[Q:7.1-260]
[Q:7.1-261]
[Q:7.1-262]
2.2 lbs
Ethyl phosphonyl difluoride
753-98-0
Ethyldiethanolamine
139-87-7
80.00%
220 lbs
Ethylphosphonothioic dichloride
993-43-1
30.00%
2.2 lbs
HN1 (Nitrogen Mustard-1)
[Bis(2-chloroethyl)ethylamine]
538-07-8
CUM 100g
HN2 (Nitrogen Mustard-2)
[Bis(2-chloroethyl)methylamine]
51-75-2
CUM 100g
HN3 (Nitrogen Mustard-3)
[Tris(2-chloroethyl)amine]
555-77-1
CUM 100g
Isopropylphosphonothioic dichloride
1498-60-8
Isopropylphosphonyl difluoride
677-42-9
CUM 100g
Lewisite 1
[2-chlorovinyldichloroarsine]
541-25-3
CUM 100g
Lewisite 2
[Bis(2-chlorovinyl)chloroarsine]
40334-69-8
CUM 100g
Lewisite 3
[Tris(2-chlorovinyl)arsine]
40334-70-1
CUM 100g
CUM 100g
30.00%
2.2 lbs
MDEA
[Methyldiethanolamine]
105-59-9
80.00%
220 lbs
Methylphosphonothioic dichloride
676-98-2
30.00%
2.2 lbs
DHS Form 9007 (6/07)
Portable
Page 93 of 113
Version 1.3
CSAT Top-Screen Questions
Chemical Name
O-Mustard (T)
[Bis(2-chloroethylthioethyl)ether]
Nitrogen mustard hydrochloride
[Bis(2-chloroethyl)methylamine hydrochloride]
OMB No. 1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
63918-89-8
Screening
Threshold
Quantity
30.00%
2.2 lbs
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
80.00%
220 lbs
Propylphosphonothioic dichloride
2524-01-8
30.00%
2.2 lbs
Propylphosphonyl difluoride
690-14-2
CUM 100g
57856-11-8
CUM 100g
Sarin
[o-Isopropyl methylphosphonofluoridate]
107-44-8
CUM 100g
Sesquimustard
[1,2-Bis(2-chloroethylthio)ethane]
3563-36-8
CUM 100g
Soman
[o-Pinacolyl methylphosphonofluoridate]
96-64-0
CUM 100g
Sulfur Mustard (Mustard gas (H))
[Bis(2-chloroethyl)sulfide]
505-60-2
CUM 100g
Tabun
[o-Ethyl-N,N-dimethylphosphoramido-cyanidate]
77-81-6
CUM 100g
Thiodiglycol
[Bis(2-hydroxyethyl)sulfide]
111-48-8
DHS Form 9007 (6/07)
Bulk
Transport
Bulk
Storage
[Q:7.1-260]
[Q:7.1-261]
[Q:7.1-262]
CUM 100g
55-86-7
QL
[o-Ethyl-o-2-diisopropylaminoethyl methylphosphonite]
Portable
30.00%
Page 94 of 113
2.2 lbs
Version 1.3
CSAT Top-Screen Questions
Chemical Name
OMB No.1670-0007
Expires: 2/29/2008
CAS#
Min. Conc.
Screening
Threshold
Quantity
Triethanolamine
102-71-6
80.00%
220 lbs
Triethanolamine hydrochloride
637-39-8
80.00%
220 lbs
Triethyl phosphite
122-52-1
80.00%
220 lbs
Trimethyl phosphite
121-45-9
80.00%
220 lbs
VX
[o-Ethyl-S-2-diisopropylaminoethyl methyl
phosphonothiolate]
DHS Form 9007 (6/07)
50782-69-9
Page 95 of 113
Portable
Bulk
Transport
Bulk
Storage
[Q:7.1-260]
[Q:7.1-261]
[Q:7.1-262]
CUM 100g
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Sabotage/Contamination Chemicals
Sabotage/Contamination Chemicals of Interest
The presence or amount of a particular chemical is not the sole factor in determining whether a facility presents a high level of security
risk. This information informs the subsequent parts of the Department's assessment. The Department will use its best judgment and all
available information in determining whether a facility presents a high level of security risk.
Does the facility ship or has it shipped any of the following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a sabotage/contamination chemical of interest if it ships or has shipped the chemical and is or
was required to placard the shipment of that chemical pursuant to the provisions of subpart F of 49 CFR part 172.
(The default settings on this list indicate that the chemicals are NOT currently present on site nor have been onsite within the past 60
days. At the end of the list, you must indicate that these settings have been changed as applicable to the facility.)
These chemicals were determined by the US Department of Homeland Security to be a potential security risk at "high risk chemical facilities" as
defined in Section 550 the Department of Homeland Security Act of 2007. A facility should indicate which COI it either currently possesses or
possessed within the past 60 days at or above the screening threshold quantity.
A Commercial Grade (ACG) refers to any quality or concentration of a COI offered for commercial sale that a facility uses, stores, manufactures or
ships.
A Placarded Amount (APA) refers to the STQ for a sabotage and contamination chemical of interest, as calculated in accordance with § 27.203(d).
If “No” selected for all chemicals, go to Mission Critical Chemicals (page 103)
DHS Form 9007 (6/07)
Page 96 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
[Q:8.1-722]
Chemical Name
CAS#
Min. Conc.
Screening
Threshold
Quantity
Does the facility ship or has it shipped any of the
following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a
sabotage/contamination chemical of interest if it ships
or has shipped the chemical and is or was required to
placard the shipment of that chemical pursuant to the
provisions of subpart F of 49 CFR part 172.
Yes
Acetone cyanohydrin, stabilized
75-86-5
ACG
APA
Acetyl bromide
506-96-7
ACG
APA
Acetyl chloride
75-36-5
ACG
APA
Acetyl iodide
507-02-8
ACG
APA
Allyltrichlorosilane, stabilized
107-37-9
ACG
APA
Aluminum bromide, anhydrous
7727-15-3
ACG
APA
Aluminum chloride, anhydrous
7446-70-0
ACG
APA
Aluminum phosphide
20859-73-8
ACG
APA
Amyltrichlorosilane
107-72-2
ACG
APA
Antimony pentafluoride
7783-70-2
ACG
APA
Boron tribromide
10294-33-4
ACG
APA
Bromine pentafluoride
7789-30-2
ACG
APA
Bromine trifluoride
7787-71-5
ACG
APA
Butyltrichlorosilane
7521-80-4
ACG
APA
DHS Form 9007 (6/07)
Page 97 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min. Conc.
Screening
Threshold
Quantity
Does the facility ship or has it shipped any of the
following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a
sabotage/contamination chemical of interest if it ships
or has shipped the chemical and is or was required to
placard the shipment of that chemical pursuant to the
provisions of subpart F of 49 CFR part 172.
Yes
Calcium hydrosulfite
[Calcium dithionite]
15512-36-4
ACG
APA
Calcium phosphide
1305-99-3
ACG
APA
Chlorine dioxide
[Chlorine oxide, (ClO2)]
10049-04-4
ACG
APA
79-04-9
ACG
APA
Chlorosulfonic acid
7790-94-5
ACG
APA
Chromium oxychloride
14977-61-8
ACG
APA
98-12-4
ACG
APA
1719-53-5
ACG
APA
Dimethyldichlorosilane
[Silane, dichlorodimethyl-]
75-78-5
ACG
APA
Diphenyldichlorosilane
80-10-4
ACG
APA
Dodecyltrichlorosilane
4484-72-4
ACG
APA
Ethyltrichlorosilane
115-21-9
ACG
APA
Chloroacetyl chloride
Cyclohexyltrichlorosilane
Diethyldichlorosilane
DHS Form 9007 (6/07)
Page 98 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min. Conc.
Screening
Threshold
Quantity
Does the facility ship or has it shipped any of the
following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a
sabotage/contamination chemical of interest if it ships
or has shipped the chemical and is or was required to
placard the shipment of that chemical pursuant to the
provisions of subpart F of 49 CFR part 172.
Yes
Fluorosulfonic acid
7789-21-1
ACG
APA
Hexyltrichlorosilane
928-65-4
ACG
APA
Iodine pentafluoride
7783-66-6
ACG
APA
Lithium amide
7782-89-0
ACG
APA
Lithium nitride
26134-62-3
ACG
APA
Magnesium diamide
7803-54-5
ACG
APA
Magnesium phosphide
12057-74-8
ACG
APA
Methyldichlorosilane
75-54-7
ACG
APA
Methylphenyldichlorosilane
149-74-6
ACG
APA
Methyltrichlorosilane
[Silane, trichloromethyl-]
75-79-6
ACG
APA
Nonyltrichlorosilane
5283-67-0
ACG
APA
Octadecyltrichlorosilane
112-04-9
ACG
APA
Octyltrichlorosilane
5283-66-9
ACG
APA
DHS Form 9007 (6/07)
Page 99 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min. Conc.
Screening
Threshold
Quantity
Does the facility ship or has it shipped any of the
following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a
sabotage/contamination chemical of interest if it ships
or has shipped the chemical and is or was required to
placard the shipment of that chemical pursuant to the
provisions of subpart F of 49 CFR part 172.
Yes
Phenyltrichlorosilane
98-13-5
ACG
APA
Phosphorus oxychloride
[Phosphoryl chloride]
10025-87-3
ACG
APA
Phosphorus pentabromide
7789-69-7
ACG
APA
Phosphorus pentachloride
10026-13-8
ACG
APA
Phosphorus pentasulfide
1314-80-3
ACG
APA
Phosphorus trichloride
7719-12-2
ACG
APA
Potassium cyanide
151-50-8
ACG
APA
Potassium phosphide
20770-41-6
ACG
APA
Propyltrichlorosilane
141-57-1
ACG
APA
Silicon tetrachloride
10026-04-7
ACG
APA
Sodium cyanide
143-33-9
ACG
APA
Sodium hydrosulfite
[Sodium dithionite]
7775-14-6
ACG
APA
Sodium phosphide
12058-85-4
ACG
APA
DHS Form 9007 (6/07)
Page 100 of 113
No
Version 1.3
CSAT Top-Screen Questions
Chemical Name
CAS#
OMB No. 1670-0007
Expires: 2/29/2008
Min. Conc.
Screening
Threshold
Quantity
Does the facility ship or has it shipped any of the
following chemicals of interest in a placarded amount?
A facility meets or exceeds the STQ for a
sabotage/contamination chemical of interest if it ships
or has shipped the chemical and is or was required to
placard the shipment of that chemical pursuant to the
provisions of subpart F of 49 CFR part 172.
Yes
Strontium phosphide
12504-16-4
ACG
APA
Sulfuryl chloride
7791-25-5
ACG
APA
Thionyl chloride
7719-09-7
ACG
APA
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]
7550-45-0
ACG
APA
Trichlorosilane
[Silane, trichloro-]
10025-78-2
ACG
APA
Trimethylchlorosilane
[Silane, chlorotrimethyl-]
75-77-4
ACG
APA
Vinyltrichlorosilane
75-94-5
ACG
APA
7779-86-4
ACG
APA
Zinc hydrosulfite
[Zinc dithionite]
DHS Form 9007 (6/07)
Page 101 of 113
No
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
The list above has been reviewed and all chemicals of interest that the facility either currently possesses or possessed within the past
60 days at or above the screening threshold quantity have been indicated by selecting "Yes."
[Q:8.1-718]
Yes No
DHS Form 9007 (6/07)
Page 102 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Mission Critical Chemicals
Mission Critical Chemical Production
Does this facility account for 20% or more of the domestic production of any chemical
AND supply the chemical to one or more of the following critical infrastructure sectors:
Defense Industrial Base, Energy (electricity generation only), Public Health or Healthcare,
and/or Public Drinking Water? The facility should answer this question for chemicals
listed in Appendix A, as well as for those not listed in Appendix A.
[Q:9.0-692]
Yes
No
This question should be answered "Yes" if this facility accounts for 20% or more of the
domestic production of a chemical to one or more critical infrastructure sectors. A single facility
may produce more than one chemical that meets the criteria.
If answered “No”, go to Economically Critical Chemicals (page 107)
For each chemical, copy the following pages (104-106) and answer the following fields:
• “Chemical Name”
• “Enter the CAS# (if available)”
• “Is there another common name for this chemical?”
• “Select the facility’s estimated domestic market share of this chemical.”
• “What is the primary application of this chemical by this facility’s customer(s)?”
• “Indicate the primary sector(s) for which this facility produces this chemical.”
• ”Exact (or direct) substitute(s) for this chemical produced to meet the supply needs of this
facility’s customer(s)”
o Is there North American production?
o Is there overseas production?
• “Functional substitute(s) for this chemical produced to meet the supply needs of this facility’s
customer(s)”
o Is there North American production?
o Is there overseas production?
• “What is this facility's estimated annual average Capacity Utilization Rate for this chemical?”
• “What is this facility's estimated National Emergency Production Rate for this chemical?”
• “What is the total annual production of this chemical (in pounds/year) from this facility?”
• “What is the estimated replacement cost of the production unit(s) for this chemical at this
facility?”
After the above information has been entered, go to Economically Critical Chemicals (page 107)
DHS Form 9007 (6/07)
Page 103 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Enter the chemical name(s) that account for 20% of the domestic production to one or
more critical infrastructure sectors. The critical infrastructure sectors are defined as
Defense Industrial Base, Energy (electric generation only), Public Health and Healthcare,
or Public Drinking Water.
For each chemical, enter the appropriate information.
Chemical Name
[Q:9.1-693]
Enter the CAS# (if available).
CAS#
[Q:9.3-852]
Is there another common name for this chemical?
[Q:9.3-733]
Enter another common name for this chemical.
This question is optional if you provided a CAS#.
Select the facility's estimated domestic market share of this chemical.
[Q:9.3-734]
20% - 29%
30% - 39%
40% - 50%
50% - 99%
100%
What is the primary application of this chemical by this facility's customer(s)?
[Q:9.3-737]
DHS Form 9007 (6/07)
Page 104 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Indicate the primary sector(s) for which this facility produces this chemical. Check all that
apply.
[Q:9.3-1131]
Defense Industrial Base
Public Heath or Healthcare
Energy (electric generation only)
Public Drinking Water
Exact (or direct) substitute(s) for this chemical produced to meet the supply needs of this
facility's customer(s):
Is there North American production?
Is there overseas production?
[Q:9.4-755]
[Q:9.4-756]
Yes
No
Yes
No
Functional substitute(s) for this chemical produced to meet the supply needs of this
facility's customer(s):
Is there North American production?
Is there overseas production?
[Q:9.4-759]
[Q:9.4-760]
Yes
No
Yes
No
What is this facility's estimated annual average Capacity Utilization Rate for this chemical?
Capacity Utilization Rate
[Q:9.5-762]
< 50%
50% - 69%
70% - 89%
>= 90%
Explain: "Capacity Utilization Rate" (operating rate) is estimated by dividing the average amount
of the chemical produced over the previous two years by the amount that could have been
produced if the facility had been operating at full capacity during that period. The rate may be
derived from the information your facility may have already provided as part of the U.S. Census
Bureau's Annual Plant Capacity Utilization Survey (form MQ-C1, question 2c). The survey and
instructions are available at http://www.census.gov/cir/www/mqc1pag2.html. Assumptions that
should be used for estimating this rate are available in the related downloadable guidance on the
DHS website.
What is this facility's estimated National Emergency Production Rate for this chemical?
Emergency Production Rate
[Q:9.5-763]
< 50%
50% - 69%
70% - 89%
>= 90%
DHS Form 9007 (6/07)
Page 105 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Explain: The National Emergency Production Rate is estimated by dividing the average amount
of chemical produced over the previous two (2) years by the amount that could have been
produced if the plant had been operating under national emergency conditions during that period.
The rate may be derived from the information your facility may have already provided as part of
the U.S. Census Bureau's Annual Plant Capacity Utilization Survey (form MQ-C1, question 2c).
The survey and instructions are available at http://www.census.gov/cir/www/mqc1pag2.html.
Assumptions that should be used for estimating this rate are available in the related
downloadable guidance on the DHS website. Your rate of production at national emergency
levels should be greater than or equal to the rate of full production capacity.
What is the total annual production of this chemical (in pounds/year) from this facility?
Annual Production
[Q:9.5-764]
Explain: This information is similar to that which is reported under EPA's Inventory Update Rule
(for updating the Toxic Substances Control Act Chemical Inventory Database) for those organic
and inorganic substances manufactured or imported in quantities of 25,000 pounds per site per
reporting year. Report production only, not imports. If your chemical is not on the TSCA Inventory,
provide an estimate of your annual production.
What is the estimated replacement cost of the production unit(s) for this chemical at this
facility?
Replacement Cost(s) of Production Units
[Q:9.5-765]
> $1,000,000,000
$750,000,000 - $1,000,000,000
$500,000,000 - $749,999,999
$100,000,000 - $499,999,999
$50,000,000 - $99,999,999
$25,000,000 - $49,999,999
$12,000,000 - $24,999,999
$6,000,000 - $11,999,999
< $6,000,000
Explain: Replacement Costs apply to the production unit(s) related to the manufacture of this
chemical and any other onsite property likely to be damaged beyond repair that would need to be
replaced to restore the original functionality of the unit or equipment to its design productivity
levels. The economic value to repair or replace the damaged or destroyed unit(s) and its
associated equipment, plus the economic value of any lost products, should be estimated in US
dollars. For the purposes of this analysis use the historic (undepreciated) cost of the facility
property plus the undepreciated value of betterments/improvements (excluding maintenance and
repair) to the production unit less the amount that is covered by insurance.
Have you listed all chemicals for which the facility accounts for 20% or more of domestic
production and are supplied to the aforementioned critical infrastructure sectors?
[Q:9.1-2772]
Yes
Go to Economically Critical Chemicals (page 107)
DHS Form 9007 (6/07)
Page 106 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Economically Critical Chemicals
Economically Critical Chemical Production
If you are a manufacturer, what is the total value of products shipped and other receipts
from the facility? (In dollars - number without dollar sign or commas)
If you are not a manufacturer, please enter "0".)
[Q:10.0-3092]
The total value will be the same as that provided in the Annual Survey of Manufactures
(conducted annually for a sample of manufacturing sectors every year except those ending in "2"
and "7") or in the Economic Census (a survey of all manufacturing sectors conducted only in
years ending in "2" and "7"). Information and sample forms are available by searching for the
survey names at the Census Bureau website http://www.census.gov/index.html. Facilities may
provide the response from a recent Census Bureau survey if the information accurately reflects
current facility operations.
Does this facility account for 35% or more of the domestic production of any chemical
(including Appendix A and non-Appendix A chemicals) and supply the chemical(s) to any
sector of the US economy excluding these critical infrastructure sectors: Defense
Industrial Base, Energy (electricity generation only), Public Health or Healthcare, and/or
Public Drinking Water?
[Q:10.0-771]
Yes
No
This question should be answered "Yes" if this facility accounts for 35% or more of the
domestic production of a chemical and this chemical is not supplied to Defense Industrial Base,
Energy (electricity generation only), Public Health or Healthcare, and/or Public Drinking Water.
If answered “No”, go to page 113
For each chemical, copy the following pages (109-112) and answer the following fields:
• “Chemical Name”
• “Enter the CAS# (if available)”
• “Is there another common name for this chemical?”
• “Select the facility’s estimated domestic market share of this chemical.”
• “What is the application(s) of this chemical by this facility’s customer(s)?”
• “Enter other application(s) of this chemical by this facility's customer(s) that were not listed on
the previous page.”
• “Indicate the primary sector(s) for which this facility produces this chemical.”
• “Enter other primary sector(s) for which this facility produces this chemical that was not listed
on the previous page.”
• ”Exact (or direct) substitute(s) for this chemical produced to meet the supply needs of this
facility’s customer(s)”
o Is there North American production?
o Is there overseas production?
DHS Form 9007 (6/07)
Page 107 of 113
Version 1.3
CSAT Top-Screen Questions
•
•
•
•
•
OMB No. 1670-0007
Expires: 2/29/2008
“Functional substitute(s) for this chemical produced to meet the supply needs of this facility’s
customer(s)”
o Is there North American production?
o Is there overseas production?
“What is this facility's estimated annual average Capacity Utilization Rate for this chemical?”
“What is this facility's estimated National Emergency Production Rate for this chemical?”
“What is the total annual production of this chemical (in pounds/year) from this facility?”
“What is the estimated replacement cost of the production unit(s) for this chemical at this
facility?”
DHS Form 9007 (6/07)
Page 108 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Enter the name of the chemical(s) for which the facility accounts for 35% or more of
domestic production excluding chemical(s) produced for the critical infrastructure
sectors: Defense Industrial Base, Energy (electricity generation only), Public Health or
Healthcare, and/or Public Drinking Water.
For each chemical, enter the appropriate information.
Chemical Name
[Q:10.1-772]
Enter the CAS# (if available).
CAS#
[Q:10.2-860]
Is there another common name for this chemical?
[Q:10.2-872]
Enter another common name for this chemical.
This question is optional if you provided a CAS# above.
Select the facility's estimated domestic market share of this chemical.
[Q:10.2-873]
35% - 49%
50% - 75%
76% - 99%
100%
What is the application(s) of this chemical by this facility's customer(s)? Check all that
apply.
[Q:10.3-793]
Adhesive or Sealant
Catalyst
Coating
Cosmetic additive
Electronic chemical
Fine chemical
Flavor or fragrance
Food additive
Functional fuel or lubricant additive
Institutional or industrial cleaner
Oilfield chemical
DHS Form 9007 (6/07)
Page 109 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Paper additive
Plastic additive
Plastic compounding
Rubber processing chemical
Water management chemical
Pharmaceutical (active ingredient)
Consumer product (e.g., soaps, cosmetics, toiletries)
Check for other application(s) not listed. [Q:10.3-911]
Enter other application(s) of this chemical by this facility's customer(s) that were not listed
on the previous page.
[Q:10.4-912]
Indicate the primary sector(s) for which this facility produces this chemical. Check all that
apply.
[Q:10.5-794]
Agriculture and food
Energy (except electric generation)
National Monuments and Icons
Banking and Finance
Public Water Treatment Systems (not drinking water systems)
Commercial facilities
Dams, Locks & Levees
Emergency Services
Commercial Nuclear Reactors, Materials and Wastes
Information Technology
Telecommunications
Postal and Shipping
Transportation Systems
Government Facilities
Check for other primary sector(s) not listed. [Q:10.5-914]
Enter other primary sector(s) for which this facility produces this chemical that was not
listed on the previous page.
[Q:10.6-915]
DHS Form 9007(6/07)
Page 110 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Exact (or direct) substitute(s) for this chemical produced to meet the supply needs of this
facility's customer(s):
Is there North American production?
Is there overseas production?
[Q:10.7-815]
[Q:10.7-816]
Yes
No
Yes
No
Functional substitute(s) for this chemical produced to meet the supply needs of this
facility's customer(s):
Is there North American production?
Is there overseas production?
[Q:10.7-812]
[Q:10.7-813]
Yes
No
Yes
No
What is this facility's estimated annual average Capacity Utilization Rate for this chemical?
Capacity Utilization Rate
[Q:10.8-818]
< 50%
50% - 69%
70% - 89%
>= 90%
Explain: "Capacity Utilization Rate" (operating rate) is estimated by dividing the average amount
of the chemical produced over the previous two years by the amount that could have been
produced if the facility had been operating at full capacity during that period. The rate may be
derived from the information your facility may have already provided as part of the U.S. Census
Bureau's Annual Plant Capacity Utilization Survey (form MQ-C1, question 2c). The survey and
instructions are available at http://www.census.gov/cir/www/mqc1pag2.html. Assumptions that
should be used for estimating this rate are available in the related downloadable guidance on the
DHS website.
What is this facility's estimated National Emergency Production Rate for this chemical?
Emergency Production Rate
[Q:10.8-820]
< 50%
50% - 69%
70% - 89%
>= 90%
Explain: The National Emergency Production Rate is estimated by dividing the average amount
of chemical produced over the previous two (2) years by the amount that could have been
produced if the plant had been operating under national emergency conditions during that period.
The rate may be derived from the information your facility may have already provided as part of
the U.S. Census Bureau's Annual Plant Capacity Utilization Survey (form MQ-C1, question 2c).
The survey and instructions are available at http://www.census.gov/cir/www/mqc1pag2.html.
Assumptions that should be used for estimating this rate are available in the related
downloadable guidance on the DHS website. Your rate of production at national emergency
levels should be greater than or equal to the rate of full production capacity.
DHS Form 9007 (6/07)
Page 111 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
What is the total annual production of this chemical (in pounds/year) from this facility?
Annual Production
[Q:10.8-821]
Explain: This information is similar to that which is reported under EPA's Inventory Update Rule
(for updating the Toxic Substances Control Act Chemical Inventory Database) for those organic
and inorganic substances manufactured or imported in quantities of 25,000 pounds per site per
reporting year. Report production only, not imports. If your chemical is not on the TSCA Inventory,
provide an estimate of your annual production.
What is the estimated replacement cost of the production unit(s) for this chemical at this
facility?
Replacement Cost(s) of Production Units
[Q:10.8-822]
> $1,000,000,000
$750,000,000 - $1,000,000,000
$500,000,000 - $749,999,999
$100,000,000 - $499,999,999
$50,000,000 - $99,999,999
$25,000,000 - $49,999,999
$12,000,000 - $24,999,999
$6,000,000 - $11,999,999
< $6,000,000
Explain: Replacement Costs apply to the production unit(s) related to the manufacture of this
chemical and any other onsite property likely to be damaged beyond repair that would need to be
replaced to restore the original functionality of the unit or equipment to its design productivity
levels. The economic value to repair or replace the damaged or destroyed unit(s) and its
associated equipment, plus the economic value of any lost products, should be estimated in US
dollars. For the purposes of this analysis use the historic (undepreciated) cost of the facility
property plus the undepreciated value of betterments/improvements (excluding maintenance and
repair) to the production unit less the amount that is covered by insurance.
Have you listed all chemicals for which the facility accounts for 35% or more of domestic
production and are supplied to other than the aforementioned critical infrastructure
sectors?
[Q:10.1-2774]
Yes
DHS Form 9007 (6/07)
Page 112 of 113
Version 1.3
CSAT Top-Screen Questions
OMB No. 1670-0007
Expires: 2/29/2008
Finish
DHS Communications
A letter with the preliminary tiering will be sent to the Submitter.
Preparer Copy
Do you want a copy of the letter with the preliminary tiering to be sent to the Preparer in
addition to the Submitter?
[Q:15.3-931]
Yes
No
Submission Statement
My statements in this submission are true, complete, and correct to the best of my
knowledge and belief and are made in good faith. I understand that a knowing and willful
false statement on this form can be punished by fine or imprisonment or both. (See
section 1001 of title 18, United States Code).
DHS Form 9007 (6/07)
Page 113 of 113
Version 1.3
| File Type | application/pdf |
| File Title | General |
| Author | mstaubin |
| File Modified | 2008-02-25 |
| File Created | 2008-01-02 |