DHS Form 9007 CSAT Top Screen

Chemical Security Assessment Tool (CSAT)

CSAT TopScreen Questions

CSAT Top-Screen

OMB: 1670-0007

Document [pdf]
Download: pdf | pdf
CSAT Top-Screen
Questions
January 2009
Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Change Log .........................................................................................................3
CVI Authorizing Statements...............................................................................4
General ................................................................................................................6
Facility Description.................................................................................................................... 7
Facility Regulatory Mandates ................................................................................................... 7
EPA RMP Facility Identifier ....................................................................................................... 9
Refinery Capacity....................................................................................................................... 9
Refinery Market Share ............................................................................................................. 10
Airport Fuels Supplier ............................................................................................................. 11
Military Installation Supplier ................................................................................................... 11
Liquefied Natural Gas (LNG) Capacity................................................................................... 12
Liquefied Natural Gas Exclusion Zone .................................................................................. 13
Liquefied Natural Gas Exclusion Zone Exception................................................................ 13
Liquefied Natural Gas Exclusion Details............................................................................... 13

Release Toxics..................................................................................................14
Release Toxic Chemicals of Interest ..................................................................................... 14
Release Toxic Chemicals of Interest - Detail ........................................................................ 20
Underground Storage for Release Toxic COI Detail ............................................................ 30
Underground Storage for Release Toxic COI (continued)................................................... 34
Release Toxic COI Stored Below Grade ................................................................................ 39

Release Flammables.........................................................................................44
Release Flammable Chemicals of Interest ............................................................................ 44
Release Flammable Chemicals of Interest - Detail ............................................................... 54
Gasoline Storage Detail........................................................................................................... 64
Gasoline Stored in Aboveground Atmospheric Tanks ........................................................ 64
Underground Storage for Release Flammable COI Detail ................................................... 66
Underground Storage for Release Flammable COI (continued) ......................................... 75
Release Flammable COI Stored Below Grade....................................................................... 93
Underground Release Flammable COI Stored in Cavern or Non-Cavern Type Formations
........................................................................................................................................ 102

Release Explosives ........................................................................................104
Release Explosive Chemicals of Interest ............................................................................ 104
Release Explosive Chemicals of Interest - Detail ............................................................... 110

Theft/Diversion EXP/IEDP ..............................................................................114
Theft/Diversion Explosive/IED Precursor (EXP/IEDP) Chemicals of Interest .................. 114
Theft/Diversion Explosive/IED Precursor Chemicals of Interest - Detail ......................... 121

Theft/Diversion WME ......................................................................................127
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest .......................... 127
Theft/Diversion Weapons of Mass Effect (WME) Chemicals of Interest - Detail ............. 133

Theft/Diversion CW/CWP ...............................................................................137
Theft/Diversion of Chemical Weapons/Chemical Weapon Precursors (CW/CWP)
Chemicals of Interest............................................................................................................. 137
Theft/Diversion Chemical Weapons/Chemical Weapon Precursors (CW/CWP) Chemicals
of Interest - Details................................................................................................................. 143

Sabotage/Contamination Chemicals.............................................................148
Sabotage/Contamination Chemicals of Interest ................................................................. 148

Mission Critical Chemicals ............................................................................155
Mission Critical Chemical Production ................................................................................. 155

Economically Critical Chemicals...................................................................160
Economically Critical Chemical Production ....................................................................... 160

Finish ...............................................................................................................167

DHS Form 9007

Page 2 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Change Log
Version 2.7.a ->Version 2.8
• Changed version number to 2.8
• Added CVI Authorizing Statements
• Added “in transportation packaging” to questions [Q:5.0-714], [Q:6.0-715], and [Q:7.0721] such that they all read:
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 in transportation packaging have been indicated by selecting "Yes."
Version 2.5.a -> Version 2.7.a
• Changed version number to 2.7.a
• Changed date on cover page to November 2008
• Updated table of contents
• Removed Facility Information pages (added to Update Facility Info page)
• Added Flammable Fuels: Gasoline aboveground storage questions
• Reformatted Flammable cavern/non-cavern questions
Version 2.0.a -> Version 2.5.a
• Changed version number to 2.5.a
• Updated table of contents
• Added Toxic UG storage type and containment questions and associated guidance
• Removed Release Flammable questions referring to Methane only
• Added Flammable UG storage category questions and associated guidance
• Changed Methane cavern questions to cavern/non-cavern type containment for any UG
Flammable COI
Version 2.0 -> Version 2.0.a
• Changed version number to 2.0.a
• Changed date on cover page to June 2008
• Updated table of contents
• Added “Change Log” page
• Changed point of contact to Dennis Deziel
• Changed Chemical Security Compliance Division to Infrastructure Security Compliance
Division
• Changed PRA Expiration date to 5/31/2011

DHS Form 9007

Page 3 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CVI Authorizing Statements
Please read the following information and check the boxes to indicate that you understand and
accept these requirements. Additional guidance about Chemical-terrorism Vulnerability
Information (CVI), as well as specific training to become a CVI Authorized User, can be found on
www.dhs.gov/chemicalsecurity.
I understand that by completing this agreement I will have access to Top-Screen related
information which is considered CVI under Section 550 of Public Law 109-295 and 6 CFR
§ 27.400. This information is exempt from release under the Freedom of Information Act
(5 U.S.C. §§ 552, et seq.) and State and local disclosure laws. Except under exigent or
emergency circumstances, no part of this CVI may be disclosed to other persons unless
they are CVI Authorized Users and have a "need to know," as defined in 6 CFR §
27.400(e). Unauthorized release may result in a civil penalty or other action.
As a chemical facility representative, I acknowledge that I may only share CVI with CVI
Authorized Users with a need to know, except under exigent or emergency
circumstances.
Marking:

Ensure documents containing CVI are properly marked on the top and bottom
of each page. (See 6 CFR § 27.400(f)). Affix a CVI cover page to the front and
back of all documents containing CVI.

Storage:

When not in your possession, store CVI in a secure container such as in a
locked desk drawer or locked container. Unless in an area authorized for open
storage of classified material, do not leave the CVI document unattended.
Computers and other media used to handle, store or transmit material
containing CVI should be protected to prevent unauthorized access or
disclosure.

Transmission:

You may transmit CVI by the following means to a CVI Authorized User with a
need to know.

Hand
Delivery:

You may hand carry CVI as long as access to the material is controlled while in
transit.

Email:

If practical and available, encryption should be used to send CVI by email. If
encryption is not practical or available, send CVI as an encrypted attachment or
password protected attachment and provide the password under separate
cover. Do not include CVI in the subject line or body of an email. Do not send
CVI to personal, non-employment related email accounts.

Mail:

CVI may be transmitted by USPS First Class mail or a commercial equivalent.
The CVI should be placed under an appropriate cover sheet or in an envelope
or container, and then placed in an outer, opaque envelope or container that
has no marking on it to identify the contents as CVI. The outer envelope or
container must bear the complete name and address of the sender and the
addressee who must be an Authorized User with a need to know. The outer
envelope must bear the following statement below the return address:
"POSTMASTER: DO NOT FORWARD: RETURN TO SENDER."

DHS Form 9007

Page 4 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Fax:

Secure faxes are encouraged, but not required, for sending CVI. When sending
via non-secure fax, coordinate with the recipient, who must be an Authorized
User with a need to know, to ensure that the faxed materials will not be left
unattended or subjected to unauthorized disclosure on the receiving end.

Telephone:

A Secure Telephone Unit/Equipment is encouraged, but not required, for verbal
transmission of CVI to a CVI Authorized User with a need to know. Use cellular
or cordless phones to discuss CVI only in exigent circumstances or if the
transmission is encoded or otherwise protected.

Destruction:

Destruction of CVI should occur when the CVI is no longer needed. Destruction
must be in compliance with in 6 CFR § 27.400(k) and consistent with 6 CFR §
27.255(b).

Derivative
Products:

Mark any newly created document containing CVI with "Chemical-terrorism
Vulnerability Information" on the top and bottom of each page that contains
CVI. Mark "(CVI)" beside each paragraph containing CVI. Place a copy of a CVI
cover page over all newly created documents containing CVI.

I agree to abide by the above requirements and understand that this agreement only
authorizes access to CVI created by the preparation and submission of the CSAT TopScreen. Access to other CVI will require meeting additional criteria as specified by the
Department of Homeland Security.
If you do not accept these requirements, please logoff now by closing your browser.

DHS Form 9007

Page 5 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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/Infrastructure Security Compliance Division, Attention:
Dennis Deziel, 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

Page 6 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Facility Description
Choose the facility type that best describes your facility
[Q:1.1-65]

Chemical manufacturing, usage, storage, and distribution
Petroleum refining
Liquefied natural gas storage

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.

DHS Form 9007

Page 7 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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.
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.

DHS Form 9007

Page 8 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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://www.epa.gov/emergencies/content/rmp/index.htm
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 14)

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]

DHS Form 9007

Page 9 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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]

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]

DHS Form 9007

Page 10 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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]

% Share of Aviation
Gasoline

% Share of Jet
Fuel/Kerosene

[Q:1.53-376]

[Q:1.53-378]

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)

DHS Form 9007

Page 11 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 14)

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.
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.

DHS Form 9007

Page 12 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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
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 14)

DHS Form 9007

Page 13 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 44)

DHS Form 9007

Page 14 of 167

Version 2.8

CSAT Top-Screen
Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 15 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 16 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 17 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 18 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 19 of 167
167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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)
Under CFATS, a COI is considered stored underground if it is stored in a containment vessel (e.g., a tank) that is physically buried in the ground,
is stored in a containment vessel below grade, or stored in cavern or non-cavern type containment. Basement level storage would not be
considered underground if the containment vessels are portable. If any amount of the COI is stored underground the facility must select Yes, and
will then be required to answer a series of specific questions on underground storage.

DHS Form 9007

Page 20 of 167

Version 2.8

CSAT Top-Screen
Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min Conc.

Screening
Threshold
Quantity

Total
On-site
Quantity
(pounds)
[Q:2.1-124]

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

7782-50-5

1.00%

2,500 lbs

Carbon disulfide
Chlorine

DHS Form 9007

Page 21 of 167
167

Distance
of Concern
(miles)
[Q:2.1-126]

Is the Toxic COI
Stored
Underground?
[Q:2.1-7958]

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min Conc.

Screening
Threshold
Quantity

Total
On-site
Quantity
(pounds)
[Q:2.1-124]

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

50-00-0

1.00%

15,000 lbs

7647-01-0

37.00%

15,000 lbs

Chlorine dioxide
[Chlorine oxide, ClO2]

Diborane

Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)

DHS Form 9007

Page 22 of 167
167

Distance
of Concern
(miles)
[Q:2.1-126]

Is the Toxic COI
Stored
Underground?
[Q:2.1-7958]

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min Conc.

Screening
Threshold
Quantity

Total
On-site
Quantity
(pounds)
[Q:2.1-124]

Hydrocyanic acid

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

Nitric acid

7697-37-2

80.00%

15,000 lbs

DHS Form 9007

Page 23 of 167
167

Distance
of Concern
(miles)
[Q:2.1-126]

Is the Toxic COI
Stored
Underground?
[Q:2.1-7958]

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min Conc.

Screening
Threshold
Quantity

Total
On-site
Quantity
(pounds)
[Q:2.1-124]

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

DHS Form 9007

Page 24 of 167

Distance
of Concern
(miles)
[Q:2.1-126]

Is the Toxic COI
Stored
Underground?
[Q:2.1-7958]

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Screening
Threshold
Quantity

Min Conc.

Total
On-site
Quantity
(pounds)
[Q:2.1-124]

Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]

75-74-1

1.00%

10,000 lbs

7550-45-0

1.00%

2,500 lbs

Distance
of Concern
(miles)
[Q:2.1-126]

Is the Toxic COI
Stored
Underground?
[Q:2.1-7958]

Yes

No

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

Chemical Name

DHS Form 9007

Page 25 of 167

Quantity in
AHQ
(pounds)

Distance of
Concern
for AHQ
(miles)

[Q:2.2-2792]

[Q:2.2-2793]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

Chloromethyl methyl ether
[Methane, chloromethoxy-]

107-30-2

1.00%

5,000 lbs

Chemical Name

Carbon disulfide

DHS Form 9007

Page 26 of 167

Quantity in
AHQ
(pounds)

Distance of
Concern
for AHQ
(miles)

[Q:2.2-2792]

[Q:2.2-2793]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

78-82-0

1.00%

20,000 lbs

Chemical Name

Diborane

Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid

Isobutyronitrile
[Propanenitrile, 2-methyl-]

DHS Form 9007

Page 27 of 16
167

Quantity in
AHQ
(pounds)

Distance of
Concern
for AHQ
(miles)

[Q:2.2-2792]

[Q:2.2-2793]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

10025-87-3

1.00%

5,000 lbs

Chemical Name

Phosphorus oxychloride
[Phosphoryl chloride]

DHS Form 9007

Page 28 of 167
167

Quantity in
AHQ
(pounds)

Distance of
Concern
for AHQ
(miles)

[Q:2.2-2792]

[Q:2.2-2793]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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)-]

Quantity in
AHQ
(pounds)

Distance of
Concern
for AHQ
(miles)

[Q:2.2-2792]

[Q:2.2-2793]

If the answer to question [Q:2.1-7958], “Is the Toxic COI Stored Underground?” is “No” for all chemicals, go to Release Flammables (page 44)

DHS Form 9007

Page 29 of 167
167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Underground Storage for Release Toxic COI Detail
The following questions regarding underground storage should only be answered about the amount of COI stored underground.
•
•
•

Enter the number of underground storage tanks.
Enter the collective capacity of the underground storage tanks (pounds).
Enter the distance from the underground tank(s) to the nearest infrastructure (in feet) that is not associated with the underground storage
operation. Infrastructure may include buildings, bridges, or other above ground structures or pipelines.

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

Chemical Name

DHS Form 9007

Page 30 of 167
167

Number of
Underground
Tanks

Collective
Capacity of
Underground
Tanks
(pounds)

Distance to
Nearest
Infrastructure
(feet)

[Q:2.3-7933]

[Q:2.3-7934]

[Q:2.3-7938]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

106-89-8

1.00%

20,000 lbs

Chemical Name

Carbon disulfide

Diborane
Epichlorohydrin
[Oxirane, (chloromethyl)-]

DHS Form 9007

Page 31 of 167
167

Number of
Underground
Tanks

Collective
Capacity of
Underground
Tanks
(pounds)

Distance to
Nearest
Infrastructure
(feet)

[Q:2.3-7933]

[Q:2.3-7934]

[Q:2.3-7938]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Chemical Name

Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid

DHS Form 9007

Page 32 of 167
167

Number of
Underground
Tanks

Collective
Capacity of
Underground
Tanks
(pounds)

Distance to
Nearest
Infrastructure
(feet)

[Q:2.3-7933]

[Q:2.3-7934]

[Q:2.3-7938]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Chemical Name

DHS Form 9007

Page 33 of 16
167

Number of
Underground
Tanks

Collective
Capacity of
Underground
Tanks
(pounds)

Distance to
Nearest
Infrastructure
(feet)

[Q:2.3-7933]

[Q:2.3-7934]

[Q:2.3-7938]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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)-]

Number of
Underground
Tanks

Collective
Capacity of
Underground
Tanks
(pounds)

Distance to
Nearest
Infrastructure
(feet)

[Q:2.3-7933]

[Q:2.3-7934]

[Q:2.3-7938]

Underground Storage for Release Toxic COI (continued)
The following questions regarding underground storage should only be answered about the amount of COI stored underground.
•
•
•
•

Enter the pressure rating of tank(s) (psig).
Is/Are the tank(s) double walled?
Enter depth (from ground surface to tank top) of underground tanks (feet).
Select the underground storage type

Buried storage is set in the ground and covered by soil. Below grade storage is set entirely below the surface of the ground in a storage pit but is
not covered by soil.

DHS Form 9007

Page 34 of 167
167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:2.4-7954]

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

0%

10,000 lbs

75-15-0

1.00%

20,000 lbs

7782-50-5

1.00%

2,500 lbs

Bromine
Carbon disulfide
Chlorine

DHS Form 9007

Page 35 of 167
167

Tank(s)
Double
Walled?
[Q:2.4-7955]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:2.4-12760]

[Q:2.4-7956]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:2.4-7954]

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

50-00-0

1.00%

15,000 lbs

7647-01-0

37.00%

15,000 lbs

Chlorine dioxide
[Chlorine oxide, ClO2]

Diborane

Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)

DHS Form 9007

Page 36 of 167
167

Tank(s)
Double
Walled?
[Q:2.4-7955]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:2.4-12760]

[Q:2.4-7956]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:2.4-7954]

Hydrocyanic acid

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

Nitric acid

7697-37-2

80.00%

15,000 lbs

DHS Form 9007

Page 37 of 167
167

Tank(s)
Double
Walled?
[Q:2.4-7955]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:2.4-12760]

[Q:2.4-7956]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:2.4-7954]

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

DHS Form 9007

Page 38 of 167
167

Tank(s)
Double
Walled?
[Q:2.4-7955]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:2.4-12760]

[Q:2.4-7956]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:2.4-7954]

Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]

75-74-1

1.00%

10,000 lbs

7550-45-0

1.00%

2,500 lbs

Tank(s)
Double
Walled?
[Q:2.4-7955]

Yes

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:2.4-12760]

[Q:2.4-7956]

No

Buried

Below
grade

Release Toxic COI Stored Below Grade
Answer the following question only for underground COI that is stored below grade.

Chemical Name

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:2.5-12762]

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

DHS Form 9007

Page 39 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:2.5-12762]

Yes
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

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

Carbon disulfide

DHS Form 9007

Page 40 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:2.5-12762]

Yes
Diborane

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

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

Formaldehyde (solution)
Hydrochloric acid (conc. 37% or greater)
Hydrocyanic acid

DHS Form 9007

Page 41 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:2.5-12762]

Yes
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

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

DHS Form 9007

Page 42 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:2.5-12762]

Yes
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

Tetramethyllead
[Plumbane, tetramethyl-]
Titanium tetrachloride
[Titanium chloride (TiCl4) (T-4)-]

DHS Form 9007

Page 43 of 167

No

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 104)

DHS Form 9007

Page 44 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 45 of 167

No

Version 2.8

CSAT Top-Screen Questions
Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 46 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 47 of 167
167

No

Version 2.8

CSAT Top-Screen
Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 48 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 49 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 50 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 51 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 52 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 53 of 167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 54 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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.
Under CFATS, a COI is considered stored underground if it is stored in a containment vessel (e.g., a tank) that is physically buried in the ground,
is stored in a containment vessel below grade, or stored in cavern or non-cavern type containment. Basement level storage would not be
considered underground if the containment vessels are portable. If any amount of the COI is stored underground the facility must select Yes, and
will then be required to answer a series of specific questions on underground storage.

Chemical Name

CAS#

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

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

DHS Form 9007

Page 55 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
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

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

DHS Form 9007

Page 56 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
Cyclopropane

75-19-4

1.00%

10,000 lbs

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

Dichlorosilane
[Silane, dichloro-]

DHS Form 9007

Page 57 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

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), (TB511)-]

13463-40-6

1.00%

10,000 lbs

DHS Form 9007

Page 58 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

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

Methyl ether
[Methane, oxybis-]

115-10-6

1.00%

10,000 lbs

DHS Form 9007

Page 59 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
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

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

1.00%

10,000 lbs

Peracetic acid
[Ethaneperoxic acid]

79-21-0

1.00%

10,000 lbs

7803-51-2

1.00%

10,000 lbs

Phosphine

DHS Form 9007

Page 60 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
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

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

DHS Form 9007

Page 61 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
Trichlorosilane
[Silane, trichloro-]

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

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

DHS Form 9007

Page 62 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

Min. Conc.

Screening
Threshold
Quantity

Total On-site
Quantity
(pounds)
[Q:3.1-131]

Quantity in
AHQ
(pounds)
[Q:3.1-2794]

Is the Flammable
COI Stored
Underground?
[Q:3.1-7967]

Yes
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)
Fuels: JP 5 (jet fuel)
Fuels: JP 8 (jet fuel)
Fuels: Kerosene
Fuels: LPG
If the answer to question [Q:3.0-129], “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?” is “No” for Fuels: Gasoline, skip the gasoline storage questions.

DHS Form 9007

Page 63 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Gasoline Storage Detail
Is gasoline stored in aboveground atmospheric tanks?
[Q:3.11-13415]

Yes
No
If Yes, provide the following details about aboveground gasoline storage.

Gasoline Stored in Aboveground Atmospheric Tanks
Round quantities to two significant digits (e.g., round 24750 gallons to 25000 gallons, and round 3625 feet to 3600 feet).
What is the facility's maximum gasoline storage capacity (in gallons, based on design capacity) taking into consideration Federal, State,
and local laws and regulations?
[Q:3.12-13416]

What is the facility's single largest gasoline storage vessel (in gallons, based on design capacity) taking into consideration Federal,
State, and local laws and regulations?
[Q:3.12-13417]

DHS Form 9007

Page 64 of 167
167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

What is the shortest distance (in feet) from a large gasoline storage tank to offsite businesses or retail areas where another company's
employees or members of the public would be located?
[Q:3.12-13418]

For purposes of this question, typically a “large storage tank” is defined as 30,000 gallons or greater (based on design capacity) taking into
account Federal, State, and local laws and regulations, however enter the shortest distance from the largest gasoline storage tank at the facility..
What is the shortest distance (in feet) from a large gasoline storage tank to offsite residences?
[Q:3.12-13419]

For purposes of this question, typically a “large storage tank” is defined as 30,000 gallons or greater (based on design capacity) taking into
account Federal, State, and local laws and regulations, however enter the shortest distance from the largest gasoline storage tank at the facility..
What is your estimate of the largest population (either daytime or nighttime) other than onsite employees/contractors within nearby
distances from any large gasoline storage tank or containment area?
Within 250 feet?
[Q:3.12-13420]

Within 500 feet?
[Q:3.12-13422]

Within 1,000 feet?
[Q:3.12-13423]

DHS Form 9007

Page 65 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

What is the source or basis for this estimate?
[Q:3.12-13421]

For each chemical that the answer to question [Q:3.1-7967], “Is the Flammable COI Stored Underground?” is “Yes”, answer the following; or if the
answer is “No” for all chemicals, go to Release Explosives (page 104)

Underground Storage for Release Flammable COI Detail
Select the underground storage categories that apply to each underground COI.
•
•

A storage tank is a man-made cylindrical or spherical container that is used for the storage of chemicals.
Cavern/non-cavern type containment is a below-the-surface natural earth formation used for storage of chemicals. Examples include
aquifers, depleted reservoirs, and salt caverns.

DHS Form 9007

Page 66 of 167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

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

2-Butene-cis

590-18-1

1.00%

10,000 lbs

DHS Form 9007

Page 67 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

4109-96-0

1.00%

10,000 lbs

Dichlorosilane
[Silane, dichloro-]

DHS Form 9007

Page 68 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

Ethyl mercaptan
[Ethanethiol]

75-08-1

1.00%

10,000 lbs

DHS Form 9007

Page 69 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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), (TB511)-]

13463-40-6

1.00%

10,000 lbs

75-28-5

1.00%

10,000 lbs

Isobutane
[Propane, 2-methyl]

DHS Form 9007

Page 70 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

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

DHS Form 9007

Page 71 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

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

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

DHS Form 9007

Page 72 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

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

Trichlorosilane
[Silane, trichloro-]

DHS Form 9007

Page 73 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
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

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

DHS Form 9007

Page 74 of 167
167

No

Yes

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Is the COI stored
in bulk tanks?
[Q:3.2-12712]

Is the COI stored
in cavern/noncavern type
containment?
[Q:3.2-12713]

Yes
Vinylidene fluoride
[Ethene, 1,1-difluoro-]

75-38-7

1.00%

No

Yes

No

10,000 lbs

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
Fuels: LPG

Underground Storage for Release Flammable COI (continued)

DHS Form 9007

Page 75 of 167
167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

The following questions regarding underground storage should only be answered about the amount of COI stored underground in bulk tanks.
•
•
•

Enter the number of underground storage tanks.
Enter the collective capacity of the underground tanks (pounds).
Enter the distance from underground tank(s) to the nearest infrastructure (in feet) that is not associated with the underground storage
operation. Infrastructure may include buildings, bridges, or other above ground structures or pipelines.

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

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

DHS Form 9007

Page 76 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

DHS Form 9007

Page 77 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

75-19-4

1.00%

10,000 lbs

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

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

Cyclopropane
Dichlorosilane
[Silane, dichloro-]

DHS Form 9007

Page 78 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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), (TB511)-]

13463-40-6

1.00%

10,000 lbs

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

DHS Form 9007

Page 79 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

Methyl ether
[Methane, oxybis-]

115-10-6

1.00%

10,000 lbs

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

DHS Form 9007

Page 80 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

1.00%

10,000 lbs

Peracetic acid
[Ethaneperoxic acid]

79-21-0

1.00%

10,000 lbs

7803-51-2

1.00%

10,000 lbs

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

Phosphine

DHS Form 9007

Page 81 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

DHS Form 9007

Page 82 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Chemical Name

Number of
Underground
Tanks
[Q:3.3-7960]

Trichlorosilane
[Silane, trichloro-]

DHS Form 9007

Page 83 of 167

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

Number of
Underground
Tanks
[Q:3.3-7960]

Collective
Capacity of
Underground
Tanks
(pounds)
[Q:3.3-7961]

Distance to
Nearest
Infrastructure
(feet)
[Q:3.3-7962]

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
Fuels: LPG

DHS Form 9007

Page 84 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

The following questions regarding underground storage should only be answered about the amount of COI stored underground in bulk tanks.
•
•
•
•

Enter the pressure rating of tank(s) (psig).
Is/Are the tank(s) double walled?
Enter depth (from ground surface to tank top) of underground storage tanks (feet).
Select the underground storage type

Buried storage is set in the ground and covered by soil. Below grade storage is set entirely below the surface of the ground in a storage pit but is
not covered by soil.

Chemical Name

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

DHS Form 9007

Page 85 of 167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

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

DHS Form 9007

Page 86 of 167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

Cyclopropane

75-19-4

1.00%

10,000 lbs

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

Dichlorosilane
[Silane, dichloro-]

DHS Form 9007

Page 87 of 167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

75-28-5

1.00%

10,000 lbs

Isobutane
[Propane, 2-methyl]

DHS Form 9007

Page 88 of 167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

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

DHS Form 9007

Page 89 of 167
167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

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

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

DHS Form 9007

Page 90 of 167
167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

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

Trichlorosilane
[Silane, trichloro-]

DHS Form 9007

Page 91 of 167
167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

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

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

DHS Form 9007

Page 92 of 167
167

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Pressure
Rating of
Tank(s)
(psig)
[Q:3.4-7964]

Vinylidene fluoride
[Ethene, 1,1-difluoro-]

75-38-7

1.00%

Tank(s)
Double
Walled?
[Q:3.4-7965]

Yes

No

Depth of
Underground
Tanks (feet)

Underground
Storage Type
[Q:3.4-12714]

[Q:3.4-7966]

Buried

Below
grade

10,000 lbs

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
Fuels: LPG

Release Flammable COI Stored Below Grade
Answer the following question only for underground COI that are stored below grade.

DHS Form 9007

Page 93 of 167
167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

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

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

DHS Form 9007

Page 94 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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

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

Dichlorosilane
[Silane, dichloro-]

DHS Form 9007

Page 95 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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

Ethylene
[Ethene]

74-85-1

1.00%

10,000 lbs

DHS Form 9007

Page 96 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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

Isopropylamine
[2-Propanamine]

75-31-0

1.00%

10,000 lbs

Methane

74-82-8

1.00%

10,000 lbs

DHS Form 9007

Page 97 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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

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

DHS Form 9007

Page 98 of 167
167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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

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

Page 99 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

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

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

Trichlorosilane
[Silane, trichloro-]

DHS Form 9007

Page 100 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

Is the below grade
containment covered?
[Q:3.41-12717]

Yes
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)
Fuels: JP 5 (jet fuel)
Fuels: JP 8 (jet fuel)
Fuels: Kerosene
Fuels: LPG

DHS Form 9007

Page 101 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

For each COI stored in cavern/non-cavern type containment [Q:3.2-12713], copy the following pages (102-103) as needed and answer the following.

Underground Release Flammable COI Stored in Cavern or Non-Cavern Type Formations
Flammable COI stored in Cavern/non-Cavern type
formations.

The following questions regarding underground storage should only be answered about the amount of the COI that is stored underground in
cavern or non-cavern type formations. Cavernous formations refer to porous rock formations. Non-cavernous formations refer to old gas or oil
fields that are no longer productive.
Is the release flammable COI stored in caverns or
in non-cavern storage?
[Q:3.5-12771]

Cavern
Non-cavern

How many wells are in the storage field?
[Q:3.5-12772]

What is the aerial extent of the storage formation
(in acres)?
[Q:3.5-8791]

What is the total storage weight (in pounds)?
[Q3.5-12773]

DHS Form 9007

Page 102 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

List the well heads located in High Consequence Areas (HCA) as defined by DOT PHMSA in 49 CFR part 192
List information for the well heads associated with the COI that are located in a High Consequence Area. For the distance from infrastructure
question, use the distance (in feet) from the well head to the nearest infrastructure that is not associated with the underground storage operation.
Infrastructure may include buildings, bridges, or other above ground structures or pipelines.
Enter the Name or ID
of the Well Head

Depth of Well
(feet)

Maximum
Pressure at Well
Head (psig)

Absolute Open Flow
Rate at Maximum
Pressure (mmcf/min)

Distance to Closest Infrastructure Not
Associated with Storage Operation
(feet)

[Q:3.5-8813]

[Q:3.5-8831]

[Q:3.5-8833]

[Q:3.5-8832]

[Q:3.5-8834]

DHS Form 9007

Page 103 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 127)
If “No” selected for all chemicals, go to Theft/Diversion EXP/IEDP (page 114)

DHS Form 9007

Page 104 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 105 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 106 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 107 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 108 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 109 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Dingu
[Dinitroglycoluril]

55510-04-8

ACG

5,000 lbs

Dinitrophenol

25550-58-7

ACG

5,000 lbs

Chemical Name

Total On-site
Quantity
(pounds)
[Q:4.1-712]

Barium azide

DHS Form 9007

Page 110 of 167

Quantity in
AHQ
(pounds)
[Q:4.1-2795]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

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

15825-70-4

ACG

5,000 lbs

Chemical Name

Total On-site
Quantity
(pounds)
[Q:4.1-712]

Guanyl nitrosaminoguanylidene hydrazine
Hexanitrostilbene

Nitromannite
[Mannitol hexanitrate, wetted]

DHS Form 9007

Page 111 of 167

Quantity in
AHQ
(pounds)
[Q:4.1-2795]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

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

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

67713-16-0

ACG

5,000 lbs

Chemical Name

Total On-site
Quantity
(pounds)
[Q:4.1-712]

Tetranitroaniline

Torpex
[Hexotonal]

DHS Form 9007

Page 112 of 167

Quantity in
AHQ
(pounds)
[Q:4.1-2795]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min.
Conc.

Screening
Threshold
Quantity

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

Page 113 of 167

Quantity in
AHQ
(pounds)
[Q:4.1-2795]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 127)

DHS Form 9007

Page 114 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 115 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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

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

Guanyl nitrosaminoguanylidene
hydrazine
Hexanitrostilbene

DHS Form 9007

Page 116 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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

Page 117 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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

Page 118 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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

Page 119 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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

Page 120 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

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 in transportation packaging 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

Page 121 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 122 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:5.1-233]

[Q:5.1-234]

[Q:5.1-235]

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Guanyl nitrosaminoguanylidene hydrazine

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

Page 123 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:5.1-233]

[Q:5.1-234]

[Q:5.1-235]

Version 2.8

CSAT Top-Screen Questions

Chemical Name
Nitromethane

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 124 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:5.1-233]

[Q:5.1-234]

[Q:5.1-235]

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 125 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:5.1-233]

[Q:5.1-234]

[Q:5.1-235]

Version 2.8

CSAT Top-Screen Questions

Chemical Name
Trinitrophenetole

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 126 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:5.1-233]

[Q:5.1-234]

[Q:5.1-235]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 137)

DHS Form 9007

Page 127 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 128 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 129 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 130 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 131 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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 in transportation packaging have been indicated by selecting "Yes."
[Q:6.0-715]

Yes
No

DHS Form 9007

Page 132 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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.
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

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

DHS Form 9007

Page 133 of 167

Portable
[Q:6.1-253]

Bulk
Transport
[Q:6.1-254]

Bulk
Storage
[Q:6.1-7071]

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

Chlorine pentafluoride

13637-63-3

4.07%

15 lbs

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

Hydrogen chloride (anhydrous)

7647-01-0

ACG

500 lbs

74-90-8

4.67%

15 lbs

Hydrogen cyanide
[Hydrocyanic acid]

DHS Form 9007

Page 134 of 167

Portable
[Q:6.1-253]

Bulk
Transport
[Q:6.1-254]

Bulk
Storage
[Q:6.1-7071]

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

Phosgene
[Carbonic dichloride] or [carbonyl dichloride]

DHS Form 9007

Page 135 of 167

Portable
[Q:6.1-253]

Bulk
Transport
[Q:6.1-254]

Bulk
Storage
[Q:6.1-7071]

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

Screening
Threshold
Quantity

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

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

DHS Form 9007

Page 136 of 167

Portable
[Q:6.1-253]

Bulk
Transport
[Q:6.1-254]

Bulk
Storage
[Q:6.1-7071]

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 148)

DHS Form 9007

Page 137 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

30.00%

Page 138 of 167

No

2.2 lbs

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

No

CUM 100g

Page 139 of 167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 140 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

No

CUM 100g

Page 141 of 167

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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-dimethylphosphoramidocyanidate]

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

50782-69-9

No

CUM 100g

Page 142 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 in transportation packaging 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#

Min. Conc.

7784-34-1

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 143 of 167

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

Portable

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 144 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:7.1-260]

[Q:7.1-261]

[Q:7.1-262]

Version 2.8

CSAT Top-Screen Questions

Chemical Name
N,N-Dipropyl phosphoramidic dichloride

OMB PRA # 1670-0007
Expires: 5/31/2011

CAS#

Min. Conc.

40881-98-9

30.00%

Screening
Threshold
Quantity

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

Bulk
Storage

[Q:7.1-260]

[Q:7.1-261]

[Q:7.1-262]

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

Page 145 of 167

Bulk
Transport

2.2 lbs

Ethyl phosphonyl difluoride

DHS Form 9007

Portable

Version 2.8

CSAT Top-Screen Questions

Chemical Name
O-Mustard (T)
[Bis(2-chloroethylthioethyl)ether]
Nitrogen mustard hydrochloride
[Bis(2-chloroethyl)methylamine hydrochloride]

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 146 of 167

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%

2.2 lbs

Version 2.8

CSAT Top-Screen Questions

Chemical Name

OMB PRA # 1670-0007
Expires: 5/31/2011

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

50782-69-9

Page 147 of 167

Portable

Bulk
Transport

Bulk
Storage

[Q:7.1-260]

[Q:7.1-261]

[Q:7.1-262]

CUM 100g

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 155)

DHS Form 9007

Page 148 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

[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

Page 149 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 150 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 151 of 16
167
7

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 152 of 167

No

Version 2.8

CSAT Top-Screen Questions

Chemical Name

CAS#

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 153 of 167

No

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 154 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 160)
For each chemical, copy the following pages (156-159) 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 160)

DHS Form 9007

Page 155 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 156 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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.

DHS Form 9007

Page 157 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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%
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.
U

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
U

DHS Form 9007

Page 158 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 160)

DHS Form 9007

Page 159 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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 167
For each chemical, copy the following pages (162-166) 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

Page 160 of 167

Version 2.8

CSAT Top-Screen Questions
•

•
•
•
•

OMB PRA # 1670-0007
Expires: 5/31/2011

“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

Page 161 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 162 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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]

DHS Form 9007

Page 163 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Enter other primary sector(s) for which this facility produces this chemical that was not
listed on the previous page.
[Q:10.6-915]

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.
U

DHS Form 9007

Page 164 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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.
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
U

DHS Form 9007

Page 165 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

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

Page 166 of 167

Version 2.8

CSAT Top-Screen Questions

OMB PRA # 1670-0007
Expires: 5/31/2011

Finish
12B

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

Page 167 of 167

Version 2.8


File Typeapplication/pdf
File TitleCSAT Top-Screen Questions
AuthorUS Department of Homeland Security
File Modified2014-05-14
File Created2009-02-16

© 2024 OMB.report | Privacy Policy