Download:
pdf |
pdfCSAT 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 Type | application/pdf |
| File Title | CSAT Top-Screen Questions |
| Author | US Department of Homeland Security |
| File Modified | 2014-05-14 |
| File Created | 2009-02-16 |