High-Piled Permits

Hazardous Materials Storage Questionnaire

Determine the amount and type of hazardous materials stored in your building. Please complete this questionnaire as accurately as possible.
Instructions
How to Complete This Form

Important: For each hazardous material class that applies to your facility, expand the section below and enter your quantities. The maximum allowable quantities (MAQs) are shown for reference — quantities above these thresholds will classify the space as an H-occupancy. Use the container type, temperature, and pressure codes listed in the reference legend.

Container Type Codes

AAboveground Tank BBelowground Tank CTank Inside Building DSteel Drum EPlastic / Nonmetallic Drum FCan GCarboy HSilo IFiber Drum JBag KBox LCylinder MGlass Bottle or Jug NPlastic Bottle or Jug OTote Bin PTank Wagon QRail Car ROther

Temperature Codes

4Ambient 5Greater than Ambient 6Less than Ambient (not Cryogenic) 7Cryogenic (< −150°F / −101°C)

Pressure Codes

1Ambient (Atmospheric) 2Greater than Ambient 3Less than Ambient
Section 1
Hazardous Material Inventory
Click each material class that applies to expand it and enter your quantities. Only fill in the classes you store.
▶ Combustible Liquid — Class II Permit > 25 gal
Liquids with a closed cup flash point at or above 100°F (38°C) and below 140°F (60°C).
Storage MAQ: 120 gal Use-Closed MAQ: 120 gal Use-Open MAQ: 30 gal
▶ Combustible Liquid — Class IIIA Permit > 25 gal
Liquids with a closed cup flash point at or above 140°F (60°C) and below 200°F (93°C).
Storage MAQ: 330 gal Use-Closed MAQ: 330 gal Use-Open MAQ: 80 gal
▶ Combustible Liquid — Class IIIB Permit: tanks/vessels > 60 gal
Liquids with a closed cup flash point at or above 200°F (93°C).
Storage MAQ: 13,200 gal Use-Closed MAQ: 13,200 gal Use-Open MAQ: 3,300 gal
▶ Flammable Liquid — Class IA Permit > 5 gal
Liquids with flash point below 73°F (23°C) and boiling point below 100°F (38°C).
Storage MAQ: 30 gal Use-Closed: 30 gal Use-Open: 10 gal
▶ Flammable Liquid — Class IB Permit > 5 gal
Liquids with flash point below 73°F (23°C) and boiling point at or above 100°F (38°C).
Storage MAQ: 60 gal Use-Closed: 60 gal Use-Open: 15 gal
▶ Flammable Liquid — Class IC Permit > 5 gal
Liquids with flash point at or above 73°F (23°C) and below 100°F (38°C).
Storage MAQ: 90 gal Use-Closed: 90 gal Use-Open: 20 gal
▶ Flammable Liquid — Aggregate IA/IB/IC Permit > 5 gal
Aggregate amount of IA, IB, and IC flammable liquids in combination.
Storage MAQ: 120 gal Use-Closed: 120 gal Use-Open: 30 gal
▶ Cryogenic Flammable Permit > 1 gal
Liquid with boiling point lower than −150°F (−101°C) at 14.7 psia.
Storage MAQ: 45 gal Use-Closed: 45 gal Use-Open: 10 gal
▶ Cryogenic Inert Permit > 60 gal
Inert cryogenic liquids.
MAQs: Unlimited (all categories)
▶ Cryogenic Oxidizing Permit > 10 gal
Oxidizing cryogenic liquids.
Storage MAQ: 45 gal Use-Closed: 45 gal Use-Open: 10 gal
▶ Explosives Permit: any amount
Dynamite, black powder, detonators, safety fuses, squibs, detonating cord, igniters, and materials within USC Title 18: Chapter 40 or DOT 49 CFR Parts 100-185.
Storage MAQ: 1 lb Use-Closed: 0.25 lb Use-Open: 0.25 lb
▶ Flammable Gas (Gaseous) Permit > 200 ft³
Gas at 68°F or less at 14.7 psia; ignitable at 13% or less in air, or has flammable range of 12%+.
Storage MAQ: 1,000 ft³ Use-Closed: 1,000 ft³
▶ Flammable Gas (Liquified) Permit > 200 ft³
Liquefied compressed gas, partially liquid at 68°F under charged pressure, and flammable.
Storage MAQ: 30 lbs Use-Closed: 30 lbs
▶ Flammable Solid Permit > 100 lbs
Solid capable of causing fire through friction, moisture absorption, spontaneous chemical change, or retained heat; or ignition temp below 212°F.
Storage MAQ: 125 lbs Use-Closed: 125 lbs Use-Open: 25 lbs
▶ Organic Peroxide — Unclassified / Detonable Permit: any amount
Organic peroxides capable of detonation — extremely high explosion hazard.
Storage MAQ: 1 lb Use-Closed: 0.25 lb Use-Open: 0.25 lb
▶ Organic Peroxide — Class I Permit: any amount
Capable of deflagration but not detonation.
Storage MAQ: 5 lbs Use-Closed: 1 lb Use-Open: 1 lb
▶ Organic Peroxide — Class II Permit: any amount
Burns very rapidly; moderate reactivity hazard.
Storage MAQ: 50 lbs Use-Closed: 50 lbs Use-Open: 10 lbs
▶ Organic Peroxide — Class III Permit > 1 gal liq / > 10 lbs solid
Burns rapidly; moderate reactivity hazard.
Storage MAQ: 125 lbs Use-Closed: 125 lbs Use-Open: 25 lbs
▶ Organic Peroxide — Class IV Permit > 2 gal liq / > 20 lbs solid
Burns like ordinary combustibles; minimal reactivity hazard.
MAQs: Unlimited
▶ Oxidizer — Class 4 Permit: any amount
Can undergo explosive reaction; causes severe increase in burning rate and spontaneous ignition of combustibles.
Storage MAQ: 1 lb Use-Closed: 0.25 lb Use-Open: 0.25 lb
▶ Oxidizer — Class 3 Permit > 1 gal liq / > 10 lbs solid
Causes severe increase in burning rate of combustibles.
Storage MAQ: 10 lbs Use-Closed: 2 lbs Use-Open: 2 lbs
▶ Oxidizer — Class 2 Permit > 10 gal liq / > 100 lbs solid
Causes moderate increase in burning rate of combustibles.
Storage MAQ: 250 lbs Use-Closed: 250 lbs Use-Open: 50 lbs
▶ Oxidizer — Class 1 Permit > 55 gal liq / > 500 lbs solid
Does not moderately increase burning rate of combustibles.
Storage MAQ: 4,000 lbs Use-Closed: 4,000 lbs Use-Open: 1,000 lbs
▶ Oxidizing Gas (Gaseous) Permit > 504 ft³ @NTP
Gas that supports and accelerates combustion more than air.
Storage MAQ: 1,500 ft³ Use-Closed: 1,500 ft³
▶ Oxidizing Gas (Liquid) Permit > 504 ft³ @NTP
Storage MAQ: 15 gal Use-Closed: 15 gal
▶ Pyrophoric Permit: any amount
Auto-ignition temperature in air at or below 130°F (54.4°C).
Storage MAQ: 4 lbs / 50 ft³ gas Use-Closed: 1 lb / 10 ft³ gas Use-Open: Not Allowed
▶ Unstable Reactive — Class 4 Permit: any amount
Readily capable of detonation or explosive decomposition at normal temperatures and pressures.
Storage MAQ: 1 lb / 10 ft³ gas Use-Closed: 0.25 lb / 2 ft³ gas Use-Open: 0.25 lb
▶ Unstable Reactive — Class 3 Permit: any amount
Capable of detonation or explosive reaction but require strong initiating source or heating under confinement.
Storage MAQ: 5 lbs / 50 ft³ gas Use-Closed: 1 lb / 10 ft³ gas Use-Open: 1 lb
▶ Unstable Reactive — Class 2 Permit > 5 gal liq / 50 lbs solid / any gas
Normally unstable; readily undergo violent chemical change but do not detonate.
Storage MAQ: 50 lbs / 250 ft³ gas Use-Closed: 50 lbs / 250 ft³ gas Use-Open: 10 lbs
▶ Unstable Reactive — Class 1 Permit > 10 gal liq / 100 lbs solid
Normally stable but can become unstable at elevated temperatures and pressure.
MAQs: Unlimited
▶ Water Reactive — Class 3 Permit: any amount
Reacts explosively with water without requiring heat or confinement.
Storage MAQ: 5 lbs Use-Closed: 5 lbs Use-Open: 1 lb
▶ Water Reactive — Class 2 Permit > 5 gal liq / 50 lbs solid
Reacts violently with water; may produce flammable/toxic gases or autoignition of combustibles.
Storage MAQ: 50 lbs Use-Closed: 50 lbs Use-Open: 10 lbs
▶ Water Reactive — Class 1 Permit > 55 gal liq / > 500 lbs solid
Reacts with water with some release of energy, but not violently.
MAQs: Unlimited
▶ Aerosol — Level 3 Permit > 500 lbs
Heat of combustion > 13,000 Btu/lb (30 kJ/g).
Storage MAQ: 1,000 lbs
▶ Aerosol — Level 2 Permit > 500 lbs
Heat of combustion > 8,600 Btu/lb (20 kJ/g) and ≤ 13,000 Btu/lb (30 kJ/g).
Storage MAQ: 2,500 lbs
▶ Aerosol — Level 1 Permit > 500 lbs
Heat of combustion ≤ 8,600 Btu/lb (20 kJ/g).
MAQs: Unlimited
▶ Corrosive Permit > 55 gal liq / 1,000 lbs solid / 200 ft³ gas
Causes visible destruction of, or irreversible alterations in, living tissue by chemical action at point of contact.
Storage MAQ: 5,000 lbs solid / 500 gal liq / 810 ft³ gas Use-Open: 1,000 lbs solid / 100 gal liq
▶ Toxic (Oral / Dermal / Inhalation) Permit > 10 gal liq / 100 lbs solid / any gas
Oral LD50 > 50 mg/kg but ≤ 500 mg/kg; Dermal LD50 > 200 mg/kg but ≤ 1,000 mg/kg; Inhalation LC50 > 200 ppm but ≤ 2,000 ppm.
Storage MAQ: 500 lbs / 810 ft³ gas Use-Open: 125 lbs
▶ Highly Toxic (Oral / Dermal / Inhalation) Permit: any amount
Oral LD50 ≤ 50 mg/kg; Dermal LD50 ≤ 200 mg/kg; Inhalation LC50 ≤ 200 ppm or ≤ 2 mg/L.
Storage MAQ: 10 lbs / 20 ft³ gas Use-Open: 3 lbs
▶ Combustible Fibers (Loose) Permit > 100 ft³
Readily ignitable fibrous or shredded materials: cocoa fiber, cloth, cotton, excelsior, hay, hemp, jute, kapok, rags, sisal, straw, tow, wastepaper, certain synthetic fibers.
▶ Baled Cotton Permit > 1,000 ft³
Natural seed fiber wrapped in industry-accepted materials, secured with bands or wire; includes linters and motes.
Section 2
Business Information
Section 3
Declaration

"I certify that the information above and on all parts of this form is true and correct to the best of my knowledge."

Must be signed by owner/operator or designated representative.

This information will be compared to applicable Codes and Standards required by the AHJ.