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PART 6. PERMITTING INFORMATION
The most frequent mechanism for controlling non-criteria emissions is
through source permitting. The Clearinghouse plans to establish a registry of
permitted sources of air toxics which includes data on pollutant emissions,
emission limits, and control equipment. This information can be used for
purposes such as determining what non-criteria pollutants might be emitted by
a specific facility, identifying potentially applicable control equipment/
requirements for a particular facility, or prioritizing facilities for permit-
ting or other air toxics control decisions.
Table 10 presents information collected to date on 43 facilities per-
mitted by twelve states or localities. Data include facility category, SIC
Code, State or locality, year(s) permit issued/amended, permit identification
number, control equipment, pollutants, emission limit, and source of emis-
sions. The information is organized by the SIC Code of the permitted facil-
ities in the following order (including only those categories in which per-
mitting information is currently available):
• Agriculture Services (SIC 07)
• Lumber and Wood Products (SIC 24)
• Furniture and Fixtures (SIC 25)
• Paper and Allied Products (SIC 26)
• Chemicals and Allied Products (SIC 28)
• Rubber and Miscellaneous Plastics (SIC 30)
• Primary Metal Industries (SIC 33)
• Instruments and Related Products (SIC 38)
• Electric, Gas, and Sanitary Services (SIC 49)
• Automobile Repair, Services, and Garages (SIC 75).
These SIC categories will be expanded as the Clearinghouse collects more per-
mitting data. The reader should address any questions or requests for addi-
tional information about the permits identified in Table 10 to the permitting
contacts identified in Tables 1 and 2 in Part 2.
122
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131
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PART 7. SOURCE TESTING INFORMATION
Many states and localities conduct emissions testing for non—criteria air
pollutants as part of their air toxics control program. Table 11 presents in-
formation collected to date on 36 facilities tested by eleven states or local-
ities. Data include the facility category, SIC Code, state or locality, test
date, test or facility identification number, sampling technique, analytical
method, pollutants, measured emission rates, and location of measurement. The
information is organized by the SIC Code of the tested facilities in the fol-
lowing order (including only those categories in which source testing informa-
tion is currently available):
® Agricultural Services (SIC 07)
a Furniture and Fixtures (SIC 25)
* Paper and Allied Products (SIC 26)
» Chemicals and Allied Products (SIC 28)
« Petroleum and Coal Products (SIC 29)
• Rubber and Miscellaneous Plastics Products (SIC 30)
• Primary Metals Industries (SIC 33)
« Fabricated Metals Products (SIC 34)
» Transportation Equipment (SIC 37)
• Instruments and Related Products (SIC 38)
• Electric, Gas, and Sanitary Services (SIC 49)
• Personal Services (SIC 72).
These SIC categories will be expanded as the Clearinghouse collects more
scarce testing data. The reader should address any questions or requests for
additional information about the source tests identified in Table 11 to the
source testing contacts identified in Tables 1 and 2 in Part 2.
132
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PART 8. AMBIENT MONITORING INFORMATION
Ambient monitoring information has been collected from 19 states and lo-
calities on more than 100 pollutants. Table 12 presents these data, including
the pollutant measured, state or locality conducting the measurement, and the
sampling technique and analytical method used by the state or locality. The
sampling techniques and analytical methods have been coded; an explanation of
the code is provided at the end of the table. The reader should address any
questions or requests for additional information on a state or local agency's
ambient monitoring activities to the ambient monitoring contacts identified in
Tables 1 and 2 in Part 2.
141
-------
TABLE 12. AMBIENT MONITORING INFORMATION
Pollutant
Acetates
Acetone
Acrylonitrile
Alcohols
Aliphatics
Aluminum
Amines
Ammonia
Ant imony
Aroma tics
Arsenic
Asbestos
Barium
State
or
CAS No. Locality
MA
67-64-1 IL
NH
107-13-1 SC
MA
MA
7429-90-5 KS
MT
TX
MA
7664-41-7 NVd
7440-36-0 OH
OH
TX
MA
7440-38-2 AZ
IL
IL
KS
MT
OH
TX
1332-21-4 MN
PA«
SC
7440-39-3 KS
MT
OH
TX
Sampling8
Technique
M
Cr
MS
DI
Tn
C
C
M
M
P
-
HV
M
Cont
SF
SF
HV
M
P
P
HV
P
-
HV
HV
MF
E
MF
P
-
HV
HV
Analytical^
Method
MS
GCMS
GCFID
PID
GCFID
MS
MS
M
-
XRF
MS
Chi
AA
AA
XRF
MS
GFAA
AA
AA
AA
-
AA
XRF
M
M
M
AA
-
AA
XRF
(Continued)
142
-------
TABLE 12. Continued
Pollutant
Benzene
Benzo(a)pyrene
Beryllium
Bismuth
Boron
Bromine
Bromodi chl or ome thane
Bromome thane
Cadmium
State
or
CAS No. Locality
71-43-2 AR
CA*
CA
IL
MA
NH
PAe
50-32-8 MN
PAe
7440-41-7 IL
IL
KS
MT
7440-69-9 MT
7440-42-8 MT
7726-95-6 TX
75-27-4 CA
74-83-9 CA
7440-43-9 IL
IL
KS
MT
OH
PAe
SC
TX
Sampl inga
Technique
Tn
TB
TB
Cr
C
M
G
DI
Tn
C
C
HV
BV
P
HV
P
—
-
-
HV
TB
T
P
H
P
-
H
H
H
H
Analytical"
Method
GCFID
PID
GCMS
GCFID
GCMS
MS
GCPID
GCMS
MS
GCPID
GCFID
GCECD
PID
GC
HPLC
AA
AA
AA
—
-
-
XRF
GCECD
GCECD
AA
AA
AA
-
AA
AA
AA
XRF
(Continued)
143
-------
TABLE 12. Continued
Pollutant
Calcium
Carbon tetrachloride
Chlorides, total gaseous
Chlorinated hydrocarbons
Chlorine
Chlorobenzene
Chi or odibromome thane
1-Chloroethene
Chloroform
Chi or ome thane
Chlorophenols
State
or
CAS No. Locality
7440-70-2 MT
PAe
TX
56-23-5 CA
NH
NVd
MA
7782-50-5 KS
PAe
TX
108-90-7 NH
124-48-1 CA
CA
67-66-3 CA
CAC
CA*
NH
MA
74-87-3 CA
AR
Sampling8
Technique
HV
HV
Tn
C
TB
DI
Tn
C
BT
M
P
HV
HV
DI
Tn
C
TB
TB
TB
C
TB
DI
Tn
C
C
TB
Tn
Analytical^
Method
AA
XRF
PID
GCECD
GCECD
PID
Ar
T
MS
1C
C
XRF
GCFID
PID
GCECD
GCFID
GCECD
GCMS
GCMS
GCECD
PID
GCPID
GCMS
GCECD
GCECD
(Continued)
144
-------
TABLE 12. Continued
Pollutant
Chromium
Cobalt
Copper
Curene
Cyclohexane
1 ,2-Dibromoe thane
1,1-Dichloroethane
1 ,2-Dichloroe thane
1,2-Dichloroethylene
State
or
CAS No. Locality
7440-47-3 CA
IL
KS
MT
MN
PAe
OH
TX
7440-48-4 KS
MT
TX
7440-50-8 KS
MT
OH
OH
PAe
SC
TX
101-14-4 MI
110-82-7 MA
106-93-4 CA
75-34-3 MA
107-06-2 CA
MA
540-59-0 CA
NH
Sampling8
Technique
P
HV
P
-
HV
HV
HV
HV
P
-
HV
P
-
HV
HV
HV
HV
HV
HV
M
TB
C
TB
C
B
Tn
C
Analytical"
Method
XRF
AA
AA
-
AA
AA
AA
XRF
AA
-
XRF
AA
-
AA
AA
AA
AA
XRF
GCECD
MS
GCECD
GCPID
GCMS
GCECD
GCPID
GCMS
GCECD
GCFID
GCECD
PID
(Continued)
145
-------
TABLE 12. Continued
Pollutant
Dichlorome thane
1 ,2-Dichloropropane
Dimethyl formamide
Dioxins
Ethyl Ether
Ethyl benzene
Ethyl ene dibromide
Ethylene dichloride
Fluoride
Fluorides, gaseous as HF
Fluorine
Formaldehyde
CAS No.
75-09-2
78-87-5
68-12-2
—
60-29-7
100-41-4
106-93-4
107-06-2
16984-48-8
7664-39-3
7782-41-4
50-00-0
State
or
Locality
CA
NH
MA
CA
MA
MA
IL
NH
MA
NH
AR
CA*
MT
PAe
OH
OH
SC
KS
NVd
PAe
SC
Sampl inga
Technique
TB
DI
Tn
C
C
TB
C
G
M
HV
Tn
C
G
Tn
C
C
TB
—
HV
SF
SF
DT
P
BT
A
NaHSOi
Analytical^
Method
GCECD
GCFID
PID
GCPID
GCMS
GCECD
GCPID
GCMS
MS
GCPID
MS
GCMS
GCFID
PID
GCPID
GCFID
PID
GCECD
GCMS
—
SIE
SIE
SIE
SIE
1C
HPLC
C
CA
(Continued)
146
-------
TABLE 12. Continued
Pollutant CAS No.
Freon 11. 21, 113
Germanium —
Halogenated hydrocarbons —
Hexane 110-54-3
Hydrogen sulfide 7783-06-4
Iodine 7553-56-2
Iron 15438-31-0
Ketones —
Lanthanum —
Lead 7439-92-1
Light scattering —
Magneseum 7439-95-4
State
or
Locality
NH
TX
MA
MA
NH
MI
NH
PAe
TX
IL
KS
MT
PAe
TX
MA
TX
CA
KS
OH
TX
NVd
MT
Sampling8
Technique
DI
Tn
C
HV
M
G
DI
Tn
C
HV
DI
Tn
C
Cont
HV
P
P
-
HV
HV
M
HV
P
P
HV
HV
Cont
-
Analytical^
Method
GCFID
XRF
MS
GCPID
GCFID
PID
GCECD
PID
C
XRF
AA
AA
-
AA
XRF
MS
XRF
XRF
AA
AA
XRF
N
-
(Continued)
147
-------
TABLE 12. Continued
Pollutant
Manganese
Mercury vapor
Methylene chloride
Methyl ethyl ketone
Methyl isobutyl ketone
Molybdenum
Nickel
Nitrate
Pentane
State
or
CAS No. Locality
7439-96-5 CA
IL
KS
MX
PAe
TX
7439-97-6 MT
SC
75-09-2 NH
78-93-3 NH
108-10-1 NH
7439-98-7 MT
TX
7440-02-2 CA
IL
KS
MT
PAe
OH
TX
AZ
AZ
IL
KS
MT
PAe
109-66-0 NH
Samplinga
Technique
P
P
P
-
HV
HV
-
H
Tn
C
Tn
C
Tn
C
-
HV
P
HV
P
-
HV
HV
HV
P
P
P
P
-
HV
DI
Tn
C
Analytical"
Method
XRF
AA
AA
-
AA
XRF
-
AA
GCFID
GCECD
PID
GCFID
PID
GCFID
PID
-
XRF
XRF
AA
AA
-
AA
AA
XRF
CdR
GFAA
IEC
C
1C
-
C
GCFID
(Continued)
148
-------
TABLE 12. Continued
Pollutant
Peroxyacetylnitrate
Peroxybenzoylnitrate
Pesticides
Phenols
Phosphorus
Phthalic anhydride
Polychlorinated biphenyls
Potassium
Rubidium
Selenium
Silicon
Silver
Strontium
Styrene
CAS No.
2278-22-0
—
—
108-95-2
7723-14-0
85-44-9
53469-21-9
11097-69-1
7440-09-7
7440-17-7
7782-49-2
7440-21-3
7440-22-4
—
100-42-5
State
or
Locality
NVd
NVd
ID
MA
TX
PAe
IL
SC
KS
MT
TX
TX
MT
TX
TX
KS
MT
TX
AR
Sampling8
Technique
Cont
BT
P
G
M
HV
BT
HV
PUF
P
-
BV
HV
—
HV
HV
P
—
HV
Tn
Analytical^
Method
GC
DAUR
GC
MS
GCPID
MS
XRF
DV
GCECD
GCECD
AA
-
XRF
XRF
_
XRF
XRF
AA
—
XRF
GCFID
PID
(Continued)
149
-------
TABLE 12. Continued
Pollutant CAS No.
Sulfate
Sulfur 7704-34-9
1,1,2,2-Tetrachloroethane 79-34-5
Tetrachloroethylene 127-18-4
Tetrahydrofuran 109-99-9
Thallium 7440-28-0
Tin 7440-31-5
Titanium 7440-32-6
State
or
Locality
AZ
AZ
IL
KS
MN
MT
PAe
MT
TX
MA
CA
CAC
CA^
NH
MA
VT
NH
TX
MT
TX
MT
TX
Sampling*
Technique
P
P
P
P
HV
-
HV
_
HV
C
TB
C
TB
DI
Tn
C
C
ss
Tn
C
HV
—
HV
-
HV
Analytical"
Method
T
GFAA
IEC
C
1C
-
C
_
XRF
GCPID
GCMS
GCECD
GCMS
GCMS
GCFID
GCECD
PID
GCPID
GCMS
GC
GCFID
XRF
_
XRF
—
XRF
(Continued)
150
-------
TABLE 12. Continued
Pollutant
Toluene
Tribromome thane
1,1,1 -Trichl oroe thane
1,1,2-Trichloroethane
Trichl oroe thy lene
Trichlorotrif luoroe thane
Trimethylpentane
State
or
CAS No. Locality
108-88-3 AR
IL
MA
NH
PAe
75-25-2 CA
71-55-6 CAC
CA*
CA
MA
NH
79-00-5 MA
79-01-6 CA
CA*
CAC
MA
NH
76-13-1 CAC
MA
540-84-1 NH
Sampl inga
Technique
Tn
Cr
C
G
M
DI
Tn
C
C
TB
C
TB
TB
C
DI
Tn
C
C
TB
TB
C
C
DI
Tn
C
C
C
DI
Tn
C
Analytical^
Method
GCFID
PID
GCMS
MS
GCPID
GCMS
GCPID
MS
GCFID
PID
GC
GCECD
GCMS
GCMS
GCECD
GCPID
GCMS
GCECD
PID
GCPID
GCMS
GCECD
GCMS
GCMS
GCPID
GCMS
GCECD
PID
GCMS
GCPID
GCMS
GCFID
PID
(Continued)
151
-------
TABLE 12. Continued
Pollutant
VOC species
Vanadium
Vinyl chloride
Vinyl idene chloride
Xylene
p-Xylene
Zinc
Zirconium
State
or
CAS No. Locality
NVd
7440-62-2 MT
TX
75-01-4 CA*
75-35-4 CA
CA*
NH
1330-20-7 IL
MA
NH
PAe
106-42-3 SC
7440-66-6 KS
MT
PAe
TX
7440-67-2 TX
Sampling*
Technique
Cyl
—
HV
TB
TB
TB
Tn
C
Cr
M
Tn
C
C
C
P
-
HV
HV
HV
Analytical^*
Method
GCMS
-
XRF
GCMS
GCMS
GCMS
GCECD
GCMS
MS
MS
GCFID
GC
GCFID
AA
-
AA
XRF
XRF
Footnotes on next page,
152
-------
TABLE 12. Continued
aSampling Techniques:
A = Aqueous
BT = Bubbler Train
C = Charcoal
Cont = Continuous
Cr = Cryogenic Trap
Cyl = Cylinders
DI = Drect Injection
DT = Double Tape
F = Filter
G = Grab sample
bAnalytical Methods:
AA = Atomic Absorption
Ar = Argentometric
C = Colorimetry
CA = Chromatropic Acid
Cdr = Cadmium Reduction
Chi = Chemiluminescence
GC = Gas Chromatography
GCECD = Gas Chromatography Electron
Capture Detector
GCFID - Gas Chronatography/Flame
lonization Detector
GCMS = Gas Chromatography Mass
Spectrometry
cLocality: Sacramento, CA
^Locality: Clark Co., NV
eLocality: Allegheny Co., PA
fLocality: South Coast, CA
H = Hopcalite Solid Sorbent
HV = HiVol
M = Mobile real time
MB = Membrane Filter
PUF = PDF Solid Sorbent
SF = Sodium Formate Filter
SS = Solid Sorbent
T = Turbidome trie
TB = Tedlar Bag
Tn = Tenax
GFAA = Graphite Furnace/Atomic
Absorption
IEC = Ion Exchange Chroma-
tography
M = Microscopic Analysis
MS = Mass Spectrometry
N = Nephelometer
P = Particulate
PID = Photoionization
SIE = Selective Ion Electrode
TJV = Ultraviolet Absorption
XRF = X-Ray Fluorescence
153
-------
APPENDIX A
Data Collection Forms
This appendix includes the six data collection forms used to solicit in-
formation from state and local agencies for inclusion in the Clearinghouse
database. They are:
• Form 1. Agency General Information
• Form 2. Regulatory Program Information
• Form 3. Permitting Information
• Form 4. Ambient Monitoring Information
• Form 5. Toxicity Test Results
• Form 6. Source Testing Information
This report presents the information collected using these forms. No data
have been received to date from Form 5 (Toxicity Test Results).
154
-------
I. Agency Information
Agency Name:
Address:
National Air Toxics Information Clearinghouse
Form 1. Agency General Information
Telephone
City, State, Zip:
II: Air Toxics Program Information
Please indicate below the areas in which you have information to share with other
Clearinghouse users regarding non-criteria air pollutants. Also, please give the
name and telephone number (if different from above) of a contact person in the areas
of expertise noted below. This person will receive data collection forms, and may be
contacted directly by the Clearinghouse staff or other Clearinghouse users with
requests for information. Page 2 presents the kinds of information that will be
sought under each of the identified subject areas.
Subject
Name
Telephone Number
Regulatory Program:
Permitting:
Source Tests:
Ambient Monitoring:
Emissions Inventory:
Health Effects:
If you have so much information to submit in any of these areas such that it may be
reporting burden, please circle the appropriate subject area and someone from the
Clearinghouse staff will contact you to discuss sending representative samples.
Please return this form to:
Ms. Sandra Smith
Radian Corp.
8501 Mo-Pac Blvd.
P.O. Box 9948
Austin, Texas 78766
If you have questions on completing this form,
please call Sandra Smith (512) 454-4797.
Page 1 of 2
155
-------
INFORMATION FOR POSSIBLE SUBMITTAL TO THE NATIONAL AIR TOXICS
INFORMATION CLEARINGHOUSE
Please Indicate by circling the appropriate numbers below the kinds of Information on toxic air
pollutants that you have and are willing to submit to the National Air Toxics Information Clearinghouse
Subject Area
Regulatory Program
Information
1) Basis for establishment
of program
2) Pollutants regulated or
for which guidelines
exist
3) Sources regulated
4) Acceptable'ambient
concentrations and
basis
Information Needs
5) Research on pollutants
toxlcity
source assessment
exposure assessment
risk assessment
monitoring study
emission factor
development
6) Pollutant ranking
schemes
7) Risk assessment
guidelines
8) Pollutant categori-
zation schemes
9) Detailed descriptions
of control programs in
place
10) Results of state/local
sponsored toxlcity'
testing
11) Results of Industry
sponsored toxicity
testing
Permitting Data
(from a represen-
tative sample of
case^l
1) List of permits
for toxics by
source category
2) Pollutants emitted
by source category
3) Emission factors
(If used)
4) Estimated emission
rates
5) Emission limits
6) Averaging time
7) Control requirements
8) Process description
9) Basis for emission
rate estimate
10) Control efficiency of
equipment
11) Total estimated emissic
reduction
12) Basis for emission
limit
13) Detailed descriptions
of selected case studv
Source Test Data
(from a representa-
tive sample of
source tests)
1) List of source tests
by source category
2) Pollutants detected by
source category
3) Measured emission rates
4) Process description
5) Emission control
equipment
6) Control efficiency
of equipment
7) Source test methods
8) Quality assurance
procedures
9) Case studies
Ambient Monitoring
Data (from a
representative
sample of studies)
1) List of pollutants
monitored
2) Reference to study
3) Site, location
4) Site classification
5) Pollutants measured
6) Period of study
7) Concentrations detected
8) Averaging period
9) Monitoring methods
10) Site selection criteria
11) Quality assurance
procedures
12) Case studies
156
-------
NATIONAL AIR TOXICS INFORMATION CLEARINGHOUSE
Form 2. Regulatory Program Information
Please return this form to:
Ms. Sandra Smith
Radian Corporation
P.O. Box 9948
Austin, TX 78766
Please complete this form with respect to the control of non-criteria air pollutants by your
agency. If you have already submitted this form to the Clearinghouse at some time in the
past, please consider this a request for revised or updated information. If you have ques-
tions on completing this form, please call: Sandra Smith, Radian Corporation, (512)454-4797.
I. General Information
Agency Name:
Date:
This form was completed by:
Telephone: ( )
II. Air Toxics Program Information
Please check yes or no for the following statements with respect to the control of non-
criteria air pollutants by your agency.
Yes
No
Program Status'
1.
2.
We have an air toxics control program currently in place.
include delegation of NESHAPs authority).
(This does not
We are developing an air toxics program which is scheduled to be in place
by (date) .
Program Structure
3. Our air toxics control program is based on promulgated regulations.
4. Our air toxics control program is based on informal guidelines.
Program Scope
5. The scope of our program is limited to a specified list of pollutants.
6. The scope of our program is limited to a specified list of sources or source
categories.
Application
7. We use acceptable ambient concentrations in the permit review process.
8. We use formally adopted ambient standards for non-criteria air pollutants.
9. Some or all of our acceptable ambient concentrations or standards are based
on the application of a safety factor to an established Threshold Limit
Value (TLV). We use the following safety factor(s): .
10. Some or all of our acceptable ambient concentrations or standards are based
on the results of original health effects research.
11. We use control technology requirements, such as "state of the art" for
sources of specified pollutants.
12. We use risk assessment on a case-specific bases.
13. We maintain an emissions inventory for air toxics.
Comments or Clarification:
Page 1 of 4
157
-------
III. Acceptable Ambient Concentrations/Ambient Standards
If you have established acceptable ambient concentrations or ambient standards, please suppl
the following information to the extent that it applies to your air toxics control program.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
CAS // or Pollutant Name1
Ambient
Standard
or
Acceptable
Ambient
Concentration^
(specify unit)
Averaging
Time3
Basis4
abed
If Concentration is Basec
on Threshold Limit Value
Source of TLV (/) Safet:
Factoi
ACGIH OSHA NTOSH Used
Comments or Clarification:
If more than 20 pollutants, please continue on duplicate page,
^See instructions for clarification of terms.
3l5-minute, 1-hour, 24-hour, annual, etc.
a. TLV/safety factor
b. agency-sponsored original research
c. adoption of concentration set by another agency or group
d. other
Page 2 of 4
158
-------
IV
Pollutant Research
If your agency sponsors or participates in a pollutant assessment or research program (not
including methods development-see Section V), please supply the following information to
the extent that it applies to your air toxics control program. Please supply the same in-
formation if you are aware of relevant research conducted by other agencies in your state
or locality.
1.
2.
3.
4.
5.
6.
7.
CAS // or Pollutant Name1
Type of Research or
Assessment Activities2
Other
HA SA EA TT ES MS EF RA (specify)
Is supporting
documentation
available?
Yes No
9 .
10.
11 .
12.
13.
14.
15.
16.
17.
18.
19.
20.
*If more than 20 pollutants, please continue on duplicate form.
2HA = health assessment, SA = source assessment, EA = exposure assessment, TT = toxicity
testing, ES = epidetniological study, MS = monitoring study, EF = emission factor develop-
ment, RA = risk assessment. For additional clarification of terms, see instructions.
Comments or Clarification:
Page 3 of 4
159
-------
V. Methods Development Activities
If your agency sponsors or participates in methods development or research in any of the
following areas, please indicate below:
Yes No Explain, if yes
1. Emissions Testing
2. Ambient Monitoring
3. Dispersion Modeling
Application, Evaluation
and Development
4. Emergency Response
Procedures
5. Ambient Exposure
Assessment
6. Emissions Modeling from
Non-Traditional Sources
(e.g., impoundments and
landfills)
7. Other (e.g., indoor/outdoor
exposure relationships)
VI. Non-Health Related Impacts
Please submit in the space provided below or attach any information you may have on case
studies of non-health related impacts of non-criteria air pollutants (e.g., odor, vegetation
damage).
Page 4 of
160
-------
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NATIONAL AIR TOXICS INFORMATION CLEARINGHOUSE
Form 4. Ambient Monitoring Information
Please return this form to:
Ms. Sandra Smith
Radian Corporation
P.O. Box 9948
Austin, TX 78766
If you have questions on completing this
form, call:
Sandra Smith
Radian Corporation
(512) 454-4797
I. General Information
Agency Name:
This form was completed by:
Telephone: ( )_
II. Pollutants Monitored
Please list the non-criteria pollutants (or CAS numbers) for which ambient monitoring
data are available, the year(s) the measurement took place, the location of the measure-
ment, and the sample collection technique and analytical method^ used.
CAS //or
Year
Location of
Measurement
Pollutant: Measured Measured (city/county) Samp 1 ing Techni_q_ue Analytical Method^
1.
2.
3.
7.
9.
10.
11.
12.
13.
14.
15.
lrl"echnique used to collect ambient air sample, e.g., single or multi-stage solid sorbent
tubes, cryogenic traps, charcoal traps, particulate samplers, etc.
2Methodology used to analyze sample for chemical constituents, e.g., gas chromatography/
mass spectrometry (GC/MS), gas chromatography-electron capture detection (GC-ECD), etc.
3If more than 15 pollutants, please continue on duplicate form.
p. 1 of 1
163
-------
NATIONAL AIR TOXICS INFORMATION CLEARINGHOUSE
Form 5. Toxicity Test Results
Please return this form to:
Ms. Sandra Smith
Radian Corporation
P.O. Box 9948
Austin, TX 78766
If you have questions on completing this form.
please call:
Sandra Smith, Radian Corporation
(512) 454-4797
Please complete this form for each pollutant for which you have the results of agency-
sponsored or industry-sponsored toxicity testing which you are willing to share with the
Clearinghouse. Fill out only those sections for which you have test results. Use a sep-
arate form for each pollutant.
I. General Information
Agency Name:
This form was completed by:
Pollutant Name:
Telephone: (
II. Mutagenicity, Teratogenicity, Carcinogenicity Test Observations
Give the observations from each of the following tests (dose and effects).
Mutageuicity
Salmonella
Drosophila
Cell Transformation
Sister Chromatid Exchange
Other
Teratogenicity
Carcinogenicity
p. 1 of 3
164
-------
III. Acute Toxicity Test Results
Give results of acute toxicity testing (24 hours to one week, LD5Q determination).
Dosage
(specify units)
Single Multiple
Route of Administration Dose Dose Animal Species
Observations and Other Toxic Effects:
IV. Sub Acute Toxicity Test Results
Results of sub acute toxicity testing (generally 90 days).
Dosage
(specify
Daily Weekly
Route of Administration _ Dose Dose Animal Species
Observations and Other Toxic Effects:
p. 2 of 3
165
-------
V. Chronic Toxicity Test Results
Give results of chronic toxicity testing (generally 1-2 years).
Dosage
(specify units)
Daily Weekly
Route of Administration Dose Dose Other Animal Species
Observations and Other Toxic Effects:
Survival Race of Animals During Test:
Autopsy Findings:
VI. Human Effects
Describe effects on humans (acute, chronic, occupational exposure and epidemiological
studies):
VII. References
Give references to toxicity studies which document data reported on this form (if avail-
able) :
p. 3 of 3
166
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