FORM R REPORTS

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1304202829964

Facility Registry System ID:  110001397881

Section 1. Reporting Year

Reporting Year: 2004

Section 2. Trade Secret Information

2.1 Trade Secret: NO

2.2 Sanitized Copy: Unsanitized

Section 3. Certification

CERTIFYING OFFICIAL'S NAME	CERTIFYING OFFICIAL'S TITLE	CERTIFYING OFFICIAL'S SIGNATURE	DATE SIGNED
ED SNYPE	ED SNYPE	Original	30-JUN-05

Section 4. Facility Identification

TRI Facility ID: 50021RGSNR41SEC

4.1 Facility Name and Address.

Facility Information

NAME	STREET	CITY	COUNTY	STATE	ZIP CODE
AIRGAS USA LLC	410 SE CREEKVIEW RD	ANKENY	POLK	IA	50021

BIA Tribal Code	Tribe
NO DATA	NO DATA

Mailing Information

NAME	STREET	CITY	STATE	ZIP CODE
AIRGAS USA LLC	3011 EAST CAPITOL DRIVE	APPLETON	WI	54911

PROVINCE	COUNTRY (NON - US)
NO DATA	NO DATA

4.2 Facility Classification

ENTIRE FACILITY	PARTIAL FACILITY	FEDERAL FACILITY	GOCO FACILITY
YES	NO	NO	NO

4.3 Technical Contact

Not Available to the Public as this information is only for Intranet.

4.4 Public Contact

NAME	PHONE
No Data	No Data

4.5 SIC Codes

SIC CODE	PRIMARY	SIC CODE DESCRIPTION
2813	YES	INDUSTRIAL GASES

4.6 Location

LATITUDE	LONGITUDE
041-43-41	093-34-24

4.7 Dun Numbers

DUNS NUMBER
198976359

4.8 RCRA ID Numbers

RCRA ID NUMBER
NO DATA

4.9 NPDES Permit Numbers

NPDES PERMIT NUMBER
NO DATA

4.10 Underground Injection Well Code (UIC) ID Number

UIC ID NUMBER
NO DATA

5. Parent Company Information

Parent Company Name: AMERICAN AIR LIQUIDE HOLDINGS INC

Parent Company DUNS Number: 003312600

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PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1304202829964

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000115071

1.2 Toxic Chemical or Chemical Category Name: Propylene

1.3 Generic Chemical Name: NA

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