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FORM R REPORTS



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Reference Point/Description Latitude Longitude Collection Method Accuracy Value
N/A 41.712081 -86.868514 N/A N/A

RCRA ID NUMBER
INR000117598
INR000007062

NPDES PERMIT NUMBER
NO DATA

UIC ID NUMBER
NO DATA

To correct the FRS latitude, longitude or program ID values click on the "Report an Error" button in the top right corner of this page. Facilities wishing to correct other data elements with the FORM R or FORM A should refer to the related TRI-MEweb tutorial..
For more information, see Collection of Latitude, Longitude and Program ID Data Has Been Discontinued.


PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481491

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481491

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000095636

1.2 Toxic Chemical or Chemical Category Name: 1,2,4-Trimethylbenzene

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481503

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481503

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000098862

1.2 Toxic Chemical or Chemical Category Name: Acetophenone

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481515

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481515

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0007664417

1.2 Toxic Chemical or Chemical Category Name: Ammonia

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481527

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481527

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000097563

1.2 Toxic Chemical or Chemical Category Name: C.I. Solvent Yellow 3

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481539

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481539

Section 1. Toxic Chemical Identity

1.1 CAS Number: N230

1.2 Toxic Chemical or Chemical Category Name: Certain glycol ethers

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481541

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481541

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0007440508

1.2 Toxic Chemical or Chemical Category Name: Copper

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481554

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481554

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000111422

1.2 Toxic Chemical or Chemical Category Name: Diethanolamine

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481566

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481566

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000107211

1.2 Toxic Chemical or Chemical Category Name: Ethylene glycol

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481578

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481578

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000067561

1.2 Toxic Chemical or Chemical Category Name: Methanol

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481580

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481580

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000091203

1.2 Toxic Chemical or Chemical Category Name: Naphthalene

1.3 Generic Chemical Name: NA

PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1310208481592

The Facility Registry System ID is not submitted as part of the TRI Form RFacility Registry System ID:  110003126732

Section 1. Reporting Year

Reporting Year: 2010

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
GINA AKE
 VICE PRESIDENT, ADMINISTRATION
 Electronic
 21-JUN-11

Section 4. Facility Identification

TRI Facility ID: 46360FSPKN411FA

4.1 Facility Name and Address.

Facility Information

NAME STREET CITY COUNTY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 LAPORTE
 IN
 46360

BIA Tribal Code Tribe
NO DATA
 NO DATA

Mailing Information

NAME STREET CITY STATE ZIP CODE
FAS-PAK INC
 411 FAIRFIELD AVE
 MICHIGAN CITY
 IN
 46350

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
GINA AKE
 2198747990

4.5 NAICS Codes

NAICS CODE PRIMARY NAICS CODE DESCRIPTION
325612
 YES
 Polish and Other Sanitation Good Manufacturing
324191
 NO
 Petroleum Lubricating Oil and Grease Manufacturing
561910
 NO
 Packaging and Labeling Services

4.7 Dun Numbers

DUNS NUMBER
807542691

5. Parent Company Information

Parent Company Name: FAS-PAK INC

Parent Company DUNS Number: 807542691

PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1310208481592

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0001330207

1.2 Toxic Chemical or Chemical Category Name: Xylene (mixed isomers)

1.3 Generic Chemical Name: NA