FORM R REPORTS

Reference Point/Description	Latitude	Longitude	Collection Method	Accuracy Value
PLANT ENTRANCE (GENERAL)	34.56494	-117.45026	ADDRESS MATCHING-HOUSE NUMBER	150

RCRA ID NUMBER
CAR000066548
CAL000214164

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.

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PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1311209826852

Facility Registry System ID:  110002933149

Section 1. Reporting Year

Reporting Year: 2011

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
TOM KIRKMYER	No Data	Original	03-JUL-12

Section 4. Facility Identification

TRI Facility ID: 92301FBRCR9832Y

4.1 Facility Name and Address.

Facility Information

NAME	STREET	CITY	COUNTY	STATE	ZIP CODE
FIBER CARE BATH	9832 YUCCA RD	ADELANTO	SAN BERNARDINO	CA	92301

BIA Tribal Code	Tribe
NO DATA	NO DATA

Mailing Information

NAME	STREET	CITY	STATE	ZIP CODE
FIBER CARE BATH	9832 YUCCA RD	ADELANTO	CA	92301

PROVINCE	COUNTRY (NON - US)
NO DATA	NO DATA

4.2 Facility Classification

ENTIRE FACILITY	PARTIAL FACILITY	FEDERAL FACILITY	GOCO FACILITY
NO	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
JACQUELINE ORLOFF	9096280044

4.5 NAICS Codes

NAICS CODE	PRIMARY	NAICS CODE DESCRIPTION
326140	YES	Polystyrene Foam Product Manufacturing
INVALD	NO	INVALID
INVALD	NO	INVALID
INVALD	NO	INVALID
INVALD	NO	INVALID

4.7 Dun Numbers

DUNS NUMBER
NA

5. Parent Company Information

Parent Company Name: No US Parent Company

Parent Company DUNS Number: NA

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PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1311209826852

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0007440484

1.2 Toxic Chemical or Chemical Category Name: Cobalt

1.3 Generic Chemical Name: NA

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PART I. FACILITY IDENTIFICATION INFORMATION (FORM A)

DOCUMENT CONTROL NUMBER: 1311209826876

Facility Registry System ID:  110002933149

Section 1. Reporting Year

Reporting Year: 2011

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
TOM KIRKMYER	No Data	Original	03-JUL-12

Section 4. Facility Identification

TRI Facility ID: 92301FBRCR9832Y

4.1 Facility Name and Address.

Facility Information

NAME	STREET	CITY	COUNTY	STATE	ZIP CODE
FIBER CARE BATH	9832 YUCCA RD	ADELANTO	SAN BERNARDINO	CA	92301

BIA Tribal Code	Tribe
NO DATA	NO DATA

Mailing Information

NAME	STREET	CITY	STATE	ZIP CODE
FIBER CARE BATH	9832 YUCCA RD	ADELANTO	CA	92301

PROVINCE	COUNTRY (NON - US)
NO DATA	NO DATA

4.2 Facility Classification

ENTIRE FACILITY	PARTIAL FACILITY	FEDERAL FACILITY	GOCO FACILITY
NO	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
JACQUELINE ORLOFF	9096280044

4.5 NAICS Codes

NAICS CODE	PRIMARY	NAICS CODE DESCRIPTION
326140	YES	Polystyrene Foam Product Manufacturing
INVALD	NO	INVALID
INVALD	NO	INVALID
INVALD	NO	INVALID
INVALD	NO	INVALID

4.7 Dun Numbers

DUNS NUMBER
NA

5. Parent Company Information

Parent Company Name: No US Parent Company

Parent Company DUNS Number: NA

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PART II. CHEMICAL - SPECIFIC INFORMATION

DOCUMENT CONTROL NUMBER: 1311209826876

Section 1. Toxic Chemical Identity

1.1 CAS Number: 0000100425

1.2 Toxic Chemical or Chemical Category Name: Styrene

1.3 Generic Chemical Name: NA

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