HomeMy WebLinkAboutBuilding Permit 09-0066
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
J. 30,07
I. White File I PERMIT NO I
; :~~~w ;:~~icant . 09: 00 ro (p
LOT
LEGAL DESCRIPTION (office use only)
BLOCK
ADDITION
PID 25'
ZONING (office use)
63
(Phone) 9s-.Z;!'ZZ--5~JZ-
(PhOne)~/2(' ZS-I-~3
NA-J ~9Z
TYPE OF WORK 0 New Cons~ion o Deck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition ~eration o Utility Connection ~1$/,....o"'}~ IIV Pt..,.LNW'--e,/IJ&- C~
KJ (i) o Misc: DID J.-61srqJD r(A?v5 -roI'1n-CLx-l It..
If: r' ~ ~ ~ U PROJECT COST IV AL~ i /GL; ~ I /1.rcrJ e
2 3 4 5 (excluding land) , 1P..oa::>~'Z5::J
CODE: OI.R.C. &.B.C.
Type of CODStruction: ~ I
Occupancy Group: A <2!/ E
Division:
II
F
I
ished information on is application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
t co true' will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
fo . s au . F rm?re, I hereby agree that the city official or a designee ~ enter upon the property to perform needed inspe 'ODS.
--- 79Lf~ -
, Contractor's License No. Da 01 2)
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Park Support Fee
SAC
o COO. -
. '':; SO
2...., '1Q
:='. u
5500
#
#
$
$
$
$
$
$
$
$
$
TOTAL DUE
*!>hlo,
f I Date
This is to certiJy that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance ana may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Special Conditions, if any
~ 4t \ (J -CJ?e?
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
L Pink File
2. Green City
3. Yellow Applicant
ZONING (office use)
(l'kaoe_m _ ...."'" ..~
ADDRESS
I \ Co &1 D ~1'-L.14 Tg.x....l-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
/'
(phone)
w-c/
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT TERATIONS
FURNACE MAKE AND MODEL -~ FUEL
FLUE SIZE ___ RETURN OPENINGS INPUT OUTPur-
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
~t. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
~ndustrial. Commercial & Multi-Family ~ 1% of job cost Residential, Gas Fireplace
--~ $49.50 minimum
Residential, Heating & AlC (New Construction) $149.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential, AC Only
$49.50
$49.50
$49.50
Estimated Cost $ '2-, z. 00 -
/
Building Permit #
HEATING PERMIT FEE
SI A IE SURCHARGE
TOTAL PERMIT FEE
$ 4CI C,O
$~
$ S() ---
Pai~o. (}()
Dat~.3,O
0'5?2.5..5
24 hour notice for all inspections (952) 447-9~, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
../'~' / /.
" ..",;
, "
"
i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I /
I (:...____
Accepted
Denied
"
::.;.,,,
I'
Accepted With Corrections
\
J'
j ,
, .I, {
r-/ ,,1'1'
--'" .
Date:
" ""\
}
I
Reviewed By:
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
_h_ ..-_......_._...,. _~_._._. ----...-~-'--~~~._----..--.---_T"".--.~.----.-~-.--.--.-~-- ~_.__~,__,~ --~-_..._---,_._~- ----.,-~---.-.- --", ----~.--...-_.- -------.~_.
.. ........ . ----------
C::-~;=;y ::~~~~~
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
KAI2K6LA 6()NSr--tC.
/,30,0;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I&~ 70 r/24CJN/GurJ 77ZA-1L-
)<..
(
Accepted
Reviewed By:
Comments:
Date:
Denied
./
I
o oX" 3.e1A
7
d- f)0r cos Ox tJ2.e
d(~C(~S~r tef,u,'~ lay OW~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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C):"~I,_~IN ~TED CEILING
Sjoquist Architects~ 1m
2800 UniPersity Avenue SE #100
Minneapolis, Minnesota 55414
612.379.9233 Fax 612.379.9263
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@CoprrWIl 200t
~ Boe GASES
MA TER/At SAFETY DA TA SHEET
I PRODUCT NAME: OXYGEN
1. Chemical Product and Company Identification
BOC Gases,
Division of
The BOC Group, Inc.
575 Mountain Avenue
Murray Hill, NJ 07974
BOC Gases
Division of
BOC Canada Limited
5975 Falbourne Street, Unit 2
Mississauga, Ontario L5R 3W6
TELEPHONE NUMBER: (908) 464-8100
24-HOUR EMERGENCY TELEPHONE NUMBER:
CHEMTREC (800) 424-9300
TELEPHONE NUMBER: (905) 501-1700
24-HOUR EMERGENCY TELEPHONE NUMBER:
(905) 501-0802
EMERGENCY RESPONSE PLAN NO: 20101
PRODUCT NAME: OXYGEN
CHEMICAL NAME: Oxygen
COMMON NAMES/SYNONYMS: None
TDG (Canada) CLASSIFICATION: 2.2 (5.1)
WHMIS CLASSIFICATION: A, C
PREPARED BY: Loss Control (908)464-8100/(905)501-1700
PREPARATION DATE: 611/95
REVIEW DATES: 6/7/96
2. Composition, Information on Ingredients
INGREDIENT % VOLUME PEL..QSHA' TLV-ACGIH' LDso or LC50
RoutelSDecles
Oxygen 99.6 to 100.0 Not Available Not Available Not Available
FORMULA: 02
CAS: 7782-44-7
RTECS #: RS2060000
I AB stated in 29 CFR 1910, Subpart Z (revised July I, 1993)
2 AB stated in the ACGlH 1994-95 Threshold Limit Values for Chemical Substances and Physical Agents
3. Hazards Identification
EMERGENCY OVERVIEW
Elevated oxygen levels may result in cough and other pulmonary changes. High concentrations of
oxygen (greater than 75%) causes symptoms of hyperoxia which included cramps, nausea, dizziness,
hypothermia, ambylopia, respiration difficulties, bradycardia, fainting spells and convulsions capable of
leading to death. Nonflammable. Oxidizer, will accelerate combustion.
ROUTE OF ENTRY:
Skin Contact
No
Skin Absorption
No
Eye Contact
No
Inhalation
Yes
Ingestion
No
MSDS: G-l
Revised: 617/96
Page 1 of 6
I PRODUCT NAME: OXYGEN
HEALTH EFFECTS:
Exposure Limits Irritant Sensitization
No No No
Teratogen Reproductive Hazard Mutagen
No No Yes
Synergistic Effects
None known
Carcinogenicity: -- NTP: No lARC: No OSHA: No
EYE EFFECTS:
Adverse effects not anticipated.
SKIN EFFECTS:
Adverse effects not anticipated.
INGESTION EFFECTS:
Adverse effects not anticipated.
INHALATION EFFECTS:
High concentrations of oxygen (greater than 75%) causes symptoms ofhyperoxia which included cramps,
nausea, dizziness, hypothennia, ambylopia, respiration difficulties, bradycardia, fainting spells and convulsions
capable ofleading to death. The property is that ofhyperoxia which leads to pneumonia. Concentrations
between 25 and 75% present a risk of inflammation of organic matter in the body.
Oxygen concentrations between 20 to 95% have produced genetic changes in mammalian cell assay test systems.
NFPA HAZARD CODES
HMIS HAZARD CODES
RATINGS SYSTEM
Health: 0
Flammability: 0
Reactivity: 0
Health: 0
Flammability: 0
Reactivity: 0
0= No Hazard
1 = Slight Hazard
2 = Moderate Hazard
3 = Serious Hazard
4 = Severe Hazard
4. First Aid Measures
EYES:
Never introduce ointment or oil into the eyes without medical advice. If pain is present, refer the victim to an
ophthalmologist for treatment and follow up.
SKIN:
Remove contaminated clothing and flush affected areas with lukewann water. If irritation persists, seek medical
attention.
INGESTION:
Ingestion is not anticipated.
MSDS: G-I
Revised: 6/7/96
Page 2 of6
I PRODUCT NAME: OXYGEN
INHALATION:
PROMPT MEDICAL ATTENTION IS MANDATORY IN ALL CASES OF OVEREXPOSURE TO
OXYGEN. RESCUE PERSONNEL SHOULD BE EQUIPPED WITH SELF-CONTAINED BREATHING
APP ARA TUS. Conscious persons should be assisted to an uncontaminated area and inhale fresh air. Quick
removal from the contaminated area is most important. Further treatment should be symptomatic and
supportive. Inform the treating physician that the patient could be experiencing hyperoxia.
5. Fire Fighting Measures
Conditions of Flammabili
Flash point:
None
LEL % : None
Hazardous combustion roducts: None
Sensitivi to mechanical shock: None
Sensitivi to static dischar e: None
None
FIRE AND EXPLOSION HAZARDS:
High oxygen concentrations vigorously accelerate combustion.
EXTINGUISHING MEDIA:
Water spray to keep cylinders cool. Extinguishing agent appropriate for the combustible material.
FIRE FIGHTING INSTRUCTIONS:
If possible, stop the flow of oxygen which is supporting the fire.
6. Accidental Release Measures
Evacuate all personnel from affected area. Use appropriate protective equipment. Ifleak is in user's equipment,
be certain to purge piping with inert gas prior to attempting repairs. If leak is in container or container valve,
contact the appropriate emergency telephone number listed in Section I or call your closest ROC location.
7. Handling and Storage
Electrical classification:
Nonhazardous
Dry product is noncorrosive and may be used with all materials of construction. Moisture causes metal oxides
which are formed with air to be hydrated so that they include volume and lose their protective role (rust
formation). Concentrations ofS02, C12, salt, etc. in the moisture enhances the rusting of metals in air.
Carbon steels and low alloy steels are acceptable for use at lower pressures.
For high pressure applications stainless steels are acceptable as are copper and its alloys, nickel and its alloys,
brass bronze, silicon alloys, Monel @, Inconel @ and beryllium. Lead and silver or lead tin alloys are good
gasket materials. Teflon @, Teflon @ composites, or Kel-F @ are preferred non-metallic gasket materials.
Check with the supplier to verifY oxygen compatibility for the service conditions.
Oxygen should not be used as a substitute for compressed air in pneumatic equipment since this type generally
contains flammable lubricants.
MSDS: G-I
Revised: 6/7/96
Page 3 of6
I PRODUCT NAME: OXYGEN
Stationary customer site vessels should operate in accordance with the manufacturer's and BOC's instruction.
Do not attempt to repair, adjust or in any other way modify the operation of these vessels. If there is a
malfunction or other type of operations problem with the vessel, contact the closest BOC location immediately.
Valve protection caps must remain in place unless container is secured with valve outlet piped to use point. Do
not drag, slide or roll cylinders. Use a suitable hand truck for cylinder movement. Use a pressure reducing
regulator when connecting cylinder to lower pressure (<3000 psig) piping or systems. Do not heat cylinder by
any means to increase the discharge rate of product from the cylinder. Use a check valve or trap in the discharge
line to prevent hazardous back flow into the system.
Protect cylinders from physical damage. Store in cool, dry, well-ventilated area away from heavily trafficked
areas and emergency exits. Do not allow the temperature where cylinders are stored to exceed 130"F (540C).
Cylinders should be stored upright and finnly secured to prevent falling or being knocked over. Full and empty
cylinders should be segregated. Use a "first in-first out" inventory system to prevent full cylinders being stored
for excessive periods of time. Post "NO SMOKING OR OPEN FLAMES" signs in the storage area or use area.
There should be no sources of ignition in the storage or use area.
For additional storage recommendations, consult Compressed Gas Association's Pamphlets pol, P-14 and Safety
Bulletin SB-2.
Never carry a compressed gas cylinder or a container of a gas in cryogenic liquid fonn in an enclosed space such
as a car trunk, van or station wagon. A leak can result in a fire, explosion, asphyxiation or a toxic exposure.
8. Exposure Controls, Personal Protection
EXPOSURE LIMITS t:
INGREDIENT % VOLUME PEL.QSHA2 TLV-ACGIW LD50 or LC50
Route/SDecles
Oxygen 99.6 to 100.0 Not Available Not Available Not Available
FORMULA: 02
CAS: 7782-44-7
RTECS #: RS2060000
I Refer to individual state of provincial regulations, as applicable, for limits which may be more stringent than
those listed here.
2 As stated in 29 CFR 1910, Subpart Z (revised July 1, 1993)
3 As stated in the ACGIH 1994-1995 Threshold Limit Values for Chemical Substances and Physical Agents.
ENGINEERING CONTROLS:
Use local exhaust to prevent accumulation of high concentrations that increase the oxygen level in air to more
than 25%.
EYEIFACE PROTECTION:
Safety goggles or glasses as appropriate for the job.
SKIN PROTECTION:
Protective gloves made of any suitable material appropriate for the job.
OTHER/GENERAL PROTECTION:
Safety shoes, safety shower.
MSDS: G-I
Revised: 6/7/96
Page 4 of6
I PRODUCT NAME: OXYGEN
9. Physical and Chemical Properties
PARAMETER
Physical state (gas, liquid, solid)
Vapor pressure
Vapor density (Air = 1)
Evaporation point
Boiling point
VALUE UNITS
: Gas
: Above critical temp.
: 1.11
: Not Available
: -297.3 "F
: -182.9 oC
: -361.8 "F
: -218.8 oC
: Not Applicable
: Not Available
: Not Available
: Slightly soluble
: Not Applicable
: Colorless, odorless gas
Freezing point
pH
Specific gravity at SIP
Oil/water partition coefficient
Solubility (H20)
Odor threshold
Odor and appearance
10. Stability and Reactivity
ST ABILITY:
Stable.
INCOMPATIBLE MATERIALS:
AlI flammable materials.
HAZARDOUS DECOMPOSITION PRODUCTS:
None.
HAZARDOUS POLYMERIZATION:
WilI not occur.
11. Toxicological Information
MUTAGENIC:
Oxygen concentrations between 20 to 95% have produced genetic changes in mammalian celI assay test systems.
12. Ecological Information
No data given.
13. Disposal Considerations
Do not attempt to dispose of residual waste or unused quantities. Return in the shipping container PROPERLY
LABELED, WITH ANY VALVE OUTLET PLUGS OR CAPS SECURED AND VALVE PROTECTION CAP
IN PLACE to BOC Gases or authorized distributor for proper disposal.
MSDS: G-l
Revised: 6/7/96
Page 5 of6
I PRODUCT NAME: OXYGEN
14. Transport Information
PARAMETER United States DOT Canada TOG
PROPER SHIPPING NAME: Oxygen, compressed Oxygen, compressed
HAZARD CLASS: 2.2 2.2 (5.1)
IDENTIFICATION NUMBER: UN 1072 UN 1072
SHIPPING LABEL: NONFLAMMABLE GAS, OXIDIZER NONFLAMMABLE GAS, OXIDIZER
15. Regulatory Information
SARA TITLE III NOTIFICATIONS AND INFORMATION
SARA TITLE II1- HAZARD CLASSES:
Fire Hazard
Sudden Release of Pressure Hazard
16. Other Information
Compressed gas cylinders shan not be refined without the express written permission of the owner. Shipment of
a compressed gas cylinder which has not been fined by the owner or with his/her (written) consent is a
violation of transportation regulations.
DISCLAIMER OF EXPRESSED AND IMPLIED WARRANTIES:
Although reasonable care has been taken in the preparation of this document, we extend no warranties and make
no representations as to the accuracy or completeness of the information contained herein, and assume no
responsibility regarding the suitability of this information for the user's intended purposes or for the
consequences of its use. Each individual should make a determination as to the suitability of the information for
their particular purpose(s).
MSDS: 0-1
Revised: 6/7/96
Page 6 of6
~ Boe GASES
MATERIAL SAFETY DATA SHEET
I PRODUCT NAME: NITROUS OXIDE
1. Chemical Product and Company Identification
BOC Gases,
Division of
The BOC Group, Inc.
575 Mountain Avenue
Murray Hill, NJ 07974
BOC Gases
Division of
BOC Canada Limited
5975 Falbourne Street, Unit 2
Mississauga, Ontario L5R 3W6
TELEPHONE NUMBER: (905) 501-1700
TELEPHONE NUMBER: (908) 464-8100
24-HOUR EMERGENCY TELEPHONE NUMBER:
CHEMTREC (800) 424-9300
24-HOUR EMERGENCY TELEPHONE NUMBER:
(905) 501-0802
EMERGENCY RESPONSE PLAN NO: 20101
PRODUCT NAME: NITROUS OXIDE
CHEMICAL NAME: Nitrous Oxide
COMMON NAMES/SYNONYMS: Din
Anhydride
TDG (Canada) CLASSIFICATION: 2.
WHMIS CLASSIFICATION: A, C, D1
INGREDIENT
PREPARED BY: Loss Control (908)464
PREPARATION DATE: 6/1195
REVIEW DATES: 617/96
2. Composition, Information
Nitrous Oxide
FORMULA: N20
CAS: 10024-97-2
RTECS #: QX1350000
I As statcd in 29 CFR 1910, Subpart Z (rcvised July
2 As statcd in thc ACGIH 1994-95 Threshold Limit
3. Hazards Identification
EMERGENCY OVERVIEW
Anesthetic effects at high concentrations. Asphyxia by exclusion of oxygen. Reproductive Hazard.
Nonflammable. Oxidizer. May accelerate combustion of other materials.
MSDS: G-3
Revised: 617/96
Page 1 of 7
I PRODUCT NAME: NITROUS OXIDE
ROUTE OF ENTRY:
Skin Contact
Yes
Skin Absorption
No
Eye Contact
Yes
Inhalation
Yes
Ingestion
No
HEALTH EFFECTS:
Exposure Limits Irritant Sensitization
Yes No No
Teratogen Reproductive Hazard Mutagen
Yes Yes Yes
Synergistic Effects
Other agents that depress the central nervous svstem
Carcinogenicity: -- NTP: No IARC: No OSHA: No
EYE EFFECTS:
Adverse effects not anticipated.
SKIN EFFECTS:
Adverse effects not anticipated.
INGESTION EFFECTS:
None known. Ingestion is unlikely.
INHALATION EFFECTS:
High concentrations may cause deep breathing, dizziness, nausea and eventual unconsciousness due to
inadequate oxygen supply. Anesthetic effects may occur when mixed with oxygen at a ratio of 80% nitrous
oxide to 20% oxygen. Laughter effects seem to occur after incipient asphyxia accompanied by the sudden return
of oxygen as in air. Nitrous oxide is a slight narcotic, but lacks substantial toxicity. Asphyxia will occur due to
oxygen exclusion. Maintain oxygen levels above 19.5% at sea level.
Chronic effects of overexposure may include reproductive effects.
NFPA HAZARD CODES
HMIS HAZARD CODES
RA TINGS SYSTEM
Health: 2
Flammability: 0
Reactivity: 0
Health: 2
Flammability: 0
Reactivity: 0
0= No Hazard
1 = Slight Hazard
2 = Moderate Hazard
3 = Serious Hazard
4 = Severe Hazard
4. First Aid Measures
EYES:
Never introduce ointment or oil into the eyes without medical advice! Ifpain is present, refer the victim to an
opthalmologist for treatment and follow up.
MSDS: G-3
Revised: 6/7/96
Page 2 of 7
I PRODUCT NAME: NITROUS OXIDE
SKIN:
No adverse effects anticipated.
INGESTION:
None required.
INHALATION:
PROMPT MEDICAL ATTENTION IS MANDATORY IN ALL CASES OF OVEREXPOSURE TO
NITROUS OXIDE. RESCUE PERSONNEL SHOULD BE EQUIPPED WITH SELF-CONTAINED
BREATHING APPARATUS. Conscious persons should be assisted to an uncontaminated area and inhale fresh
air. Quick removal from the contaminated area is most important. Unconscious persons should be moved to an
uncontaminated area, given artificial resuscitation and supplemental oxygen. Further treatment should be
symptomatic and supportive.
5. Fire Fighting Measures
Conditions ofFlammabili
Flash point:
None
LEL(%): None
Hazardous combustion roducts: None
Sensitivi to mechanical shock: None
Sensitivi to static dischar e: None
None
FIRE AND EXPLOSION HAZARDS:
Nonflammable. May decompose violently at temperatures above lll2"F (600oC).
EXTINGUISHING MEDIA:
Use extinguishing media suitable for the combustible materials involved in the fire.
FIRE FIGHTING INSTRUCTIONS:
None required. Use media suitable for surrounding fire.
6. Accidental Release Measures
Evacuate all personnel from affected area. Use appropriate protective equipment. Ifleak is in user's equipment,
be certain to purge piping with inert gas prior to attempting repairs. If leak is in container or container valve,
contact the appropriate emergency telephone number listed in Section I or call your closest BOC location.
7. Handling and Storage
Use only in well-ventilated areas. Do not drag, slide or roll cylinders. Use a suitable hand truck for cylinder
movement. Do not heat cylinder by any means to increase the discharge rate of product from the container. Use
a check valve or trap in the discharge line to prevent hazardous back flow into the container.
MSDS: G-3
Revised: 6/7/96
Page 3 of 7
I PRODUCT NAME: NITROUS OXIDE
For additional recommendations, consult Compressed Gas Association's Pamphlet P-I.
Protect containers from physical damage. Store in cool, dry, well-ventilated area of non-combustible
construction away from heavily trafficked areas and emergency exits. Do not allow the temperatures where
containers are stored to exceed 1300F (540C). Containers should be stored upright and firmly secured to prevent
falling or being knocked over. Full and empty cylinders should be segregated. Use "first in-first out" inventory
system to prevent full containers being stored for excessive periods of time.
8. Exposure Controls, Personal Protection
EXPOSURE LIMITS':
INGREDIENT 0/0 VOLUME PEL-oSHA' TLV-ACGIW LD50 or LC50
Route/Species
Nitrous Oxide 98.0 to 99.995 Not Available 50 ppm TWA lCso
FORMULA N20 160 mg/m3/6H
CAS: 10024-97-2 (rat)
RTECS #: QX1350000
I Refer to individual state of provincial regulations, as applicable, for limits which may be more stringent than
those listed herc.
2 As stated in 29 CFR 19\0, Subpart Z (revised July I, 1993)
3 As stated in the ACGlH 1994-1995 Thrcshold Limit Values for Chemical Substances and Physical Agents.
ENGINEERING CONTROLS:
Use local exhaust to prevent accumulation of high concentrations that may reduce the oxygen level in the air to
less than 19.5%.
EYE/F ACE PROTECTION:
Chemical safety goggles or safety glasses. Do not wear contact lenses.
SKIN PROTECTION:
Use protective gloves; any material suitable to the use situation.
RESPIRATORY PROTECTION:
Self-contained breathing appamtus should be available for emergency use.
OTHER/GENERAL PROTECTION:
Safety shoes, safety shower.
MSDS: 0-3
Revised: 6/7/96
Page 4 of 7
I PRODUCT NAME: NITROUS OXIDE
9. Physical and Chemical Properties
PARAMETER
Physical state (gas, liquid, solid)
Vapor pressure at 200C
Vapor density (Air = 1)
Evaporation point
Boiling point
VALUE UNITS
Gas
: 736. psig
: 1.529
: Not Available
-127.2 "F
-88.47 oC
-131.5 "F
-90.81 oC
: Not Applicable
: 1.227
: Not Available
: Slightly Soluble
: Not Available
Colorless gas, slightly sweet taste and odor.
Liquid appears similar to water.
Freezing point
pH
Specific gravity at boiling
Oil/water partition coefficient
Solubility (H20)
Odor threshold
Odor and appearance
10. Stability and Reactivity
ST ABILITY:
Stable
INCOMPATIBLE MATERIALS
All flammable materials. Nitrous oxide will serve as the oxidant for most flammable materials. Some
flammables will have a lower flammable limit in nitrous oxide than in pure oxygen. Powerful reducing agents
will react violently.
HAZARDOUS DECOMPOSITION PRODUCTS:
At elevated temperatures. Nitrous oxide decomposes into nitrogen and oxygen, the rate of decomposition being
appreciable at about 11120F (600oC). Nitrous oxide exposed to fire or other intense heat source may decompose
violently.
HAZARDOUS POLYMERIZATION:
Will not occur.
11. Toxicological Information
REPRODUCTIVE:
Reproductive toxicity has been observed in experimental animals exposed at concentrations in excess of the
current TLV. These toxic effects include:
Toxic effects to newborn rats after exposure of pregnant female to 50,000 ppm for 4 hours.
Toxic effects to testes, epididymis, sperm duct in male rat following exposures of 200,000 ppm for 8 hours.
Effects on embryo and fetus in exposed rats. Teratogenic effects observed in other mammalian species.
MUT AGENIC:
MSDS: G-3
Revised: 6/7/96
Page 5 of 7
I PRODUCT NAME: NITROUS OXIDE
Effects on genetic material have been observed in human, mammalian and insect mutation test systems exposed
at concentrations of 50,000 ppm or greater.
OTHER:
Blood changes, including changes in erythrocite and leukocyte count, have been reported in experimental rats
and mice exposed at near the current TLV (50 ppm). Changes in body and liver weight have been reported.
12. Ecological Information
No data given.
13. Disposal Considerations
Do not attempt to dispose of residual waste or unused quantities. Return in the shipping container PROPERLY
LABELED, WITH ANY VALVE OUTLET PLUGS OR CAPS SECURED AND VALVE PROTECTION CAP
IN PLACE to BOC Gases or authorized distributor for proper disposal.
14. Transport Information
PARAMETER United States DOT Canada TOG
PROPER SHIPPING NAME: Nitrous Oxide, compressed Nitrous Oxide, compressed
HAZARD CLASS: 2.2 2.2 (5.1)
IDENTIFICATION NUMBER: UN 1070 UN 1070
SHIPPING LABEL: NONFLAMMABLE GAS, OXIDIZER NONFLAMMABLE GAS, OXIDIZER
15. Regulatory Information
SARA TITLE III NOTIFICATIONS AND INFORMATION
SARA TITLE III - HAZARD CLASSES:
Acute Health Hazard
Fire Hazard
Reactivity Hazard
16. Other Information
Compressed gas cylinders shall not be refilled without the express written permission of the owner. Shipment of
a compressed gas cylinder which has not been filled by the owner or with his/her (written) consent is a
violation of transportation regulations.
MSDS: G-3
Revised: 6/7/96
Page 6 of 7
I PRODUCT NAME: NITROUS OXIDE
DISCLAIMER OF EXPRESSED AND IMPLIED WARRANTIES:
Although reasonable care has been taken in the preparation of this document, we extend no warranties and make
no representations as to the accuracy or completeness of the information contained herein, and assume no
responsibility regarding the suitability of this information for the user's intended purposes or for the
consequences of its use. Each individual should make a determination as to the suitability ofthe information for
their particular purpose(s).
MSDS: 0-3
Revised: 6/7/96
Page 7 of 7
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS (CowiG) ~)f-t-U\f.~_ I.... "'"leo
NATURE OF WORK l/L:- A f2- _ __
USE OF BUILDING +E:-NA ~ \ l
PERMIT NO. O. 00 & DATE ISSUED
CONTRACTOR V A ~ K.tIJlC~\\cJt\J PHONE I - L~ 3>
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~
~or to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
,....
-,-
/
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
1
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I S'P(L1N KL~ I I
FINALS
r ' '_'_
_ __ .:1
BUILOING
ELECTRICAL
PLUMBING
HEATING
DO NOT
t,X..
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850