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' 1. Give a brief description of the way(s) in which the carcinogen or carcinogen containing product(s) <br /> are processed, handled. used.or transported. <br /> See attached. <br /> 2. Give the in-plant.location(s)where carcinogen(s) are used. <br />' 3. Give the address of each area where carcinogen(s)are used if different from address given below. <br /> Refer to letter. <br /> 4. Other identifying information of each c2rcin0gen in use or prss+el such as trade names or synonyms, <br />' if known. <br /> Refer to letter. <br /> S. The number of employees in areas where carcinogens are tined or present during any operation <br /> including maintenance activities. <br /> See Attachment 2. <br /> 6. The total number of employees including office personnel at this establishnrxro <br />' Refer to letter. <br /> 7. The manner in which a carcinogen is present in a place of employment; e.g., whether.it is num- <br /> ufactured,processed,used. repackaged+released.stared,or otherwise handled. <br />' Refer to letter. <br /> B. The name and address of the union bargaining representative(s)~ if any, of the employees who rttay <br /> be exposed to the carcinogens. <br /> Refer to letter. <br /> 9. Nature of business. Indicate the industry and the <br /> principal product(s), Itrse of trade. service or <br /> Other activity. (Examples: General Contractors. Single Family Houses; Chemical Manufacturing. <br /> Paints and Varnishes;etc.) <br /> Refer to letter. <br /> 10. For any of the carcinogens listed under Sections 5209. 5210.5212.5213.-5214. 5215. 5219 and 5220 <br /> (see front page)include the quantity of the carcinogen used(or the quantity of the product for which the <br /> content of the carcinogen is unknown)and an estimate of the frequency of employee exposure. <br /> Refer to letter. <br /> Please type or print: <br /> 4M - <br /> Name and Title of Registrant (p print) Date <br /> Comte V'corgwration Check H operations involve <br /> temporary jobsites. <br /> _ 23456 Hawthorne Blvd. , 0220, Torrance, CA 90505 <br /> Address Zip Code <br /> _.�•_ __ 213 378-9933 <br /> Signature <br /> 009" Telephone Number <br /> This registration or any change in the registration information shall be reported in writing within 15 <br /> (10 for EDB) calendar days of such changes to: Chief. Division of Occupational Safety and Health. <br /> 525 Golden Gate Avenue.Third Floor.San Francisco.CA 94102.as referenced in the Title 8.California <br /> Administrative Code Sections cited above. <br /> (POST A COPY OF THIS REPORT IN A CONSPICUOUS PLACE WHERE CARCINOGEN 88 USED. SEE SEC. 24221 <br /> OF THE HEALTH AND SAFETY CODE.) <br /> CAL'OSMA 1R3 <br />