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Attachment 1 <br /> y <br /> $IAif OF CALIFORNIA George Deukmejian, Governor <br /> DfFARI1AfNI OF INDUSTRIAL RELATIONS <br /> DIVISION Of OCCUPATIONAL SAFETY AND <br /> HEALTH ADMINISTRATION <br /> %,'S GOLDEN GATE AVENUE <br /> .aN FRANCISCO ADDRESS REPLY To- <br /> P-0 Box 8123 <br /> SAM FRAHMSCO. CALIF IN 101 <br /> CARCINOGEN REGISTRATION FORM <br /> I <br />' Dear Sir: <br /> This letter may serve as a registration for carcinogen use in accordance with Title 8,Califomia Administrative Code, <br /> Sections Ras listed below), indicating use of the following carcinogens}. Check the substances that are used in your <br /> workplace, or potentially muld be handled, in an IT workplace. <br /> 5208 5210 <br /> .X. Asbestos y Vinyl chloride <br /> 5209 5211 <br /> X 2 — acetylaminofluorene <br /> Coke oven emissions <br /> X 4 — aminodiphenyl 5272 <br /> X Benzidine and its salts X i, 2 —dibromo—3 — chloropropane DBCP <br /> X Bis (chloromethyl) ether 5213 <br /> X ' <br /> 3, 3' — dichlorobenzidine and its sales .,X Acrylonitrile <br /> X 4 — dimethylaminoazobenzene 5214 <br /> X X <br /> Beta — naphthylamine Inorganic arsenic <br /> X <br /> _ N-nitrosodimethylamine 5215 <br /> X X <br /> Beta-propiolactone 4, 4' — Methylene bis (2 Chloroaniline) MSOCA <br /> X .. Methyl chloromethyl ether 5219 <br /> X Alpha-naphthylamine X Ethylene dibromide (EDB) <br /> X Ethyleneimine <br /> 5220 <br /> 4 -- Nitrobiphenyl X <br /> Ethylene Oxide (Et0) <br /> Other: <br /> Continued on reverse side. CAL/OSHA 183 <br /> . AD►r1 1985 <br />