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1. Give a brief description of the way(s) in which the carcinogen or carcinogen containing products). <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 carcinogens)are used if different from address given below. <br /> Refer to letter. <br /> 4. Other identifying information of each carcinogen in use or present,such as trade names or synonyms, <br /> if known. <br /> Refer to letter. <br /> S. The number of employees in areas where carcinogens are used 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 establishment. <br /> Refer to letter, <br /> 7. The manner in which a carcinogen is present in a place of employ merrt; e.g.. whether.it is man- <br /> ufactured.processed.used, repackaged,released.stored,or otherwise handled <br /> Refer to letter. <br /> S. The name and address of the union bargaining repreaentative(s), if any, of the employees who may <br /> . be exposed to the carcinogens. <br /> Refer to letter. <br /> 9. Nature of business. n <br /> I dtcat9e the industry and the principal products}, line of trade, seance or <br /> other activity. (Examples: General Contractors, Single Family Houses; Chemical Manufacturing, <br /> Paints and Varnishes;etc.) <br /> Refer to letter. <br /> I0. 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 /> Name and Title of Registrant (PI ase Printf 0 Date <br /> -- -Car.oratf on _X Cheek if operations involve <br />�. Company ' <br /> temporary jobsites. <br /> ` 23456 Hawthorne Blvd. , #220* Torrance, CA 90505 <br /> Address <br /> Zip Code <br /> 49213 378-9933 <br /> Signature <br /> Telephone Number <br /> This registration or any change in the registration information shall be reported in writing within 15 <br /> (10 for EDS) calendar days of such changes to: Chief. Division of Occupational Safety and Health. <br /> S25 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 IS USED. SEE SEC. 24ni <br /> OF THE HEALTH AND SAFETY CODE.1 <br /> CAL'OSHA IR3 <br />