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Dated: November 11,1976 WILLIAM FODOR, 354 Summit Ave., Perth Amboy,N.J.08861 Dr.Jerome P.Flesch, c/o National Institute of Occupational Safety & Health, Robert A.Taft Laboratories 4676 Columbia Parkway, Cincinnati,Ohio 45226 Dear Dr.Flesch: I am enclosing herein an original and copy of request for a health hazard evaluation'as provided by the U.S. Department of Health, Education and Welfare, National Institute for Occupational Safety and Health. This request is being made for an evaluation of the Amboy Terminaling plant as set forth in the form which is com pleted herein. I would appreciate your promptness in making this evalua tion both retrospective and prospective. You will notice that I making this application as the Chief Shop Steward as well as the President of the Union Local 825. Very.truly yours, Enc william Fodor ucc 075272 The HEALTH HAZARD EVALUATION PROGRAM of the NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH ?#rr'. UCC 075273 r.- Published by the Division of Technical Services National Institute for Occupational Safety and Health Center for Disease Control Public Health Service Department of Health, Education, and Welfare UCC 075274 INTRODUCTION Section 20(a)(6) of the Occupational Safety and Health Act of 1970 charges the Department of Health, Education, and Welfare with the responsibility for evaluating the potential toxicity of materials used or found in the workplace, upon receipt of written requests by employers and employee representatives. HEW's National Institute for Occupational Safety and Health fNIOSH) is the agency which pro vides these on-site toxicity determinations. While these activities are the responsibility of the Division of Technical Services, sev eral other Institute Divisions and programs contribute at various stages to the overall program. Coordination of on-site toxicity determinations are handled by the Division of Technical Services* Hazard Evaluation Services Branch in Cincinnati and supported by regional industrial hygienists. This hazard evaluation service is provided at no cost to the requesters. This little pamphlet is comprised of four documents which will add to your understanding of the hazard evaluation service: (1) high lights of NIOSH's health hazard evaluation program, (2) a press release summary of the final regulations governing the program, (3) a copy of the published regulations themselves, reprinted from the Federal Register, and (4) a copy of the request form - to be used by employers and employee representatives in initiating requests for hazard evaluations. The request form is available in quantity from any NIOSH location. For additional information concerning this highly important service, please feel free to contact me at the address below. Other general information about the work of the National Institute for Occupational Safety and Health may be obtained from: NIOSH, Office of Technical Publications, Room 3-10, 5600 Fishers Lane, Rockville, Maryland 20852. Marshall E. LaNier, Director Division of Technical Services National Institute for Occupational Safety and Health Post Office Building, Room 506 Cincinnati, Ohio 45202 HIGHLIGHTS OF NIOSH'S HEALTH HAZARD EVALUATION PROGRAM The Hazard Evaluation Services Branch, one of five branches within NIOSH*s Division of Technical Services, provides direct response to requests for toxicity determinations in the workplace as required by Section 20(a)(6) of the Occupational Safety and Health Act of 1970. Final regulations of NIOSH*s Health Hazard Evaluation Program, as it has come to be known, have been published in the Federal Register and give detailed requirements and operational procedures of the program. However, as an example of typical program procedures followed by NIOSH, the following highlights of-a hypothetical request are presented here: Having received a completed Request for Health Hazard Evaluation form from an employer or authorized representative of employees regarding alleged hazardous exposure to a potentially toxic substance in the workplace, the central Branch office in Cincinnati records, validates and researches the toxic substances identified on the request. The request, along with the packet of technical information, is sent to a NIOSH regional industrial hygienist who then contacts plant management and employee representatives to schedule an initial field visit. Employee representatives requesting such evaluations may have their names held confidential if they so desire. An observational survey of the workplace is conducted with these representatives to elucidate the extent of the problem and to determine the number and type of environmental samples to be collected. Employee interviews are conducted to identify adverse symptomatology experienced by the workers. Findings from the survey are reported to headquarters and a strategy developed for the environmental-medical evaluation. Sampling, analytical, and medical tests are derived and conducted by NIOSH to determine the concentration of substances found and the potentially toxic effects to affected employees. Study results are assessed, and a final determination made. Affected employees are notified of the determination. A full report of the study including recommendations for controlling observed hazards, if appropriate, is sent to the employer; representative of employees; and the U.S. Department of Labor. Health Hazard Evaluation Reports will be utilized in developing new standards where toxic substances are found but for which no standards exist. Information dervied from health hazard evaluations will also be used in assessment of the validity of existing standards. Jerome P. Flesch Chief, Hazard Evaluation Services Branch UCC 07527* Final Regulations The NIOSH Health Hazard Evaluation Program Title 42--PUBLIC HEALTH Choptr l--Public Htolth Service, De portment el Health, Education, and Welfare VJECHAATER G--OCCUPATIONAL SAFETY AND HEALTH tfSEARCH ANO RELATED ACTIVITIiS PAkT 35--REQUESTS FOR HEALTH HAZARD EVALUATIONS On March IT, 1972, a notice of pro posed rule making was published In the Fcsknal Rkcxstza <37 F.R. 53341 which prescribed the conditions and procedures for conducting health hazard evaluations pursuant to section 20(a) (6) of the Oc cupational Safety and Health Act of 1970 (29 US.C. 669(a)(6>>. That sec tion directs the Secretary of Health, Education, and Welfare to determine, following a written request by any em ployer or authorized representative of employees, whether any substance nor mally found hi a place of employment has potentially toxjc effects in such concen trations as used or found and further provides that such determinations shall be submitted to the appropriate employer and affected employees. Interested persons were Invited to sub mit. within 30 days, written comments, suggestions, or objections regarding tha proposed regulations. In addition, on June 20. 1972. the pronosed regulations and the issues raised by the public comments concerning them were discussed with the National Ad visory Committee on Occupational Safe ty and Health established by section 7 of the Occupational Safety and Health Act. All public comments, as well as the views expressed by the members of the Committee, have been taken Into con sideration with the result that a number FfOftAl REGISTER, VOL 37, NO. 21S--TUESDAY, NOVIMM* 7, 1973 UCC 075277 23640 RULES AND REGULATIONS of chances, as discussed below, have been revealed that failure to give advance during the initial physical inspection of made in the regulations which were pro notice can interfere with a thorough and the workplace Since NIOSH experience posed. All comments in response to the effective plant visit and thus impede the in the conduct of this program Indicate* rul as proposed and the transcript of health hazard evaluation. The very that visits subsequent to the initial In the Committee proceedings on June 20 process to which the request Ls directed spection are principally for the purpose t are available for public Inspection at the may not be in operation on the day of of environmental sampling and medical National Institute for Occupational the visit and the problem becomes even examinations, the presence of the repre Safety and Health. Room 10-43. 3300 more serious when the place of employ sentative of employees win not be Fishers Lane. Rockville. MD. ment is not readily accessible. Further routinely requested during these aspects 1. Applicability. A statement has been more. the employer and. in the case of of the Investigation. added to the applicability section to employee requests, the employees may 8. /mminenf dancers. In response to indicate that Part 85 is not intended to preclude the use of other channels of communication with the National In stitute for Occupational Safety and Health <NIOSH> to obtain information and assistance concerning toxic sub stances. 2. DeAntfions. Definitions of the terms "investigation'' and "health hazard eval uation" have been added and these terms have been used throughout Part 85 in an effort to distinguish the physi cal inspection of a place of employment wish to have a particular representative accompany the NIOSH officer The sur prise visit would conflict with this de sire. The Institute, after considering all comments on this matter, has concluded that the evil which this surprise visit Is. intended to avoid--the misrepresentation of artu-il production conditions--can be avoided by exercise of the authority under section 8 to conduct private Inter views with appropriate employees. Thus, the institute's decision to give employers advance notice must be read In the light a number of comments, the term "serious hazard" has been deleted and the statu tory phrase "imminent danger" has been substituted therefor. 9. Nolt/Icofion of determination to employers, affected employees and De partment of Labor. The method of noti fying affected employees of the determi nation was the subject of a substantial number of comments. Section 85.11 re quires that the employer post a copy of the determination at or near the work places of the affected employees. How by NIOSH In conducting a health hazard of the authority bf NIOSH to question ever, no posting is required if the em evaluation, from the compliance inspec employees privately. ployer requests NIOSH to mall copies tion conducted by the Department of Accordingly, the section on advance to the affected employees and furnishes Labor. The definition of "toxic effects" notice < s 85 8 has been completely re the Institute with a list of the names and has been revised to exclude those which vised to provide that advance notices of mailing addresses of the employees de produce acute discomfort. visits to the place of employment may be termined by NIOSH to be exposed to the 3. Procedures lor requesting evalua given to expedite a thorough and effective substance which Is the subject of the tions. The main thrust of the comments investigation. Advance notice will not be health hazard evaluation. * on the procedures for requesting evalua tions went to the question of who should be considered an "authorized represent ative of employees". The comments given when, in the judgment of the NlO^ff officer, civmg such notice would adversely affect the validity and effec tiveness of an investigation. In the case Effective date. These regulations shall be effective 30 days after their publica tion in the Fcdsnal Rzoistbx. ranged from a suggestion that any In of employee requests, advance notice will Dated: October 10,1972. dividual employee should be allowed to make the request, to the contention that the authorized representatives should be limited to those who represent the em ployees for puriHises of collective bar t>c given by the Institute to the requester, the representative of the employees for purpores of collective bargaining If such representative is other than the re quester. and to the employer. Where the Vendor* El Wilson, Administrator, Health- Services and Menial Health Adminis tration. gaining. The final regulations provide request is from the employer, advance Approved: October 30.1972. that an authorized representative may be either: <1> A representative for pur poses of collective bargaining: <2) an notice will be given to such employer and. uputi the request of the employer, to an authorized representative of em Elliot L. Richaudson, Secretary. See. *1 employee of the employer who has writ ployees as 1 Applicability. ten authorization from two or more em G, Conduct of investigations. The S5 3 Definition*. ployees employed in the work place major change in section 85.7 concerns 853 Procedures for requesting beaita where the substume is normally found, to represent thetn for purj>oses of the Act; or <3) where three or less employees arc employed i* the work plere where the substance >s normally found, any otic of such employees. Objections to trade secret information. Tills provision has been expanded to set forth the pro cedure where the Institute questions the dfsicnatum by nn employer of certain information as trade secret information. Where the Institute questions the identi 85 4 85 5 85 8 B5 7 as a hazard evaluation*. Acting on request*. Authority for investigation*. Advance notice of visit*. Conduct of investigations, Provision of suitable space for em- ployee interviews and examinations: i he Institute's withholding the Identity fication. the employer will be given Identification of employee*. of requesters have been considered aiul rejected. Such protection is. In our Judg ment, necessary to assure utilization of this procedure by employees. The option to withhold the requestor's identity has been extended to those who have au written notice of the Institute's inten tion to remove the trade secret designa tion from such information. The em ployer may within that period request reconsideration and provide additional tnfoimotion tu support of the trade 85 8 BS 10 89 11 as 13 Representative* of employers and em ployees: employee request*. Imminent dangers Notification of determination to em ployers. Affected employees, and De partment or Labor. Subsequent requests for health hazard thorized the requester to represent them secret designation. If after ^considera evaluation* Copies of these written authorizations must accompany the request. 4. Authority tor investigation. The sec tion. the decision of NIOSH Is to remove the designation, the employer shall then be notified Since the decision does not AuTHoarrr: The provision* ot thla Part 85 issued under the authority of section 8(g). 84 Slat. 1600; 39 U 3 C S7(g). tion has been amended to make clear that the duty to conduct a health hazard become effective until 15 days after the date of the written notice, the employer | 85.1 Applicability. evaluation and the authority to investi has the opportunity to Lake appropriate The provisions of this Part 85 are ap gate and inspect for purpor.es of con strpv t retain the irode struct designa plicable to request* submitted by any ducting (hat evaluation extend only to tion employer or authorized representative the place of employment with respect to 7 litiirescntatnrs o/ employers and of employees pursuant to section 20iaj which the request has been made, which mipiov`it .-mp/ovee requests. This sec <81 of the Occupational Safety and under the definition of "place of em tion of the regulations luw been revised Health Act of 1970 for a determination ployment" can be the entire factory or to provide that in the case of employee of potentially toxic effect* of any sub a single work place. requests a representative authorized by stance normally used or found in any 5. Advance notice of visits. NIOGH ex ttie employees shall be given an oppor place of employment to which the Act is perience over the last several months has tunity tu accompany the NIOSH officer applicable. This Part 83 la not intended FCOtftAt UCISTII, VOL 37. NO. 215--TUIAT, NOVtMUft 7, 1972 UCC 075278 y- iJ ri < VW . .w j to preclude the use of other channels of communication with the National Insti tute for occupational Safety and Health to obtain Information and technical as sistance related to toxic substances, g 85.2 Definition. Any term defined in the Occupational Safety and Health Act of 1970 and not defined below shall have the meaning given it in the Act. As used In this part: <a> "Act" means the Occupational Safety and Health Act of 1970 (39 U.S.C. 851. etseqj. <b) "Authorised representative of em ployees" means any person or organiza tion meeting the conditions specified In i 85.3(b> (4) U). (ID. or <1U>. <c> "Investigation" includes a physi cal Inspection of the place of employ ment pursuant to section 8 of the Act and means such Inspection, sampling, observations, and other measurements reasonably necessary to determine whether any substance found In the place of employment for which the re quest Is made has potentially toxic ef fects in such concentrations as used or found. <d< "Health hazard evaluation" means the Investigation and the deter mination of potentially toxic effects of any substance normally used or found In any place of employment to which the Act Is applicable. re> "Place of employment" means any factory, plant, establishment, construc tion site, or other area, workplace, or environment where work is performed by any employee of an employer. <f> "NIOSH" means the National In stitute for Occupational Safety and Health. rg) "NIOSH officer" means a person authorized by NIOSH to conduct Investigations. (hi "Substance means any chemical or biological agent which has the po tential to produce toxic efTects. Mi "Toxic effects" are those which re sult In short- or long-term disease, bod ily Injury, affect health adversely, or endanger the life of man. 85.3 Procedures for requesting health hazard evaluations. ia' A request for a health hazard evaluation should be addressed to the National Institute for Occupational Safety and Health. Hazard Evaluation Services Branch. 17 S. Department of Health. Education, and Welfare. Cincin nati. Ohio 45202. rb> A request for such an evaluation shall: <l> Bo In writing and signed by m the employer in whose place of employ ment the substance la normally found, or 'iii by an authorized representative of employees who are employed by such employer; <2> State the requester's name, ad dress. and telephone number, if any; the address of the place of employment where the substance la normally found; the specific workplace or workplaces in volved. and the specific process or type of work which la the source of the sub stance or in which such substance la used; <3> specify with reasonable particu larity the nature of the conditions, cir cumstances. or other grounds on which the request la made; <4> State, where the requester Is other than the employer: (1) That he is an authorized repre sentative. or an officer, of the organiza tion representing the employees for pur poses of collective bargaining; or Ml) That he Is an employee of the em ployer and Is authorized by two or more employees employed in the workplace where the substance is normally found to represent them for purposes of the Act. Each such authorization shall be in writing and included in the request; or (ill' That he Is one of three or less employees employed in the workplace where the substance is normally found. * 51 Indicate whether the requester or Chose persons who have autl.r-n?ed the rcquesier to represent them desire that NIOSH not reveal their names to the employer. c The request shall, if the informa tion is known to the requester: (! Identify the potentially toxic sub stance or substances involved;' 12i State the trade name, chemical name, and the manufacturer of each such substance: 13 > State whether the substance or the container of such substance has a warn ing label; and '4> Specify the physical form of the substance, number of people exposed, length of exposure 1 hours,dny. and oc cupations of exposed employees. Nort: The National Institute for Ocmpaemmu Safety and Health inis devr!> v.-d a form, entitled "Request for Health Evaluation," to assist persona In requr-ting c.AluaMniij under this part Form* are able upon request fr^ni NIOSH. Hazard E-ntnation Services 8ranch. Cincinnati < 'filo 45202 or from the NIOSH representative hi any Regional Office of the Department of Health. Education, and Welfare 8S.4 Acting on request*. 'a> When a request meeting the requirements of this part has been sub mitted in accordance therewith and des ignated employees of NIOSH have con cluded that there is reasonable cause to believe that an investigation Is war ranted. a NIOSH officer will inspect the place of employment, collect samples where appropriate and perforin such tests as necessary, including medical ex aminations of employees, to the conduct of a health hazard evaluation. (b) If there is no reasonable cause to conclude that an investigation is war ranted. the requester shall be notified in writing of such decision. <c Investigations shall be conducted m accordance with the requirements of this part. 85.5 Aulliorily for intMiealion<. >a> Employees of the National Insti tute for Occupational Safety and Health who have been issued the NIOSH official credentials (consisting of HSM Form 3W-2 entitled "Identification Record") are authorized by the Director. NIOSH, for the purposes of section 20(a><8> of the Act and pursuant to section 8. to enter without delay and at reasonable times any place of employment for which a request has been submitted, to Inspect and investigate during regular working hours and at other reasonable times, and within reasonable limits and in a reasonable manner, any such place of employment, and all pertinent condi tions. structures, machines, apparatus, devices, equipment, and materials there in as may be directly related to the de termination whether any substance nor mally found In (he place of employment for which a request has been submitted has potentially toxic effects in such con centrations as used or found. In connec tion with any inch investigation, such NIOSH employees may question privately -ny employer, owner, operator, agent, or employee and rc.icw records required by the Acr and regulations, and other re lated records. 'bi Areas containing information which is classified by any agency of the US. Government in the interest of na tional security will be inspected only by NIOSH employee* who have obtained the appropriate security clearance. 8S.lt Advance notice of (a* Advance notice of visits to the nJace of employment may be given to expedite a thorough and effective Investigation. Advance notice will not be given when, in the judgment of the NIOSH officer, giving such notice would adversely affect the validity and effectiveness of the investigation. > b) Where a request in accordance w ith this part has been made by an authorized representative of employees, advance notice in accordance with paragraph ia) of this section will be given by NIOSH to the requester, the representative of the employees for purposes of collective bar gaining if such representative Is other than the requester, and to the employer i c > Where a reauest in accordance with this part has been made by any emnioyer. advance notice will be given by NIOSH to the employer Upon the request of the emrlovcr. NIOSH will inform the author ized rcoresentative of emoloyees of the visit: Provided. The employer furnishes NIOSH m wTlttng with the Identity of such representative and with such infor mation as ts necessary to enable NIOSH promptly to inform such representative of the visit. 85.7 Conduct of investigations. a Prior to beginning an investiga tion. NIOSH officers shall present their credentials to the owner, operator, or agent In charge at the place of employ ment. exnlaln the nature. nurpO'e. and scone of the investigation and the records specified in I 85 5 which they wish to re view Where the investigation is the result of a request submitted by an authorized representative of employees, a copy of the request shall be provided to the em ployer. except where the requester or any person authorizing the reauester pursu ant to i 85.3<b>(4<) hM Indicated No. 211 FCOKlAl IIQISTft, VOL 37. HO. SIS*--TUISDAr. NOVIMilt 7, 1972 UCC 075279 " i0 n 23642 RULES ANO RfetiulA.iONS that NIOSH not reveal his name to the employer, in which case, a summary of the basis for the request shall be pro vided to the employer. ibi At the commencement of an in vestigation. the employer should precisely identify information which can be ob tained in the workplace or workplaces to be inspected as trade secrets. If the NIOSH officer has no clear reason to question such identification, such infor mation shall not be disclosed except m accordance with the provisions of sec tion 20ia 16* and section 15 of the Act. However, if NIOSH at any time ques tions such identification by an employer, not less than 15 days' notice to an em ployer shall be given of the intention to remove the trade secret designation from such Information. The employer may within that period submit a request to the Director. NIOSH. to reconsider this intention nr.d may provide additional in formation in support of the trade secret designation. Tie Director. NIOSH. 'hall notify the employer ;n 'truing of the decision which will become "ffecuve ro sooner than 15 days after the Ja:e of such notice cc * NIOSH officers are authorized fo collect environmental samples and sumulcs of substances, to take or obtain photographs related to the puiyose of the .nvestirfat.cn. employ other tca.cnable investigative teehmoues. inclu-iin? medical examinations of employees with the consent of such employees, and to question privately -any employer, owner, operator, agent. or employee The em ployer shill have the opportunity to re view photographs taken or obtained for the purpose cf identifying those which contain or might reveal a trade secret 'd* NIOSH officers shall comply with all safety and health rules and practices at the place of employment being in vestigated. and they shall provide and use appropriate protective clothing and equipment In situations requiring spe cialized or unique types of protective equipment, such equipment shall be fur nished by the employer. i e The conduct of investigations shall be such as to preclude unreasonable dis ruption of the operations of the em ployer's establishment. 85.8 Pruvitiuri of *uilablr *pni'C for employee inicr*t** and tions; idcniifivulinn of employer*. An employer shall, on request of the NIOSH officer, provide suitable space, if such space is reasonably available, to NIOSH to conduct private interviews with, and examinations of. employers NIOSH officers shall consult with 'he employer as to the time and place of the medical examination and shall schedule such examinations so ns to avoid undue disruption of the operations of the em ployer* establishment NIOSH slum con duct. and assume the medical costs of. examinations conducted under this part. 85.9 UrprrrniAlhr* of ntiployrr* end employee*; employer rcquri. fa) NIOSH officers shall be in charge of investigations Where the request for a health hazard evaluation has been made by an authorized representative of employees, a representative of the em ployer and a representative authorized bv his employees who is an employee of the employer shall be given an oppor tunity fo accompany the NIOSH officer during the initial physical inspection of any workplace (or the purpose of aiding the investigation by identifyin? the sus pected hazard. The NIOSH officer may permit additional employer representa tives and such additional representatives authorized by employees to accompany him where he determuies that such ad ditional representatives will further aid the investigation. However, if in the judgment of the NIOSH oflicer. good cause has been shown why accompani ment by a third party who is not an em ployee of tiie employer is reasonably nec- essarv to Hie conduct of an effective and thorough investigation of the workplace, such third party may accompany the NIOSH officer during the inspection: Frot iue(t. uouerer I'har by such persons to aicas ii`cnbco a paragraph ni> of ,'ms sc1't'.'.o' snail v.* m ai\.utuance vuh the requirements of suu provision, and acre.'.s to area.- ivsenoed n para- 2r:ij!U <e> <>i ems >ccnon shrttl oe witn the cnu**nt of the emplojcr a o.rtcrent employer and vinployee rcKii'sentauve may accompany the officer durxg each dtfftrcnt pnu.se of an .r.*pe''Uon if this wnl not- interfere with tne conduct of the investigation. 'b' NIOsH officers are authorized to resolve All disputes ar io who is tne repre- =e::ta?ii.e authorized oy the employer and employ'*?* for 'he purpose this section U 'here `.s no authorized representative of employees, or if the NIOSH officer ,s un able to determine with reasonable cer tainty who ts <urh representative, he shall consult with a reasonable number o/ employees concerning mutters directly related to the health hazard evaluation. <c NIOSH officers die authorized to deny the right of accompaniment under this scc'ion to any >>erson whe.-e conduct interferes with a fair and orderly physi cal inspection. di With regard to information classi fied by an agency of the U S Govern ment m the interest of national security, only persons authorized to have access to such information may accompany an offi cer in areas conta:.- mg such information >e> Upon request of an employer, any representative authorized under this .1 85 D by employees in any area contain ing trade secrets shall be an employee m that area or an employee authorized by the employer to enter that area. 11.1. If) litiintitenl il.nicer-. '.Vheiievi-r, dunner the course of. or as a re-ult uf. ;wi mi csl 'ration under Hus part, the NIOSH officer believe* that there is a reasonable basis for an allcya.Uon of an imminent danger. NIOSH will immedi ately advise the employer and those em ployees who appear to be in immediate danger of such allegation and will inform appropriate representatives of the De partment of Labor or the State agency designated under section lgcbi of the Act. 85.1 l N'llific.-iiinn of drtrrntin jlion lo employer*, nffnird employer* and Department of Ljbor. 'a) A determination made pursuant to section 20(a)'6) of the Act will, as a minimum: <t> Identify and set forth, where appropriate, the concentrations of the substances) found in the place of employment and the conditions of use.. and (2) state whether such substance's) has potentially toxic effects in such con centrations. as well as the basis for such judgments. <b> Copies o the determination will be mailed to the employer and to the authorized representatives of employees. c* Except as hereinafter provided, themplover shall post a codv of the deter mination for a period of 30 calendar days at or near the workplace's) of affected employees. The employer shall take steps to .nsure that the posted determinations arc not altered, defaced, or covered by other material during such period. The employer will not be required to post the determination if the emnlover requests that copies of the determination be mailed to affected employees and fur nishes NIOSH with a list of the names and mailing addresses of the employees employed in the workplace's) designated by the NIOSH Officer In the Utter event. NIOSH will mail such copies to affected employees at the mailing ad dresses provided by the employer. 'd> For piirposes of this section, the term "affected employees" means those employees determined by NIOSH to be exposed to the substance's' which is the suhject of the health hazard evaluation ei Copies of all determinations will be forwarded to the Department of Labor and the appropriate State agenev desig nated under section 18<b> of the Act If the Secretary of Health. Education, and Welfare determines that any substance is potentially toxic at the concentrations :n which it is used or found in a place of employment, and such substance is not covered by an occupational safety or health standard promulgated under ec- ti.on 6 of the Act. the Secretary of Health. Education, and Welfare will immediately submit such determination to the Secre tary of Labor together with all pertinent criteria. 85.12 "Mih-iijin nt rrqur-l* for hr:illli lorard r*;ilunon*. Where a request is received for a health hazard evaluation m a place rff employment in which an evaluation un der this part previously has been made, i he Secretary may make a .subsequent in vestigation if. as a result of the passage of time or additional information, he deems such a subsequent investigation consistent with the purpose of the Act. {FR Dor 72-19043 Filed U-6-13.8 91 *m| ,KPItAl tlCISTIR. VOL 37, NO, IM--TUESOAY. NOVCMICC 7 l*7X UCC 075280 U.S. DEPARTMENT OF HEALTH. EDUCATION. AND WELFARE NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH request for health hazard evaluation This form is provided to assist in registering a request for a health hazard evaluation with the U.S. Department of Health. Education, and Welfare as provided m Section 20(a)(6) of the Occupational Safety and Health Act of 1970 and 42 CFR Part 85. (See Statement of Authority on Reverse Side). Name of Establishment Where Alleged Hazardls) Exist__ Amboy Terminaling Company^ Company Address Street City _ 560 State St., Perth Amboy, State ___Telephone New Jersey 4 42--9 550 Zip Code 08861 pacKing and 1. Principal Company Activity hranspnrfatinn nf bulk chemicals namely f P.V.C . . and (u'ino. t.(>!.trf 11o'*. t<iin*ppnation. ne'v.< e. allied chemicals 2. Specify the particular building or worksite where the alleged hazard is located, including address________ _ at factory at 560 State St.,Perth Amboy#N.J. 3. Specify the name and phone number of employer's ngenhs) in charge. 4. Describe briefly the hazard(s) which exists by completing the following information: PVC,VC Monemers, Identification of Hazard or Toxic Fiiib^tnnrefsi Bisph_e_nyls, Polystyrene & other organic VC Trade Name (If Applicable! suspensions,^ ^1 ai X&BVil resins. Manufacturer ,Does the material have a warning label? Yes___ No If Yes. attach copy of label or a copy of the information contained on the label. Only PVC as Of recent Physical Form: Dust fx] G.is LJ Liquid [J Cl Other Li Type of Exposure? Breathing [X] Swallowing [24 Skin Contact [25 Number cf People Exposed_______ ___ Length of Exposure <Hours/Day ) Occupations of Exposed Employees all employees are exposed to handling the product and are known as material handlers. 5. Using the space below describe further .the nature of the conditions or circumstances which prompted tins in quest and other relevant aspects which you may consider important, such as the nature of the illness or symp toms of exposure, the concern for the potentially toxic effects of a new chemical substance-introduced into the workplace, etc. It appears that there have been at least four known cases of -------------cancer"and~probably many mure which are not known as~ of- this time. and_it_is_.important_for the employee who .are no longer there to know what their physical condition may be doing due to this" expo-sure-~a5~~we1T~ as--for"those_"who~ are ' stilt"working~to know what hazard exists for them., by .yir.tue..o--fchis-g NlOSH-4 ICml 9/72 FORM APPROVED OM8 NO. 68*flt 236 UCC 075281 G. |<t> '0 ydnr knowlpilrjn has Hus iMZurd Im*mi uoiiMtlernct pr^viou^ly bv any Government agency? (b) If so, give the nnmr* and address of nach. (cl and, the approximate date i( was so consider'd. ...... _ .___________ ____________ 7. la) Is this request, or a request aHpqing a similar h.i7dr<l, lining filer! with any other Government agency?__no(b) If so, give tltc ruimo and address of each. a j**^ i j u r ^ t * The undersigned (check one) iJ Employer ^ Authorized Representative cf 'T.-i-lovees* Chief Shop Steward & President " "> (circle one) beft^eaM^fi # iub ^ ce (or substances i normal ly foundat the following place of employment may have potentially toxic effects in the concentration used nr found. Signature Date Typed or Printed Name__ Wii-Xiam Fodor-................ ......Telephone: Home - ____ f Street_____3.54.-Summit Ave..*Business-. Address ^ Clly___Perth AmboyState.. _____ N.J_. Nov. 11,1976 Zip Code 08361 If you are a representative of employees, state the name and address of your organization. ____________________Chief Shop Steward & President_o_f International Union of Operating Engineers,Local 825 Please indicate your desire: I do not want my name revealed to the employer. My name may be revealed to the employer. Authority: Section 20(aM6> of the Occupational Safety ind Health Act, I2n u. 5. C. 663(a)(6) > provides as follows: the Secr.jipr, -u Health. Education, nod Welfare shall. .determine following a wri ttnn request by any employer or author i zed represents!' c employees, specifying with reasonable particularity the grounds on which the request is made, whether any substance i*urm.iiiy found m the pi-ice of employment has potentially toxic effects m such concentrations as used or found: and shall submit such determination both to employers and affected employees as soon as possible. If the Secretary of Health, Education, ami y.* ifare determines thjt any substance is ixitentiaily toxic at the concentrations m which it is used or found m a place uf f""ployment. and such substance 'S not covered by an occupational safety or health standard promulgated under section fi pm Secretary of Health. Education, and Welfare shall immediately submit such determination to the Secretary of Labor, together with all pertinent criteria. "Authorized representative of cnployces" means any person or orqpni/ntioh meeting the conditions S(>ecified in 42 CFf? Part 85.3 Ibl <41 to. In) or (m): (0 - that lie is n autftorized rcixosnututivo of, or no officer of thn Mri|.iriii,i(ion ropioscntmg. the employees for tmrpnvc*, collective bargaining; or till -- that he is an employ'e of the employer and is <uiti>ori,ed by two or more employees employed m the workplace when* ti. substance is normally found, to represent thorn for purposes of the Act. Each such authorization shah l>o m writing and eluded m the request: or (nit -- that he is One of three or less employees employed in the workplace where the substance >s normally found. Send the completed form to: National Institute for Occupational Safety and Health Hazard Evaluation Services Branch U.S. Oeportmcnt of Health, Education, and Welfare Cincinnati. Ohio 45202 ul ecvw--m rmniaa W*l a* -*- UCC 075282 - *'N