Document k9XBLjngbOv0zmO5Nd2qLRXpB

000012 f*. : -Af ftr- c :o X* o-c\ U. -K5. ,, P A flf ta s C - M=3g3 8m 8S* 3 3 W<aMgMffK4B ~~ ~~ * r * r. * *Eh tAL t 8/26/97 TO: Sharroa X. Lams EP - lagulatory A ffa irs O P 713/108 V ila in g tcm CC: H. D. I 1 U 1 7 V. M. Scavare A. J . Playcla TSCA V ila X fS ^ 000013 Y L P O O O lJT A g T 8 e O K S < G ) - i E C C 3Y ~ -C A a @ CT3rfc JkTOS Awwsrt e*w*tatc3 ter.)ib BuGtasNfneteT3CACooctftetcrti WHmi^aaa(Matera. OEMRIOYEE UMON OMBHBOR OTH CO CUSTOM CONSUMER a OTHER(SRECPV) T\_, f NAME ^ *-- # MMWUALRAMO OUTFORM<FHOTABOVE) ADORESE P #w* / P1 . ^ i i i l NAME \ / L. . NAMElADOREttOP LOCATOR EECSMNQNOfflMRnON ^ P **& <* fe tte.J* SEETONB TTR OSm C T A L L A (CNRK OM) OJCAIJH ENMRONMENTAL MRDMMTIOMORALLSOSPBPH'-T C4 fifi 1 .'te w-- V via^ o V IR V + ^ * +* C " * ^ ^ ^ L ^ i rXte^M_ V Vwv h ; , V WH WASA L L I ffRCT RESTNOTOS (OATlJt JIabA a___ L_- 3 __________!_______ ___________ _____________ . _ _ MONTHS * l HAS TH i ALLEGED EffSCT OCCURRED MOW THAN ONCE? 0 * 0 OVES HOW MANYTME97________ ^ A U E to E F R C T B H E A IJ H R S U T O C O IM T E T H ifiB lW N O e i OF SECTOR B i_, wn . ,_____ SCC B MALI O R M A L I /PATE OEEWTM A ., M l - f t M EOCV PARTORCROAN AfflC Tl P _______________ EXPOSURE ROUTE tCHECK) O UOSERON BnWALATTON STMON ASSOHFTION O T H P flE taE Y l ,, CHBSCAL U v * Ait Mi A nnas-. f tw < ta c t1 o * f e . a. s o o b s u m i PROOUCTNAME < 5 -.f am ,y *\. Ifcicracx^zt^rgacmmr,r* i < OATS. 000014 T1 P0 0 0 1 3 S Y059&smmmm commas,acttsecnoice<q) notwc^ tqkor possBtf&Am&ns^rnm^momtszm, effect t-tr i( i BYTK& 8(C) COOKBIN.TOf;` 1 HEALTH EFFECT ALLEGATION ONLY A. IS THIS HUMAN HEALTH EFFECT KNOWN? (CHECK ONE) YES G NO UNCERTAIN a F YES-HOW ? (CHECK ONE) LABEL MSDS LITERATURE (SPECIFY) O DOES THIS NOTICE OF EFFECT INVOLVE MORE THAN 11NOMOUAL? YES NO Z ENVIRONMENTAL EFFECT ALLEGATION ONLY A. IS THS ENVIRONMENTAL EFFECT DRECTLY ATTRBUTASLE TO AN NCOENT OF ENVRONMENTAL CONTAMINATION ALREAOY REPORTED TO THE FEDERAL GOVERNMENT? (EXAMPLE: EPA, NATIONAL RESPONSE CENTER ETC.) YES NO UNCERTAIN 3. SHOULD THIS NOTFCATION BE RECORDED UNDER TSCA SECTION 8(0? YES NO UNCSHTAM F NO--WHY NOT? n INFORMATION S A KNOWN HUMAN EFFECT AS OESCRBED M SGENTOC u LITERATURE. PROOUCT LABEUNQ 0 IN MATERIAL SAFETY DATA * * E T 3 n ALLEGATION DOES NOT MQET OERNTDON OF StGMRCANT U ADVERSE REACTION FORMATION HAS B K N SUBUTTED UNDER OTHER MANDATORY REPORT REQUIREMENTS TO THE FEDERAL GOVERNMENT AND MEETS REQUIREMENTS OF SECTION 8(C)OF TSCA O T H B *___ ________________________________________________________ _ Signafum 000015 TLP0 0 0 1 3 9