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<br />n <br /> <br />~1 <br />J j <br />tl. <br />i <br /> <br />NOTICE TO TOXICS BOARD OF TRADE SECRET REPORTS <br />FILED WITH THE OFFICE OF THE FIRE MARSHALl <br /> <br />Company: <br /> <br />rl <br />i } <br /> <br />Tax Identification Number: <br /> <br />',-", ,}, <br />! ' <br />I <br /> <br />Reporting Year: <br /> <br />~ 1 <br />1 j <br /> <br />Note: This report to the Toxics Board must be updated by April] each year only if there are <br />changes to the report last filed with the Toxics Board. <br /> <br />;ti <br /> <br />Code Number of Substance3 Category: Hazardous Date Filed With <br /> substance (HS), extremely Fire Marshal's <br /> hazardous substance (EHS) Office <br /> <br />fl <br />; <br /> <br />,or 1 <br />I <br /> <br />., l <br /> <br />, } <br /> <br />f'l <br /> <br />Signature <br /> <br />Date <br /> <br />Print name <br /> <br />'ff <br /> <br />Title <br /> <br />1 Eugene Charter Amendment IV, Section 5.2(A)(2) <br /> <br />2 The reporting year is the year previous to the April 1 reporting date. For instance, a report filed by <br />April 1, 1999 would cover the reporting year of January 1 - December 31, 1998. <br /> <br />3 Trade Secret Chemical Code Number is the facility's 9-digit Tax Identification Number followed by a hyphen <br />followed by a whole number (1,2,3 . . . n) which uniquely identifies each trade secret chemical. A <br />company with two trade secret chemicals would have Code Numbers for those two chemicals of: <br />Tax Identification Number-l (xx-xxxxxxx.-l) <br />Tax Identification Number-2 (xx-xxxxxxx.-2) <br /> <br />This form is to be filed with the Eugene Toxics Board (99 W. 10th Ave., Suite 395, Eugene OR <br />97401) when the previous form (Substantiation to Accompany Claims of Trade Secrecy) is filed <br />with the Fire Marshal's Office for one or more substances. <br /> <br />E-6 <br />