Title 8 Section 5203 Employer Carcinogen Report

All employers who use a regulated carcinogen must report that use to Cal/OHSA as required by title 8 section 5203.

Regulated carcinogen means a recognized cancer causing substance, compound, mixture, or product regulated by sections 1529, 1532, 1532.2, 1535, 8358, 8359 or Article 110, sections 5200-5220.
Use means any use by an employer that could potentially result in employee exposure to a regulated carcinogen.
Emergency means any occurrence such as, but not limited to, equipment failure, rupture of containers, or failure of control equipment which results in an unexpected and potentially hazardous release of a regulated carcinogen,

Note: Asbestos has additional report of use and asbestos-related work registration requirements in sections 1529, 5208, and 8358

For silica reporting, please use this link: https://www.dir.ca.gov/dosh/Employer-RCS-Report

For fixed work locations, employers must provide the following information within 15 days of initial use and within 15 of any changes to the reportable information below if any employees have potential exposure to a regulated carcinogen.

1. Name of the employer:

Business Name:

Doing Business As (DBA) Name:

2. An identifying description of where the use of a regulated carcinogen is located in the workplace:

3. A brief description of each process or operation which creates employee exposure to the regulated carcinogen, including the estimated number of employees engaged in each process or operation.

4. The names and addresses of any collective bargaining units or other representatives of the affected employee(s):

Space Cell	Collective Bargaining Unit Name:	Collective Bargaining Unit Street Address:	Collective Bargaining Unit City:	Collective Bargaining Unit State:	Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 1	Collective Bargaining Unit 1: Collective Bargaining Unit Name:	Collective Bargaining Unit 1: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 1: Collective Bargaining Unit City:	Collective Bargaining Unit 1: Collective Bargaining Unit State:	Collective Bargaining Unit 1: Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 2	Collective Bargaining Unit 2: Collective Bargaining Unit Name:	Collective Bargaining Unit 2: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 2: Collective Bargaining Unit City:	Collective Bargaining Unit 2: Collective Bargaining Unit State:	Collective Bargaining Unit 2: Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 3	Collective Bargaining Unit 3: Collective Bargaining Unit Name:	Collective Bargaining Unit 3: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 3: Collective Bargaining Unit City:	Collective Bargaining Unit 3: Collective Bargaining Unit State:	Collective Bargaining Unit 3: Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 4	Collective Bargaining Unit 4: Collective Bargaining Unit Name:	Collective Bargaining Unit 4: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 4: Collective Bargaining Unit City:	Collective Bargaining Unit 4: Collective Bargaining Unit State:	Collective Bargaining Unit 4: Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 5	Collective Bargaining Unit 5: Collective Bargaining Unit Name:	Collective Bargaining Unit 5: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 5: Collective Bargaining Unit City:	Collective Bargaining Unit 5: Collective Bargaining Unit State:	Collective Bargaining Unit 5: Collective Bargaining Unit Zip Code:
Collective Bargaining Unit 6	Collective Bargaining Unit 6: Collective Bargaining Unit Name:	Collective Bargaining Unit 6: Collective Bargaining Unit Street Address:	Collective Bargaining Unit 6: Collective Bargaining Unit City:	Collective Bargaining Unit 6: Collective Bargaining Unit State:	Collective Bargaining Unit 6: Collective Bargaining Unit Zip Code:

5. For Temporary locations, provide the following information at least 24 hours prior to the commencement of each job when feasible.

Space Cell	Location (Street, City, State, Zip)	Type of Business	Type of Work of Temporary Worksite
Temporary Location 1	Temporary Location 1: Location (Street, City, State, Zip)	Temporary Location 1: Type of Business	Temporary Location 1: Type of Work of Temporary Worksite
Temporary Location 2	Temporary Location 2: Location (Street, City, State, Zip)	Temporary Location 2: Type of Business	Temporary Location 2: Type of Work of Temporary Worksite
Temporary Location 3	Temporary Location 3: Location (Street, City, State, Zip)	Temporary Location 3: Type of Business	Temporary Location 3: Type of Work of Temporary Worksite
Temporary Location 4	Temporary Location 4: Location (Street, City, State, Zip)	Temporary Location 4: Type of Business	Temporary Location 4: Type of Work of Temporary Worksite
Temporary Location 5	Temporary Location 5: Location (Street, City, State, Zip)	Temporary Location 5: Type of Business	Temporary Location 5: Type of Work of Temporary Worksite
Temporary Location 6	Temporary Location 6: Location (Street, City, State, Zip)	Temporary Location 6: Type of Business	Temporary Location 6: Type of Work of Temporary Worksite

6. For any emergency, employers must provide the following information within 15 calendar days after the occurrence of an emergency:

Space Cell	Description of the Operation or Process Involved (including location)	Amount of Regulated Carcinogen Released	Duration of the Emergency	Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Analysis of the Circumstance That Led up to the Emergency	Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 1	Emergency 1: Description of the Operation or Process Involved (including location)	Emergency 1: Amount of Regulated Carcinogen Released	Emergency 1: Duration of the Emergency	Emergency 1: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 1: Analysis of the Circumstance That Led up to the Emergency	Emergency 1: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 2	Emergency 2: Description of the Operation or Process Involved (including location)	Emergency 2: Amount of Regulated Carcinogen Released	Emergency 2: Duration of the Emergency	Emergency 2: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 2: Analysis of the Circumstance That Led up to the Emergency	Emergency 2: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 3	Emergency 3: Description of the Operation or Process Involved (including location)	Emergency 3: Amount of Regulated Carcinogen Released	Emergency 3: Duration of the Emergency	Emergency 3: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 3: Analysis of the Circumstance That Led up to the Emergency	Emergency 3: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 4	Emergency 4: Description of the Operation or Process Involved (including location)	Emergency 4: Amount of Regulated Carcinogen Released	Emergency 4: Duration of the Emergency	Emergency 4: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 4: Analysis of the Circumstance That Led up to the Emergency	Emergency 4: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 5	Emergency 5: Description of the Operation or Process Involved (including location)	Emergency 5: Amount of Regulated Carcinogen Released	Emergency 5: Duration of the Emergency	Emergency 5: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 5: Analysis of the Circumstance That Led up to the Emergency	Emergency 5: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring
Emergency 6	Emergency 6: Description of the Operation or Process Involved (including location)	Emergency 6: Amount of Regulated Carcinogen Released	Emergency 6: Duration of the Emergency	Emergency 6: Known or Estimated Extent of Employee Exposure to the Regulated Carcinogen and Area of Contamination	Emergency 6: Analysis of the Circumstance That Led up to the Emergency	Emergency 6: Description of the Measures Taken (or to be taken), With Specific Dates, to Prevent Further Similar Emergencies From Reoccurring