ࡱ> Z\Y%` bjbjNN 4V,,    8D$hhhhhh{{{-//////$dh!S_w{__Shhh_Rhh-_-h\ Qr R~0"""x{"{{{SSR{{{____d   Notification and Acknowledgement of Designated Substances on Project SiteProject:Location:U of T File No.: U of T Project Manager:Attention Service Provider: In accordance with occupational health and safety, and/or environmental protection statutes, be advised that the following hazardous substances are, or may be present at the site of the proposed project (check-marked items). Please note that other hazardous substances for which there are not proactive disclosure obligations may also be present at the site. Designated Substances per Ontario Occupational Health and Safety ActOther Hazardous SubstancesAcrylonitrilePolychlorinated BiphenylArsenicOzone Depleting SubstancesAsbestosVisible Mould BenzeneEthylene OxideIsocyanatesLeadMercuryQuartz SilicaVinyl ChlorideAdditional details are provided in these attached documents:  Please Note: This Notification is provided to comply with statutory requirements to disclose the presence of specific regulated substances. This is not intended to be, nor should it be interpreted as, a complete listing of all hazardous or other substances that are or may be present at the project site. Acknowledgement of NotificationWe hereby acknowledge having received this Notification and Acknowledgement of Hazardous Substances on Project Site.Service Provider Name: Signing Officer for Service Provider:  Signature of Signing Officer: Date Signed: EXECUTE THIS DOCUMENT AND RETURN TO HOUSING SERVICES INC. WITH YOUR PROPOSAL / PRICING SUBMISSION. 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