SDMS Document 
115599 
SJ 3 7 A 5" 
Mailing List 
Please fill out and return this form to EPA so you can receive additional information on 
the Virgin Island Chemical Site and be kept informed. The form is postage-paid. Just fold 
and staple or tape where indicated. Please print clearly. 
Name 
<<^Aj>\i£-TH 
C . 
M/t-r/VJBS 
Address 
<i-0 Z.-^ 
t-V g-v-ing o >^ l-i U i 
City/State/Zip Code 
(^ U ^t s-t-tL ^ yj-^Ji ^ yyX 
<^<^ S Z.C3 ^ < 4 - ^ 3 c ^ 
Telephone 
g o q - - 7 7 S - O ^1 «-^«S 
Affiliation 
P r c r T A m . ^ ' t ^ 
C tn ci.3> t - ^ i 
C O < ^ C L - ( ftwu^l^ 
Comments or Questions 
^t 
eCtt*'>^-'I^'-<Si -t^Uu. 
u^u/^ic*-. h^AC^Ccjcr a-*y^ 
^ B 
(Please fold along the dotted line) 
_ 
^ 
Prinled on Recycled Paper 
1 0 . 0 0 0 1 
- r