Abstract: At approximately 6:30 p.m. on August 6, 1994, Employee #1, of the Owens Brockway Company, Pomona, CA, responded to a low tin reading on an A-2 tin system. While tin-tetrachloride cylinders were being changed, the system became plugged. Employee #1 cleared the system by alternately opening and closing the bypass valve. During this process, the employee was exposed to tin-tetrachloride byproducts (hydrogen chloride vapor) that had leaked by some gears. Employee #1 suffered severe dyspnea and respiratory irritation. Upon investigation, it was found that Owens Brockway employees were not given specific training on the hazards of stannic tetrachloride and how to protect themselves from exposure. The employer was cited a serious violation of T8CCR 5194(h)(2)(e).