AUGUST 10967 OPTIONAL FORM 43 disapprovals, clearances, and similar actions DATE INITIALS SIGNATURE 5041-101-01 264-6487 PHONE 23 Nov 76 DATE { | ee SEE ME VERSATION ew eon — | WOTE and RETURN INITIALS DATE INFORMATION COORDINATION CINCULA rE DATE INTTEALS INITIALS acTIioN Do NOT use this form as a RECORD of approvals, concurrences, FCDNA/FCLS FROM REMARKS Richard 0. Gilbert Battelle Pacific Northwest Laboratory Box 999 2Math Building, Room 1201 Richland, Washington 99352 To Dr. ROUTING AND TRANSMITTAL SLIP