al

O 2B 0 §%
l. -@—
Code

r PNL

3. Custodian/Phone

Health Protection

Vicki L. Berndt

7. Retiring Unit and Code
‘

8. Hanager/Phone

9. Org.
Code

10. HSIN

li. Hay records be destroyed as
scheduled without further concurrence?

Matt Lyon/376-7758

07A31

A3-60

{[] Yes

Dosimetry Records
Ie. Bux
Na.

128023

5. Date

4. Location of Records
(Area-Bldy-Rin)

2. Departient and Code

Instruction:

13, Description of Record
Type general description in capital letters and follow

with detatl description of contents.
underline key words.

Also, please highlight or

Dosimetry Historical File- Hardcopy Record
tas force

Bachicediguy Prorecthow

Hardcopy documents

14, Classification
(c,S,U)

From

To

U

1990

1993

=,

hedorical farel Cope

SLauiel Deeurertls (lem
«

oy

1S. Inclusive Dates

6. Page 1 of |

01/12/93

700 -Fed-301K

16,
Cubic
Feet

1.0

[X] No
i. Disposal

18. petention

OOE 1324.2A

Permanent

uthortty

1.5b (1)

\

2--A

103 “

ORP- 4003334 -DHP-4003432

RECORDS TRANSFER/

DATA INPUT

§4-3000-626 (02/93) GEF220

NN T9094 R

13, teeer aauested By

yeisnature)

fy
3
—/2_

v L Bont 74

20. Records Management

Approval

Wy

2t. Data Entry

Mee oa | ] sto { J

tty t- MNS heante s9([]

/

su { ]

22. Recelved by RHA

FEB Q

7 199

sy (19)

‘

23. Date

Recelved

Select target paragraph3