MEASUREMENTS AND OTHER FINDINGS
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66. FIELD OF vibioN
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78, NOTES (Conthnmad) AND GIGHIFICANT OF INTERVAL MIETORT
Using beta-gamma survey meter MI-5, background reading 202-.06 mr/hr. No radioactive
contaximtion found.
(Uee additional shesie if neserenry)
74. BUMuARY OF DEFECTS aNd OLacmosES (Lidl dhagnesa: with tem aumbers)
76.
JE. SECOMMENGATIONS—FURTHEE SPECIALIST EEAMINATIONS ImpicaTED (Speevy)
A. PHYSICAL PROFILE
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77, examinee (Check)
a. Cis quaterice ron
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76. UF MOT QUALIFIED. LIST DISQUALIFYING DEFECTS SY [Tam HUMBER
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SiGKATURE
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SIGMATURE
SYPER OF FAINTED MAME OF
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G1. THPED O8 PRINTED NAME OF DENTIET OM Pnvacian (Inches which)
SIGNATURE
$2. TYPED GOA PRINTED NAME OF REVICWING OFFICER OR APPROVING AUTHORITY
GIGHATURE
WUMSER OF ATs
TACHES SHEETS
B. SOVEANMENT PRINTING GPFICE:
BEST AVAILABLE COPY
1887 O-—“SSERSO