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78. mores (Continued) and S100 1FICANT OR INTERVAL WiIETORY
Using beta-gamma survey meter MI-5, background reading .03-.06 mr/hr. No radioactive
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74. SUMMARY OF DEFECTS AND BinewosED (Leet dragness wth item Rumbers)
FS. RECOMMENDATIONS—-PUNTHER BPECLALIOT Examinations impicaTED (Specify)
76.
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76. 1F MOT QUALIFIED. LIST DIGQUALIFYING DEFECTS @Y ITEM NUWBES
78. TYPED Of PRINTED MAME OF PHYBICIAR
SIGWATURE
GO, TYPED O8 PRINTED NAME OF PHYSICIAN
SIGNATURE
G1, TYPED Of PRINTED MAME OF DEWTIFT Of Prysician (Iadsaste which)
SIGNATURE
02. TYPED OF PRINTED MAME OF REVIEWING OFFICER OA APPROVING AUTHORITY
SiGNaTURE
CARL L. HANSEN, Lt Col, USAF, MCPS
8
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NUMBER OF AT~
TaCHED SHEETS
UM. @. GOVERN WiaT PAINTING OFFICE. 1887 O—ebEROE
BEST AVAILABLE
COPY