Document 0qYNBqgKk8DdLJG8V3m96gGMV

FILE NAME Mundet Cork MCK DATE 1966 DOC MCK101 DOCUMENT DESCRIPTION WC Claim of Puetz vohs ay e " io aa ee Uy SO . oe tea, Dae { wet . STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION ee nL APPLICATION | " VILE SIMIES ORIGINAT AND ITX COPIES , ey - PLEASE PRIIT OR TYPENAMES AND ADDRESSES S CASE NO - fee, HENRY C^ QUETZ A ri ee ? : * , se. a a ye . v o os! AFOLICAR^ VI . teases ~ t, . iy Box 101 Rt 4F6M1 4F6M1 N SUI . . Oakley California Mee not tn Me . VARIOUS + SEE ATTACHED bd Vs ae . - Neo. i ganoree Social Security No. 532-12-4180 ry 532-12-4180 CEMeTEDe heenees | - . : _4 oy % VARIOUS - ATTACHEDgurrorgesHIVAS CLIM twrwoeeses COPE a's aeeatdD te Oo a i ra . a 7Riotz C. Henry_ OF SUPLO SUP PLA OPE AE asbeston worker OCCUPATION at Tied of su , 4/25/07 4/25/07 Asc_attached__19_Asc_attached__19_ 3410 OF MAIR alleges that while employed onAsc_atached_19_ ore LET : CATE OF : at various 2 Californi + , 2:31 Town ON PLACE WHERE WHERE japest OCZNIALD 2 variova employaiene RABH OF PLOTES 1 _ sustained sustained injury arising out of and in the course of the : a inhalathi aro mfn ul materiala of - 4 SIFLAIR NOW SUJUAN WAR OGGETUR foll sztulti _lungs ~ eee oe STATE WHAT PARTS OF Bb 131 press she busOWERY BESUSPE 2 Various employer's Imbuhang^' AkufitmeYATO GRINGuate Mist of Imbuhang^' soe comPARE OD IF EMPLOY^ SB^ NNOT MEGASD 94 westbit AkufitmeYATO was the KO GRINGuate insurance carrier on date of in Rong 1. , PLIMES PLIMES OF WOLL DUE TO THE MJVat 9412 INSOLO TURBO TO WOR DATE 6437 m^hetakPur compensation 4. Wat No. .. : $ 7 = 3. Earnings at time of injury ; maximum @. Site Site ones OF TEP pT s ET ON The basis of pay was STATE PAY PERIDY ON HOWALY 1A72 WEVER ^^ akand VITE Was yes .. medical treatment needed . furnished J.D_Conto Who . 13 t no treatment , J.D_Conto 7 ' radiolog tee t a ITS MARIE MARIE or f^'ctakaund Tatats THE INJURE ANGLIATU SO PARD TREIA TREIA DILLO : ve 8 7. This application determine . 1. Temporary 4 expense Permanent 2. Litigation is filed to dusbility_ _dusbility_ __ 2 etme5) . 963 06 : be liability _ * fort ave diubility___ X_. ahd 280 08 1 DILLO et tlm . treatment costs oh cs Medical .. itt 90 be s i Medical oe ste. d Medical a ee, fey , wesee (PO RATE AND Tiitt . . : - ' oe . , a . : . BT foul buNSEPT OF BRbetatt BRbetatt 1846 MIIS that WHERETOREWHERETORE it is requested such profer under the Workmen's a time and place be fixed for bearing and that an award be made grauling Laws of California Workmen's Compenullon t relief as Dalsland CITE Hearing requested se Onklend Dalsland poe Dated _ . California Pet- " Number of wituen Fatimirritating of trish 1/2 hour Carl Carl trebafung SHMeInTrTHyIenry SMITTI PAIRPISH AIRISHPAIRISHPADLIGIE EGLANGT EGLANGT PADLIGIE @att.smee _____ _____ | intl f - } . os 315 FinialFinial Center Center Building Building Olla 12 Halfda Halfda eee: ATIGER^ ATIGER^ ATIGER^ TELE^ RJRELOHEES sy .6. 452-2000 . owe or) ... ... ... ... ...v... ane, beeran o ue oe lee HE AMMM onee A ed Real 508 ee bated te Base rene RESETS 825485apka teeloe 6644 oal ePLC046 chase ok mea es mmttee 46 ate Ober dig' s #4 .. IMJ 90 woman setario setario 279qib 279qib of 144 144 PLC046 40 peer a de # SL Pih . 8 H. P tee en and Lit. me .. Fhe th LA -- breed FLI cee cee 11. 6te ... .PLAINTIF'S PLAINTIFF'S EXHIBIT 23 EMPLOYER * Armstrong Cork Co. ' Liberty & Charlotte Sta Sta Lancaster Pa Lancaster B & Co. Inc. O. BIonxsu2l5a3t1ion Houston 1 Texas Asbestos Citics Bay Fifth Avenue Co. Ltd. Oakland California PERIOD HORKED 1051 1953-1955 1961 1953 1948 ve '. ok er) ur, Fy wey we .o 7 INSURANCE CARRIER C F. Braun & C^ 1000 So. Fremont Avenu . Alhambra California ho * . The Budlong Corporation + Grandview Bldg Co. Inc. 717 North Highland Los Angeles 30 Calif 1947 American Motoris Insurance Compai 417 Montgomery S San Francisco C The Philip Carey Mfg Co. " Lockland Cincinnati i S Ohio Otto Castrow Company Corp. 2648 North Interstate Portland 12 Oregon _ 1950 1951 1953 1957 - ". 1953 Coast Insulating Products - Angeles 2604 Lacey Street Calif t 31 Calif . Los _ Cork Insulation Company Inc. 155 East 44th Street .. | . New York 17 New York Lawrenc Laurie er Moe o ae Lawrence Des Laurier Co. , 11119 South Mariposa aLe os Angeles 44 Calif . Fibreboard Paper Products Co. Montgomery . 1789 Street _ San Francisco California 1956 1957 1957 1945 Argonaut Insurat 550 Californiai San Franciscoi Pacific Employe Insurance Com 244 Pine Street San Francisco- 1947 7 Fluor Maintenance Inc ' 406 Ward Street . 1 1955 \ ' , ie 1. Martinez Califi. , bel Gay Engineering Corp * 2863 Los East 11th Angeles 23 Streat Calif s c8.e1 LM ys 6 1955 ny ee t Gunder 1947 George Golling & E. os e 2918 Compton Blvd. 7. oa hays Gardena CalifBlvd. ~ |; os * 7 ae Joa . : +e me -" ,? Rg wy a See, Insulators The Industrial P. O. Nox 2001 5521 Armour Drive Drive : US -t*e Houston Texas an J oem " ar EMPLOYER #7. st : PERIOD WORKED , 4 toe INSURANCE CARRIER CARRIER Insulation & Acboctos * . Industry Works of No. Calif Vocation Trust Fund No. 16 200 Guerrero Street te San Francisco Calif- By Kircher Asbestos & Rubber Co. * Box 6652 . \ we Phoeni5x Arizona ae .: . R. E. Kramig & Co. Inc. 222-4 East 14th Street CincinnaCthiio 1956 1958 1954 1952 1953 7 1Oven 1Oven E. Leinio . San Jose Azbestos Co. 1140. Lennon Way San Jose California 1957 -~ Harold G..Lozentzen Company 2257 Market Street -.%/ Oakland California , ? *, Louisville Insulating & . eyed * SuppSlupyply Co. Stre t * 816-818 816-818 West West Main Street 2. Louisville 2 Kentucky 1931936 6 1951 wae Le 1952 ws . 4 e yt Industrial Indemni . 350 Sansome Street San Francisco Cal 4 das? od : a. John Manville Sales Corp. 22 East 40th Street New York 16 New York . 1949 1950 1951 64 a 1952 1953 1957 a) Marine Engineering & Supply Co. 941 Ecst Second Street Los Angeles Calif 1947 we Kiddletown Development Development & a Suply Co. Inc. + . First National Bank Bldg |. Middletown Ohio " Muldoon Company Company Inc. - 6557 East Show Show Ave. Clovis _, *s., i , Mundet Cork Corp. 7101 Tonnello Ave. North Bergen New Jersey ; a OY Northwest Insulating Co. +*,.' 800 N.E. Lombard Stroet Portland 11 Oregon . at 1945 1946 t t ** Owens Corning Fiberglass P. Eox 901 si Toled1o Ohio ay Corp. , 1955 2 1958 4 1961 1957 1959 1960 1962 + - Poy eee, e ee ie George A. Ponne & Co. 906 East Dorothy Lni . Dayton 12 Ohio ee ge Plant Asbestos Co. '1300 - 64th Street Emeryville Calif tH! 4 " M | arn the vO ae Se Thy de re : re 1. +. 1957 " " voy teeth OE es ot oy ce ee 1948 * 1 1948 1949 1950 Pacific Employers 1.953 1954 1955 244 Pine Street _ 1957 1958 1950 . San Francisco Ca a: . Bote be, _ Industrial Dutcai 350 Sausome Stree " Boe San Francisco Ce . ^' ry a 4 . FPLOYER r Sprinken Sons Corp. of Illinois 1010 23 S. Washington St. Peoria Tilinois PERIOD WORKED 1957 INSURANCE CARRIER ' A es . a Standard Asbestos Mfg & InculatAsbestos Co. 410 orth Clive Street Kansas City Missouri Luna Stevenson Co. 673 Blackbank Street Chicago Illinois Technical Survice Co. 730 Reimus vo !! Albuquerque New Mexico J. T. Chorpe & Son Inc. 2351 Ceuon Avenue Emeryville California 1947 1951 1952 1947 , a 4 1948 1949 1950 1957 Pacific Employer 244 Pine Street San Francisco C Mosulation rs - Mosulation Company 2641 South Yates Ave ua Leos Angeles 22 Calif 1953 Industrial Indem 350 Sansome Stre San Francisco C Ensulation Universal Company 1221 Middlefield Road . . Menlo Park Calif 1960 Van Streat Van Van Va? an Arsdale Harris Fifth Streat Co. Fiftahncisco Calif . ~ 2784 Calif WWestern estern Asbestos *_Do Rincon anser 7 ww Sen Fr^cisco19 Fitout Fitout * Western Fitout Gloss Products949_ 739 = Street a7 7. San Francisco 7 Calix Whiting Whiting Corporation peat) 15700 Latop Everde - , Teg Harvey Illinois 1948 oes a er. | _ aw " 1946 1947 1954 1956. 1957. 1958 1960 1961 State Compensati. Insurance Fund 3360 Grand Avent Oakland 10 Cali _.. oe te Products949_ Te _ Re > . . ate alg ofa woe a of ton, hee es 1945 00 Fe a al me er Ye yg alos ar Ae : see Co Ve sey a co. 7, te : : . . LAW OFFICES OF | Woe SMITH PARRISH PADUCK & sot . a a . . rc OLENCOUNT'S OLENCOUT'S IC Moe CLANCY *. * , a 1. CENTER BUILDING . 400.14 STREET OAKLAND CALIFORNIA 0481 : . FINANCIAL . . . 1" 1 jer -." 4 ; ve . | Workmen's Compensation Jaakcon Stroot Oakland California Ro , . Henry C. Puetz va oT Ro = . Appeals Board ' Various ee 7 : fh . V 2 Cet . be ; July 22 1966 ; . wf _ , oe " a . . *, on ote a Bee, s te ae aioe . ot, . oo 4 a . yee ' wel Le, : Enclosed horowith find original and six copios of Application for ' t te Oakland pit Hoaring on behalf of the abovo named applicant Wo would appreciate your setting thin matter down at your earliest availablo dato a we oa hoaring for in ee . Pomea ae - By copy of this letter wo are requesting that the insuranco company | reports provious - forward all medical roquost st to us unless sont upon ; Ln . Ltt company oo eo oe . a. " Pe pe ot cc see attached list x Aartcc a i : Very - . truly yours ' t 4 CLANCY , PADUCK SMITH PARRISH PADUCK & CLANCY : } A , ' a , 1. . . i or kh SN . 1 OM . *. . oe + . Aa . 1 oe Ta aa ' cl < : eet ee e ' r toe ese : "v / __t on a beg er ' any a LR: adr en . ; ct : ee . as t te et wore . . soee Ss p stat ow 8 _ es ' , tes + =. eemeineee eee mee Oe ee ve so e ra oGt enes en ee ne emt : we sme ee mows es cone 7 oo, culty eee we per ta ee eee, aves wore, fore Ny - e aad . eo, gem whys a we . aes oa a fy foes ss oy to foe + 1 nem ee eummitemenend ~ . y? ter ove. an we seewen + owe 1 wen nd ' + "ty a 4,8 ry wal an) : : . oot . on - + . Fone ad ' . ra . 2 . ; a ; _ pe ed ec e oak? - rs . " . . . . . . wee, A w . ' . wt hos at " * wie ' . er . rr} Po oy ' s? ae ee, we ; ae . toe : i rete ii wer i 1 4 os . ate . e . : t ~ os ap a ns . o os 2 a - of e . y mat 1 i ' ~ ' , , + . ; cate . i oh - Per Vel Yet . - ~? : at . , 3 . i! t id . + : t " . 1 emait -~ PuityPuity Puity Henry + C. COMPANY PLANT DIVISION ae 206 8 WCAB CLOAK CLOAK 20668 CLAIM NUMBER to 1945 1967 1967 / AGE SEX acbeatosis acbeatosis acbeatosi acbeatosis Asbestos worker OCCUPATION / .D | T.A.C. CLAIM NUMBER INJURY SUSTAINED AGENCY PART OF BODY INJURED AGENCY PART S MECHANICAL CONDITION ADDIL INFORMATION TYPE OF ACCIDENT / PERSONAL FACTOR FORM 851-385 9-62 ( FB050366 NE owe omeit THE 1 sr enmm YE * taney Henry Puetz Puetz Henry ! CHAME Henry CODE MED HOSP C. RAY 119201 code vas ge . | Met eens oie wee wee ee. $ $ $ TEMPI DAY WK OTHER EXPLANATION CK NO P.D. FROM Cha Cha WCR86600K WCR86600K WCR86600K 200 CLAIM NUMBER } THRU AMT TOTAL RESERVE 10764 7 FB050367 : a. rw aint t as . .? J. D. COATE M. D. RADIOLOGIST 2976 BUMMIT STREET 9. CALIFCO ALR IFON RNI I TELEPHONE TEMm.com 8-4017 February 17 1962 Patient Address Puetz Henry C. Rt 2. Box 192. Oakley . Physician Asbestos Workers Survey Act 54 >t . a . oo 78 22832 along Both lung fields shadows in both show considerable perihilar areas granular thickening of the root | with discrete milliary densities 4-15-61 noted on examination 4-15-61 These changes were A direct comparison to determine determine the progress of with the previous films would be important this disease CONCLUSIONS Pulmonary occupational disease probably asbestosis JDC 1148 . < Conte . Sd / . PLAINTIFF'S : 2-23 EXHIBIT DINITI LA DINITI 198 ACC BE @ @ BROBECK PHLEGER & HARRISON 4 ATTORNEYS AT LAW . ONE ELEVEN SUTTER STAKET - SAN FRANCISCO 94104 434-0800 H i - ANNUATION Novembe3r DOALU ANNUATION ANNUATIONANNUATION WOND APPIALSAPPIALS DOALU 1966 Workmen's Compensation 1111 Jackson Street Oakland California Appeals Board Re Henry C. Puetz vs. Cork Co. et al 66 OAK 20668 Armstrong Case No. Gentlemen In the entitled matter we enclose here- with on behalf of defendant Fibreboard Corporation sued herein as Fibreboard Paper Products Corporation its Answer dated November 3 1966 which please file Very truly yours BROBECK PHLEGER & HARRISON & Renall S^/m^/ Rinaldo Sciaroni Jr. ite Al PLAINTIFF'S EXHIBIT 2-23-1a ad \ fee. ape. ; DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA ie BOARD wor. . 4 * 4 1:15 > 1966 ANSWER of FIRREBOARD CORPORATION fai: LATION LATION HEREY C. PUETZ MED MED PLATE Case No. 66 oak 20668 Date of alleged injury 1945 - 1962 __ " PIBREBOARD CORPORATION 200 PECT MADE OF BAUREI insured 475 Brannan Street PEOPLETED PEOPLETED 56041861 560041861 Francisco ERIULANCE ERIULANCE SANTILES SANTILES SANTILES ADGOEIE 305 ATE W WOOP L 96-4982 . pArNesSsWlyERseItNfGortDhEaFnEdNDaAdmNiTtS adllenoythtehremaatlleergiaatlions of the Application as indicated below with such explanations as 13- DENIALS Omnes sw DENIALS Tome oO tn hoe Employment x Occupation x Injury EXPLAIN BELOW 4 B^B^ 1ii54983 ON OLFE OF MAT OF BUT MOLD REPLATE POLITI Insurance coverage mh Uobility for self procured treatment Liability for future medical treatment x Medicacol sts x Earnings x Periods of daobility x Permanent disability IT IS FURTHER ALLEGED 4482 | APLAY~OHAI MOTI MOTIF FIEDIE MOTIFD IED PO APPL48 488 0129AI 0129AI 4 . LEINE LEINE LAST Det and kostc^ 09> b1k TE & HIO to what Apportionment to periods prior to freeqaret free fre qaret doq mIa Rr S Ie STAt TOI subsequent to 1962 1945 and 1. Defendants have poid disability Indemnity in the total amount of $ _H11 at the rate of $ worek Li beginning Shrough ... 2. Affumativa delemes and other matters Jurisdiction of Board statute of limitations kn prejudice for lack of notice serious and wilful misconduct of employee continuing his exposure after diagnosis of asbestosis Defendants do not wares the right to raise additional bsues in accordance with the provisions of low and the Rules of Practice if other issues develop Euimated Kime for trials Unknown Sled defendants All defndants medical available will AddimaltionUanlkUnonwknnown be kled before trial wanted . WW Doted of San FranciCalsiforncia Caolifornia November 3,196 ICITED IMICI FIBREBOARD sued CORPORATION herein as eran insignilla Fibrebotahe rd insignilla insignilla insgnila m Pap-- 58 Its Attorneys 111 Sutter Street Francisco 1600 1600 1600 StL ANS ONE OF BETOPIC DIA WAS Tee td cnet + WAS F 36 14 415-434-0900 teow oon ome D 2 ane oii CERTIFICATE OF SERVICE BY MAIL mo I hereby certify as follows I am an active member of the State Bar of California counsel in this cause thereto On November 3 and not a party 2 1966 1966 I deposited in the mail at San Francisco California seven 7 sealed envelopes envelopes with postage fully prepaid thereon containing a true copy of the document attached hereto and addressed as follows Henry G. Sanford Esq Hobart Buildin Sagn California Building Messrs Smith Parri Pas duh ck & Clancy 315 Financial Center Building , Oakland California Messrs Hanna & Brophy 1540 San Pablo Avenue California Industrial Indemnity Company 155 Sansome Street Francisco Industrial Indemnity Exchange 155 Sansome Street San Francisco 8. Norman Hayes Esq Pacific Employers Insurance Company 222 Sansome Street San Francisco California Sedgwick Detert Moran & Arnold 111 Pine Street San Francisco Rinaldo Sciaroni er. Brobeck Phleger & Harrison ss | 111 Sutter Street San Francisco 4 California 19 __ eee WORKMEN'S COMPENSATION APPEALS BOARD HENRY C. PUETZ Vs. State of California Applicant CASE NO.66 OAK 20668 MINUTES OF HEARING CONTINUED C. F. BRAUT AMERICAN MOTORIST IISUTANCE COMPANY JONKS KANVILLE SALES COMPANY ANISTRONG CORK COMPANY TRAVELERS INSURANCE COMPANY COAST INSULATING PRODUCTS COMPANY LORENTIEN HAROLD ~ LORENTIEN COMPAITY ARGONAUT INSURANCE COMPANY GREAT AMERICAN INSURANCE COMPANY INSULATION SERVICES INC BOARD CORPORATION ACTIA CASUALTY & SURETY COMPANY OWTHS_COENING OWTHS_COENING FIBERGLASS CORK_CORP HARTFORD ACCIDENT & INDE INITY COMPAITY METAL CLAD INSULATION WESTERN MacART^ TUR COMPANY STATE COMPENSATION INSURANCE FUND WESTERN ASDESTOS COMPANY VAN ARSDALE HARRIS COMPANY M. R. CARPENTER ACCURATE INCULATION PACIFIC RPPLOYERS INSURANCE COMPANY PLANT ASBESTOS COMPANY J. T. THORPE & SON INC HICKOUAN BROTHERS CONTINENTAL CASUALTY COMPANY FLUOR CORPORATION ETD INDUSTRIAL INDENITY EXCHANGE WESTERN FIBROUS GLASS PRODUCTS INDUSTRI^ LINDEIAVITY COMPANY BAY CITIES ASISTOS PANY HULDOON COMPANY INC KELLER INSULATION CORP EMPLOYERS LIABILITY ASSURANCE CORP , LTD ASSOCIATED INSULATION COMPANY OF CALIFORNIA Defendants Place & Time Oakland November 26 1968 9:00 a.m. Referee Reporter Appearances Defendants HICKMAN Lengerich Applicant present Smith David Parrish Paduck & Nelson appearing Clancy Attys 4 General Accident Fire & Life Henry J. Sanford Attorney Assurance Corp. Ltd. American Motorist Insurance Company . Travelers Insurance Company Argonaut Insurance Company Great American Insurance Company Hanna & Brophy Attorneys Charles M. Melillan appearing Guarantee Incurance Company J. Patrick Goodwin Attorney Fibroboard Corporation Brobeck Phleger & Harrison Attorneys Rinaldo Sciaroni Jr. appearing Fireman's Fund Insurance Company James Grughran Attorney 45 PP Aetna Catunity & Surety Company Bedmwick Detert Horan E Arnold William Thomas appearing Attorneys See pnga 2 * erent e eee HENRY HENRY C. 66 66 OAK MINUTES MINUTES . Bovenver 26, 1968 Appearances Defendants Cont'd . Hartford Accident & IndeImndemnitynIintdyemnCiot-y Sedgwick Accident Accident William Thomas Moran Co. Insurance Fund State Compensation Sherbourne Insurance Harry Insurance Companys Pacific Employers 8. Norman Hays Insurance Continental Casualty CompanyCompany John Wilkes Representative Industrial Indemnity Exchango Industrial Indemnity Exchango Exchango Alexander Keenan Attorney and WITNESS FOLLOWS FOLLOWS Henry Henry Puetz Applicant STIPULATE STIPULATE INSURANCE COVERAGE AND EMPLOYMENT AS Coverage AS FOLLOWS 1 General Philip Fire Fire Life Assurance Philip Carey Mfg Company Corp. Ltd. C. Braun Insurance Company Cc. F. Braun Johns Manville Company Armstrong Armstrong Sales Co. Armstrong Cork Coast Insulating Products Harold Lorentzen Products American G. Lorentzen Co. Great Insulation Services Inc. Guarantee Services, Inc. Lawrence LawrLe.ncDeesLaLuafulfeirer Co. Lawrence Fibreboard Corporation Firemans Insulation Insulation co. , Casualty Surety Mundet Corning Fiber Glass Mundet Corp. Glass . owens Cork Mundet Cork Corp. (See Pace #2 64-65 64- 1/26/65 indicated indicated last hearing indicated indicated ; Social securit record Last quarter 1st 11994848 indicated indicated ; social securiti record 52-5 hours in in . 1955-1962 1953 HENRY C. PUETZ 66 OAK 2006B MINUTES -3- November 26 1963 Stipulations Cont'd Cont'd oo. Hartford Accident & Indemnity Co. Metal Clad Insulation Coverage Employment 04-2 6 working days Western MacArthur Company State Compensation Insurance Fund Western Asbestos Company 67-10 38 working days For periodo as shown in social security records Van Arsdale Harris Company M. R. Carpenter Accurate Insulation Pacific Employers Insurance Company Plant Asbestos J. T. Thorpe & Son Inc. 61-10 62-1 Prior to as shown security 1/1/52 in social records Prior to shown in security 1/1/52 as social records Hickman Brothera 1963 Industrial Indemnity Exchange Western Fibrous Glass Products Fibrous 1949 Industrial Indemnity Company Bay Cities Asbestos Company Plant Asbestos Company 1948-1949 1/1/52 to 1962 Harold G. Lorentzen Company _ 1956 J. T. Thorpe Company Muldoon Co. Inc. Keller Insulation Corp. Metal Clad Insulation 1957 . 61-3 63-12 63-2 ISSUES Other than the stipulations as to insurance coverage and employment all material facts are in issue including affirmative defenses of Statute of Limitations Prejudicial lack of notice Willful misconduct of the Employee in accordance with page 10 of the deposition Jurisdiction of the Appeals Board See Page 4 ANENRY C. PUETZ 66 OAK 20668 MINUTES -4- November 26 1968 EXHIBITS Applicant A A - 3 - 80.50 Report of Dr. Paul E. Crantz 11/15/62 of Dr. Leon Lewis 7/5/68 8/20/68 and Reports 10/24/68 with copies of reports from UC Medical Center and bills for 100 and bill of 2435 Webster Street Laboratory 80.50 Deposition of Applicant 11/8/68 Defendant~- D - Report of Dr. H. Corwin Hinshaw 10/8/68 State Compensation Insurance Fund D - Letter dated 12/20/67 from Corning F^'berglao Aetna Casualty & Surety Company 3 - Letter 3/29/68 from Western incArthur Co. ; Hartford Accident & Indemnity Co. Insurance Co. D Records of Dr. J. D. Conte Travelers 5 - Photocopics of Records of Dr. Crantz Industrial Indemnity Company REFEREE: It appearing that Applicant's employment by the Philip Carey Manufacturing Co. was out of state under a contract which was not made in the State of California of employment THEREFOR IT IS ORDERED THAT and GOOD CAUSE APPEARING Philip Carey Manufacturing Company and General Accident & Life Assurence Corp. Ltd. be and they are hereby Firedismisced GOOD CAUSE APPEARING THEREFOR IT IS ORDERED THAT Des Laurier and L. L. Des Laurier Company and Lawrence Firemans Fund Insurance Guarantee Insurance Company and Company be and they are hereby dismissed as parties : defendant DISPOSITION Fifteen days to the parties for further filing including points and authorities seven days thereafter for rebuttal matter then to stand e e HENRY C. PUETZ 66 oak 20668 -5- November 26 1968 SIDIARY EVIDENCE APPLICANT testified It does not involve the tar pot that much he is working now doing asbestos work physical activity He is working on . With regard to his physical restrictions he has a hard time doing anything because of shortness of breath He cannot climb a flight of staire without stopping He can walk about six hundred feet without stopping at a medium pace He can be on his feet all day long He cannot climb but he can work on a six or eight foot ladder In 1968 he has worked for about three months K 1967 He drew UCD benefits in 1963. He started drawing such bencfito in November 1967 when he went to the hospital He did not work from November until September 1963 His lest day of work wa November 11 1967 and he returned to work on about September 21 1968. He was sick during that period Since September 1908 he has had about six jobs He gets laid off He cannot do the work because he cannot climb He is receiving medical treatment for his Dr. Crantz He has paid all of the bills condition is getting worse lung condition from for medication His On examination by Mr. McMillan Applicant he has read his deposition and it is correct to recollection testified that the best of his Applicant's Attorney stated that Applicant's income tax returns show earnings of 10,023 in 1965 and 12,713 in 1966. He received unemployment insurance benefits for preceding September 21 1968. He 1B working at for Associated Insulation Company He has been days there four weeks Standard 011 Now working for five Cork_10_1953_and He worked for Armstrong Beverly Ohio but also out here He got the jobs through the union His work in 1955 was in California but his work for Cork_10_195C3ork__10a_19n53_dand Cork_10_1953_and 1954 was in whio His work for Johns Manville Company was in California eeeHis Hic work for C. F. Braun and Johns Manville was not on board ship on Armstrong Contracting and Supply is the same as Armstrong Corit Le did not boar boad rd ship for that company in 1961 His work for Coast Insulating Products Company In 1965 and 1966 was in California His work for Lorentzen in 1963 and 1964 was wao Ship repair work His work for Insulation Services in 1965 and 1964 was in Walnut Creek California He does not remember seeing a chest specialist in Oakland in 1904 On examination by Ir Thomas Applicant testified that when working for Owena Corning Fiberglass from 1955 to 1962 he was using fiber glass insulation but also asbestos It jo difficult to say how much of the time was spent in using either material lle did not necessarily use fiber glass more than asbestos HENRY C. PUETZ . 66 OAK 20668 -6- November 26 1968 Lani While working for Western MacArthur Company he used fiber glans and asbestos His work for that for Mundet job Cork was back east He was hired back east His work for Owens Corning Fiber Glass was in California about thirty per cent of that employment was aboard ship but On examination en behalf of Mr. Sherbourne Applicant testified that in 1968 his car turned over as a recult of which he had a sprained neck lie was in the hospital for eight days Ile received treatment for his neck and also for his lungs while in the hospital Antioch Memorial Hospital Hic neck and buck were treated for about three days by Dr. Crantz He did not have an appointment for the hospital prior to the accident In 1965 climb Smith's he had quit a job for Plant Asbestos because he couldn't He quit several jobs because of this He went to Attorney office in 1962 because of his lungs His work for Western Asbestos Company was in California About twenty per cent of that employment involved repair work on ships His work for Van Arsdale Harris was on ships On examination by Mr. Keenan Applicant testified that he is able to handle a job which requires climbing a few stairs in the morning His neck and back are not bothering him now He was treated in 1966 or 1967 for a kink in his neck by Dr. Crants He has no trouble with his right knee now nor with his low back He did not receive treatment for nose bleeds now nor since 1965 His work for Western Fiber Glass in 1949 was hio work for Bay Cities Asbestos in 1948 and Plant Asbestos Company was in lifornia in Californic as was 1949. His work for On examination by Mr. Sciaroni Applicent testified that his work for Fibreboard in 1947 and 1948 was in Antioch He does not reachber working for Fibreboard he remembers working for Plant Rubber and Asbestos Company which was owned by Fibreboard That work was on ships which were being repaired He worked for two months at the Hark Hopkins Hotel for Plant Rubber and Asbestos Company The ship work he did for Armstrong was on ships under repair on new doctroyers not On examination by Mr. Hays Applicant testified that he came to California in 1945. He took a traveler in 1943 and spent two years back cuct He returned to Califormia in 1850 and stayed two years He then went back east until 1954. He engaged in acbectos work back cast lle hac used a respirator ever since 194h He used a respirator on all California Jobs The respiratora are not very good They HANRY C. PULTZ 66 OAK 20668 . -7- November 26 1968 cover the mouth and nose He did not notice any shortness of breath prior to 1944. He first noticed shortness of breath in 1961. He saw Attorney Smith in 1962 for his shortness of breath On examination by fir Wilkes Applicant testified that he worked for Fluor Corporation at the Union Oil Company at Oleum in 1955 1955 and 1957. This was asbestos work His earnings at that time were about 5 per hour On further Direct Examination Applicant testified that his employment with Armstrong Cork Company in 1951 was out of state ~_s, His employment in 1953 was out of state His employment with Thorps and Plant in 1953 were in California but his employment with Armstrong ships workedfor was Armstrong Armstrong back cast Armstrong on He returned to California in 1954 at Bethlehem Steel He worked for Kitcher in Arizona and then came to California The work ~o he did for Armstrong prior to his employment with Kircher was out of state rns RAH hlq RICHARD A. HICKMAN Rofereo - os DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA HENKY C. PUETZ | CASE No. 55 OAK 20566 Applicant VI ARMSTRONG CORK COMPANY et al > and STANDARD ACCIDENT INSURANCE CO et al ORDER TAKING OFF CALECNADLEANDRAR Defendants 11/21/661 /21/6 Pursuant to request of applicant and GOOD CAUSE APPEARING IT IS HEREBY Ordered That the entitled matter be and the same hereby is taken off calendar and all further action herein suspended subject to being reset upon request of any of the parties hereto RICHARD A. HICKMAN - =" Referee WORKMEN'S COMPENSATION APPEALS BOARD PARTIES SERVED AS CHECKED ON OFFICIAL ADDRESS RECORD Date 11/15/33 h SEAL DIA WCAB FORM BO BEY 7,00 FDANCAL FORM 401 Perassone vee THE @ wer af Tye Pusto Pusto t~ ~ eoe abla abla abla eee August 31 1966 Reliance Insurance Companies Pacific Department 320 California Street P. O. Pax 2567 San Francisco California 94126 Gentlemon Attention Mr. E. W. Hauck Workmen's Compensation Pacific Department : Re Claim No. 95 C D28147 Insured - Armstrong Cork Company Claimant Houry Pusto . Supervisor We regret we can give you no information regarding the above alaimant for the year 1951 Ender our Retention of Records Schedule all payroll records prior to 1956 have been destroyed _ We had our Payroll Department check all information available for the years listed for Armstrong Cork Company on the Application to the Industrial Accident Commission We attach a copy of this information for what it may be worth to you Very truly yours Enclosure Mabol E. Barnet Insurance Department 403 24 1995 r California Inflation532 12 4103 IVY - FUNIS - 9.9.0 . => constreak Inflation Divsica end werind Cork Comp the presumablypresumably 2! constreak ad This for Divisica his betas dE Supply Corporation Curing the years 1991 1952-1955 p39 1 | Po. free his Curing Falcons a to you will ces attached copy of letter from Falcons Cos they pant exzain53 tng we any the 19517 | Do | L year 1951. 1951. yoyuou information at all for year i. . . . ; have pant and | } wo caly for 1953-1955 the and by 1951 | 1 il 1 " > \ . . it 1 i) ! instant While this company cake i during | :: port 1953-195 maumed ' | wa { 1961 v tore . by _. i ee Drunence poll is prezza Travelers Company and they too will to titing ca for | | Drmstrong and 2003 information | 1561 | f \ 1 ptehcetning tails you 1951 will you please also the what the year | ; : ct for prezza Ca youlove for the yorss 1953-19551953-195 (111 oe Be |. 4 ' moe wicked preach zveralj j \ an j | Thank you | aaetnok, Insercacd Endig preachzveralj _ preach 9-16-55 Quit Voluntarily Ending 18200 Lin Ingeles Lin . 61-5-5.61.B Lin Ingelesrecod 5-106-12861 Voluntarily | 7-30-61 18.300 : Lin : wicked zveralj | wicked do taje zveralj 61-5.61B B Ingeles Ingeles 1.320 1.3.2061-5-5.61.B 61-5-5.61.B 61-5-5.61.B 5-10-61-12-8-615-10-61-12-8-61 5-1062-861 5-10-61-12-8-61 A V 15.6.6310-18-63-17 : | j | earnig | | earnig : l Ore Quit Voluntarily ; Pay Ending Pay ; Quit Voluntarily 1820 Ending ; Voluntarily 17.16-61 18200 Voluntarily | 17.16-61 Ending an von toe _ , work | J no work Voluntariy Quit Voluntarily . Voluntariy Voluntariy J PG pig. | ftda | 1 7-73-61 7-73-61 . 14560 Ben =f be id 8.6.61 | ' 8-13-61 8-13-61 i 8-13-61 8-13-61 Lab 8-20-61 . ' 1. 4 . - | 14972 any 14972 18920 18920 ol bog. 18920 ih | m4 yt. 187.30 18730 18730 : no record ooffearning fa 8.37-01 18730 Sf ea PEE Fim (PFC, | f ' : AREAS d 1 1. | 9-3.61 il | fi h fl ; fi 18730 . | 18920 ) } 15036 ' a fo j It | I By 13-76-6E1ndin1g3-76-61 4-2-61 4-2-61 4.7-61 | | 7058.18j WaL. 117600 117600 : LO 13200 114080' | bd Days 21-610 et 182,00 4 i Days 182,0 182,00 Fe 21-610 ' Days | XH) 5-28-61 5-28-61 | 18200 1820 i YN 6-4-61 6 yada IS p fl - 2-fl498 ,,o 10-1-61 Ii 10-6 10-6 # 10-1-61 10-8-01 5555 i 18720 18720 ij meee 1842018720 18420 5555 gE 10-15-10-615-16 | | 1872018720 5555 fo 4.16-61 4-13-68 Voda 17600 17600 17600 , 19000 1! 6-4-57 BO iret _ 6-2561 18200 18200 48200 153 00 187,52 12 1 10 23.61 | < Fy i ge! 11-5-61 11-5-61 18730 fl226.04 226.04 187,52 | 5555 ; 2 1a ft H fl. 4 h foe 17605 2; a 2627 2.61 2... 75200 FT AA 2627 7 2092 - fl2627 2627 fl AUG300 AUG300 & b by OS / Oo OL obo BSUIL LSS -E.8/ L/'8FO7 A OE 49O0-27 Lepngove 19-9 Y- ff ES Oy Aug. 30 1966 HENRY C. PRETZ - - California 8.5 532-12-4188 presumably Armstrong Armstrong 1C9o5m3p-a1n9y55InsulIantsion Divson . .. at | during on. Divsion This man worked for Cork Division 1951 Supply Corporation during the and 1961 years As you will see from attached copy of letter from Reliance Cos they want his earnings year 1951 Do you have any information all for the year 19513 if 1 { too earnings | | ; | | | | ba While this insurance company only asks for 1951 during the years 1953-1955 and 1961 we were insured } by ue Travelers Insurance Company and they will be writing us for payroll for those years So i while you are checking 1951 , will you please also tee what information lave for the years 1953 Armstrong and then the year 1961 AC 1955still Thank | ew ao 7 MEBarnet Insurmce San Franciscs Franciscswordart 17.16.61 Los Angeles 7-16-55 -6 1. Quit Colinteriliy Phy . 18200 3-20-61-5-5-61 3-20-61-5-5-61 3-20-61-5-5-61 B | to to work Colinterily if] 7.23.61 i 14560 ee . io:.. 5-10-61-12-8-61 5-10-61-12-8-61 4 to San Francisco work ne 5-6-63-6-18-63-13 5-63-618-631 5-6-63-6-18-63-13 ! Lift 7-30-61 18200 | i! 8.6-64 8.6-64 14772 ly Voluntarily Voluntarily cece eee | 8-20-61 18730 ne ne ee ee eee ee eee eee ee Voluntarily 8-23-61 18129 | x a se ei i. no records of|earning earnig e : 1954 1955| Earning Ne 18-27.01 So! earning ES f VOY, APS 1954 18-27.01 18-27.01 158/20 158/20 158/20 | 1961 b |! pi 1 9-3-61 18720 Sy 1961 2058.18 2058.18 -f ood uh lhot hoi day 9-10-01 1 150 Lh for nn tm Earning EE 7-14-61 ' oo a ee a ees 35998 By 3.21610 3.21610 Ending hyo Wh By Wan | i | | a 9-24-6X 9-24-6X 8 27772 La 3.21610| bhi 17000 | 2 3-26-61 [?a4 ' 182 00 [eI 10-1-61 18720 lat 132001 4-2-61 4-2-61 ) SAP-o} ao 18200 18200 |S] 10-8-07 | 8120 en 4-7-61 2 4-16-61 4-23-61 4-23-61 14050 | A) | 6-7-67 2. 17600 |e) - 17600 sy" 6-77-64 4-30-61 ees, fal 6-75-61 6 5.7.61 5.7.61 pe 5-14-01 176'22 fo 2-3-61 en eel EEL 3 7-12-04 107901 182.00 18200 | 1a |i 10-15-6 18720 ol | | 5 10-2301 110-23-01 18130 St! 2) | - WH18130 bh 15232 Sh 11-15-07 ; 18789 ye si f 1 -15-07 Vie 3 al eaei Sli i | HA 1765171 i . 1765171 de} AUG 30 193 RELIANCE INSURANCE COMPANIES PACIFIC DEPARTMENT 320 CALIFORNIA STREET P. O. BOX 2567 SAN FRANCISCO CALIF 94126 TEL 981-7600 5/30/66 August 24 1966 5/30/6 5/30/66 5/30/66 Amstrong Corl Company Lancaster Pennsylvania 17604 Attention Miss Nabel E. Barnet >> Insurance Dept. RE Clain No. Insured Claimant : : Armstrong Cork Company ee Henry Puetz Gentlemen Acknowledging receipt 1966 to the extention Ockland California number and are giving of a carbon copy of your letter dated July 29 of the Workmen's Compensation Appeals Board in We have set up a file under the captioned this matter our preferred aattetntit on ention At At this time we would like your assistance in obtaining whatever information information you can give us concerning the employment of Mr. Puetz during the year of 1951 when Armstrong Cork Company was insured by Standard Accident Insurance Company We of course would like copies of his 1/2 forms his payroll earnings during this year and any information which you can furnish concerning the whereabouts of where he was employed and the type of work done Ne of course are filing the necessary answers with the jormen's Compensation Appeals Board making a general denial which will enable us to have a little time prior to hearing before inking a decision Any assistance that you can give us in this matter will be greatly appreciated EMH cks a % E. 7. Hauck Women's Colp Pacific Dept. Juby ec: Reliance Insurance Company ~ Pittsburgh Claim Department Attin C. 11. Koncultamp Reliance Insurance Company | Rellance Standard Life Insurance Company | Planet Insurance Company nn nr nT S| + e on DEPARTMENT OF INTIUSTRIAL REIATIONS REIATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD te e) p Apst Apst HENRY C. PUETZ 4 PUETZ Apst Apst [U- Y Case 66 OAK 20668 NOTICE OF HEARING . 1 ) VS. Applicant ARMSTRONG CORK CO et al and STANDARD ACCIDENT INSURANCE et al COMPANY Defendant 3. You are bereby noti ed that an application for compensation compensation has been fled with the WORKMEN'S COMPENSATION APPEALS of California You are further noused that mid application has been set for bearing at November 3rd 1966 3000 State Building llll Jackson Street Oakland California 9:00 ALL A.M. Before A.M. Referee Hickman and that at mid time and place the WORKMEN'S COMPENSATION APPEALS BOARD will proceed to bear and dispose of the said applicating in the manoer prescribed by law WORKMEN'S COMPENSATION APPEALS BOARD By Assistoet Seerveary Das August 11th 1966 NOTE The partics are expected to submit all disputed issues for decision at this branng All witnesses of notice solls and other proof must be available at the hearing CONTINUANCES WILL BE GRANTED ONLY OF GOOD CAUSE Requests for continuances are to be made within days the date of this NOTE TO INSURED EMPLOYERS Your attendance at this beating may not be insurance necessary Ask your evidence UPON A medical CLEAR reports pay SHOWING SERVED ON ALL PARTIES LISTED ON THE OFFICIAL ADDRESS RECORD Date 8-11-66 fc = 53 DIA WEAR Form 76 K. 13-65 Parmerty Four551 domes Bex! Angie Before the Industrial Accident Commission a of the State of California HENRY C. PJETZ vs ARMSTRONG CORK CO et al and STANDARD ACCIDENT INSURANCE Applicant | COMPANY et al Case No. 66 OAK 20668 Order Joining Party Defendant ; Defendants | Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT INSURIANNCESAUPMRSAAPTMSTNRRONGOCNEG CONTRACTING COMPANCYOMPANY and & SUPPLY TRAVELERS CORPORATION INSURANCE COMPANY STANDARD COMPANY ACCIDENT be joined as a party defendant in the entitled cause Name and Address of Persona Served Referee Olney L. H^ LL INDUSTRIAL ACCIDENT COMMISSION Date August 11th 1966 ALL PARTIES SERVED AS SHOWN ON OFFICIAL ADDRESS ADDRESS RECORD fc 53 P 365 IREV 18-641 eee eee ee ret mm ete ee ee er eee ees DiffDifn nes De iffs nes Serving Notice aewet-t000p0oe%.D gee af we oe a ere a ; te : * . . , . Brthores Lad , . / j i 161-0216 CABLE ADORISE ADORISE ALEXCAND TELETYPE PO 641 ALEXANDER AGENCY INC INSURANCE WIDE SINCE 1853 . ? 316 FOURTH AVENUE PITTSBURGH PA 15222 ood 4 Claims Department | . Reliance Insurance Company Arrott Building . Pittsburgh Pa 15222 i? : Gentlemen: / oY A f s f /} Insured = Armstrong Cork Company / Claimant = Henry Puets vs Various ff 8.8 532-12-4188 We are enclosing herewith various papers in connection with the above claim The Standard Accident insurors on this risk back in 1951 Insurance Company were the I Please let this have your attention 8/8/66 you 8/8/66 Thanking we are , Very truly yours B.R.ShriveB.R.Shrive By ! al , encls ; cc Armstrong Cork Company Lancaster Pa % DUR SECOND CENTURY OF INSURANCE SERVICE ee - wumy ne Ong ce . owe oe . eG mee vv -. a ve . se aa) a a - . + - r mee wee te ry F we & wees . . . . a 2 . , ~ Me and * - so. H o e- ~ wer.MB tee eo... - owe - 2 ' u . we so . . , ey . ee whee 6 ee . - ee 9s . sees re) $ *: -. . an ad nee : ore 8on or oS .c. ee - & ep wrk ee rrr.) on fi se ce fe en refs. tt . tf en > ~ -- ard . . Poe a? . - -. o- rs) - * ao so. . . oe. wy 5 aa. . . tee o. 4 ry os . - oe. re a ae ~ e we . wees . De . beso ee a se. a . . es - s - ee , ee ee ry . em . e+ 0m . fe, mw oe ike ss eee ew +e roe mae so eee we mew? omy ~ ~ ce. roe car Cras wee 7 wo. wo ta wee eee a2 wie fe . em soe a or . a S- wa wee Ht ase ae) t:= tee ten 8 eh af Lf ad oe oe . Coes ek Buy . C ae ' .... . C8 . . ry ome teow . oF Se rr ed ery a . ror on wy Se - 10 oe - y Lite eltivlae ee , ( , T iseea Inc. Co. ree eae aan c - fo. . . LAW OFFICES OF SMITH PARRISH PADUCK & CLANCY at 120 FINANCIAL CENTER BUILDING 405-14TH STREET DAKLAND CALIFORNIA 4812 July 22 1966 Workmen's Compensation 1111 Jackson Street Oakland California Appeals Board Re Henry C. Puetz vs. Various GLENCOURT 2.2000 Gentlemen Enclosed herewith Hearing on behalf find original and six copies of of the above named applicant Application for We would appreciate your setting this matter down for hearing in Oakland at your earliest available date By copy of this letter we are requesting that the insurance company forward all medical reports to us unless sent upon previous request DRN CC see attached list Very truly yours SMITH PARRISH PADUCK & CLANCY ay vt . STATE OF CALIFORNIA . INDUSTRIAL ACCIDENT COMMISSION APPLICATION FILE SIGNED ORIGINAL AND STX COPIES PLEASE PRINT OR TYPE NAMES AND ADDRESSES CASE NO HENRYC. PURTZ ve VARIOUS - SEE ATTACHED - : APPLICA APPLICA SEPLATED Box 101 APPLICART'S 4860206 Oakley California Social Security No. 532-12-4188 EPL & AD CLEO CLEO MaukanCE CONSE GUCE BARRIGA E APE OS L wa Henry C. Puetz MR MR of SPLATSE asbestos worker OCCUPATION 67 Tiki of ims PET _ verious E OF SEPLOTER on ., 4/25/07 alleges that while employed DATE OF DIETA see_attached_19_ TO TO LIVET 2 various + MI TOT^ DE PLACE water inju~ TBELDERLA California by be martained injury arising out of and in the course of the employment as follows inhalation of harmful materiala EMAIL Bow indent wal ateinte resulting in lungs STATE WHAT DARYO OF BOOT WIDE INJVAGO AND SUBSEQUENT SUBSEQUENT BEFULTBEFOULTO 2 Various was the employer's insurance carrier on date of injury BANG OF IRSVILLEA MIPART SA W ISAPIEN WLS HOT 1819GES STATE BOETHEA I9089EO & __none_to_date_ __none_to_date_ PD PD PD out 96 Sat mu T TU OSqubach to st MATH MAST MEDICAL FUMED 4. Was compensation paid __No_ TO BE NO 5. Earnings at time of injury 1 maximum 8 @ 6. Was medical treatment yes TER yes pe TOTAL S 3. WEEKLY BATH BATE OF ART PATULAT wenrn O08 wEEA The basis of pay was 08 WEEK STATE ME PLE WALT BAT^ Boots & 967 890 6478 A Whe furnished radi Dr. Jo . r l ao dig oli ogs is t t ONE LOES or sectens upe ^findat^/r^u/s testET AND STAY^ KH^ PAJO TR IBGILLS 7. This applicatioins filed to determine liability for a Temporary disability ven be oe e Litigation expenz via tn be b Permanent disability c Medical treatment TED OF DO TEE + BO f STATE ANY OTHER BLANDE Medic_ al core X. TE 06D O68 LOST GLS Bantied of ART OTHER APPLICATIONS PILES WHEREFORE il u requested that a time and place be fixed for bearing and that an award be made granting such relief as may be proper under the Workmen's Compensation Lews of Califormes Hearing requested Number of witnema Oakland ateOd akland California _July 1966 WN, wees 24 MATE APPLICANT matuks ei Estimated time of 1/2 hour } SMITH PARRISH PADUCK CLANCY_ APPLICART & AFGET 315 Financial Center Building Oakland 12California_ TRY & ADOSEJO AND TELEPHONE nuach 452-2000 ~ q PLdPe Lde come brul brul or LTS DATES ALADING PE primer Case will de TY MISSECTED DE ARM { PLde ser vos Comp Comp PONIBLE A A part part of the the LTS CdeEIese assait bc bc bc bc bc Ot SADOOSADL OLETE SAE DOLETESADOLT ETE eE el berm cMeruees ON I ent even or ML FINDENSO IN DE VALLJU te of the PER pe ameperantameperant et ovat films bE BULBS 76 to weten smenint spre L SETIFIST LOC DIPER angst Det belich Wild 18 GETLGETLungu e Gn ETLgune ge Tag M0108 S08 POLO of Sub e el with sum serais jama tak smenint smenint wering FEE spre ONLY BEING THE DEVICAL DIPER DIPER te of the fit at PER PER POLO ameperant PARTY DAT ovat ORFYORO bENBI ULABES 76 GET 30 FFL 37 196 Clash Clash in courtoisit Mods rere Theatre For 34 REV 6.11 nn " = | EXPLOYER Armstrong Liberty & Cork Co. Charlotte ! Sts PERIOD WORKED 1951 1953-1955 1961 B & B Insulation P. O. Box 2531 Houston 1 Texas Co. Inc. Bay Cities Asbestos Co. 251 Fifth Avenue Oakland California Ltd. C. F. Braun & Co. 1000 So. Fremont Avenue Alhambra California 1953 , 1948 1958 The Pudlong Corporation Grandview Eldg Co. Inc. 717 North Highland Los Angeles 38 Calif The Philip Lockland Cincinnati Carey Mfg 5 Ohio Co. Otto Castrov Company Corp. 2648 North Interstate Portland 12 Oregon Coast Insulating Products 2684 Lacey Street Los Angeles 31 Calif 1947 1950 1951 1953 1957 1953 1956 1957 1957 Cork Insulation Company 155 East 44th Street New York 17 New York Inc. 1945 Laurence Des Laurier Co. 11119 South Mariposa Los Angeles 44 Calif 1947 Fibreboard Paper Products 1789 Montgenery Street Sea Francisco California Co. 1947 1948 Fluor Maintenance 406 Ward Street Martinez Calif Inc. 1955 Gay Engineering Corp. 2253 East 11th Street Los Angeles 23 Calif 1955 George Golling & E. 2918 Compton Elvd Gardena Calif Gunder 1947 The Industrial Insulators Inc. P. O. Box 2501 5521 Armour Drive Houston Texas 1949 INSURANCE CARRIER American Motorists Insurance Company 417 Montgezery St San Francisco Calif Argonaut Insurance Co. 550 California Street San Francisco Calif Pacific Employers Insurance Company 244 Pine Street Calif San Francisco Calif ay wr . . . i ENGILOYER Vorko 65 No. Calif on iret nd No. 16 to Street cuncisco Calif PERIOD WORKED 1956 1958 1954 INSURANCE CARRIER 1952 1953 San Jose Asbestos Asbestos Co. 1140 Lennon Way San Jose California California Herold Herold Herold G. Lorentzon 22252757 Nzrket NzrkNzreket t Nzrket Street Street Street Oakland Oakland Oakland Oakland California Company LL ouisville ou Louiisvis llLoeuiv svilli e Loul isvill Llouiesvile e InsulstingInsulsting Insulsting Insulsting Insulsting Insulsting Insulsting Insulsting & 816-816 Host Mein Street 1957 1956 1951 1952 Industrial Indemnity Co. 350 Sansone Street San Francisco Calif John Manville Sales Corp. 22 Best 40th Street York New York York New 16 16 New New New York York York Kingine Ingineering & Supply 942 Desc Second Street 100 100 Angeles Angeles Angeles Angeles C Caallii ff Co. tePeF2Bceceon sw leei e m Development & Development Development Co. Se sional Book sional Book Bldg Bldg 1949 1950 1951 1952 1953 1957 1547 1953 1961 1962 Mondat Mondat Mondat Cork Cork Corp. Corp. Commeile 7101 Commeile Ave Ave North Hargen New Jersey Nemchitect Including Co. 809 11.3 Lombard Street Portland 11 Cregoa Curens Corning Fiberglass 3. C. Dex 902 Toledo 1, Chio Corp. Crests A. Penne & Co. $e5 Decs Devetky La Daysen .., Chio Pieno Asbestos Co. 1300 - 64th Streat Entryville Calif 1953 1945 1946 1955 1956 1957 1958 1959 1960 1961 1962 1957 1948 1949 1950 1953 1954 1955 1957 1958 1960 Pacific Employeri Ins - 244 Pine Street San Francisco Calif Industrial Indemnity Ca. 350 Sensome StreetCalif San Francisco Calif 1010 20 1010 20 TLOTIL TLOTIL 6. Mashington wowera e e Standard Standard Standard 2 Seer tos Mfg tos Mfg & C ; C Kansas Kansas Kansas City Quire Street City , Missouri Lube Stevenson Co. 073 Blackhat a Surast Surast Chicco Illinois Albuquerque Albuquerque Albuquerque Albuquerque Albuquerque NewMexico Thorpe Thorpe Thorpe Son Thorpe Thorpe & & Inc. Inc. Inc.Inc. Couch Fegasnee 382 Couch California Emeryville California 2 Inslizies Company Vases Vases Avenue Vases Avenue Angeles Angeles 22 22 ---- -- PERIOD WORKED 1957 INSURANCE CARRIEN 1947 1951 1952 1947 1948 1949 1950 1957 1953 Pacific Employers Employers 244 Pine Street Street Calif San Francisco Ins IndustrialIndustrial 350 Sansome InSdtermeneittIyndemnity C San Francisco Calif 1960 ee San modo modo modo modo Calif Calif can S23 mcisco 19 Colif 729 Cem woes tee we Chics Products eS woe Bee Sovee C7 C7 C7 C7 C7 , Calde Calde Cald,e 1948 1946 1947 1954 1955 1950 11995151 1958 1949 1945 State Compensation Insurance and 3360 Grand Avenue Oakland 10 Calif Low BEFORE THE " WORKMEN'S : NSMI ON COMPENSATION APPEALS NSMISION BOARD NSMISSION NSMISSION NSMISSION NSMISION NSMISSION NSMISSION NSMISSION OF THE STATE OF CALIFORNIA Case No. 66 OAK 20668 HENRY C. PUETZ Applicant TS C. P. BRAUN et al and AMERICAN MOTORISTS INSURANCE INSURANCE COMPANY et al Defendants Order Dismissing Party Defendant Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT and Guarantee Insurance Company General Accident Fire & Life Assurance The Philip Carey Manufacturing Company Lawrence DesLaurier L. L. Laurier Company Fireman's Fund Insurance Company Corp. Ltd. be dismissed as a party defendant in the above entitled case . ' .. RICHARD AS HICKMAN Referee DOUTORE DOUTOREISI IDX DOUTS OREISIDI X D DOUTORX EISIDX WORKMEN'S COMPENSATION APPEALS BOARD December 6 68 Copies mailed on 19 to all parties listed on Official Address Record ng Pom 40 ( 7.301 . wuss 1 PH ' ove > WORKMEN'S BEFORE THE COMPENSATION APPEALS BOARD OF THE STATE OF CALIFORNIA ---- ---- --,--,, ---- ---- --,--,, Case No. 66 OAK 20668 HENRY C. PUETZ Applicant vs. C. P. BRAUN et al and AMERICAN MOTORISTS DISURANCE COMPANY et al 7 Defendants Order Dismissing Party Defendant Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT and Guarantee Insurance Company General Accident Fire & Life Assurance The Philip Carey Manufacturing Company Lawrence Deslaurier L. L. DesLaurier Company Fireman's Fund Insurance Company Corp. Ltd. be dismissed as a party defendant in the above entitled case A RICHARD , HICKMAN Referee XKYDOSTATY DENTONAGHIBEX DENTONAGHIBEX WORKMEN'S COMPENSATION APPEALS BOARD December 6 68 Copies mailed on 19 Address all parties listed on Official Address Record hg Po 34 NEW 7-80 eae 2-04 oe & 000 pe oe . Armstrong Contracting & Supply 120 Forth Line St Lancaster Pennsylvania Quetz . 7755083 7755083 REV 2,564 ADDRESS INSEPT owe mes . - @ a Co Co Co DEPARTMENT OF INDUSTRIAL RELATIONS Co DIVISION OF INDUSTRIAL INDUSTRIAL ACCIDENTS .: wt vw WORKMEN'S COMPENSATION APPEALS BOARD el . STATE OF CALIFORNIA Case No. CG6 CAR 20064 HMMY C. PUETZ See Notice of Time inhn \ and Place of Applicant VS. Further Hearing ee NILI CAREY MEG COMPANY et al ACCIDENT FIRE aed SINERAL & LIFE ASSURANCE eee COLPODATION COLPODATION LTD et al ee E rr 7 Defendants 8/27/18 8/27/18 NOTICE TO ALL PARTIES You are hereby notified that further hearing will be held in the entitled action at November 26th 1969 3000 State Building 1111 Jackson Street Cakland California 5:00 A.X. JALt AL, Before Referee ...e.u.c.. REQUEST OF APPLICANT WORKMEN'S COMPENSATION APPEALS BOARD By Ecfeve VOTRE CONTINUANCES AND FURTHER HEARINgs are not FAVORED ay pipe -eay. 3" MAIL ON PERSONS SHOWN ON KAADDRESS KAADDRESS RECORD - per % by: . 2 ae 45 D4 wok fm 23 atv - - FOwd 00 11 60 ... ... on datemnvih . - BEFORE THE WORKMEN'S COMPENSATION APPEALS BOARD , OF THE STATE OF CALIFORNIA are = er ALENTED Notice and Request for Allowance of Lien ee Pe Various dates iros en Date of Injury 1945 through 1967 __ ag STATE OF CALIFORNIA O. Bos 1857 Oy DEPARTMENT of EmploymenT SES CLASHART wv. Henry C. Puets ere 530-12-4188 530-12-4188530-12-4188 COPLOTE Pt 2 Box 101 Oakley 94561 ASSPLIC Sean R 665-66 665-66 68CURITY QUAM a aS _Various _Various - see attached list EOPLAYED Oe agneais see list ee pennant Oe attac atth achee d d oY. eee MOONSANCE GARAISE eee cee ceemenetees 300131 a? The undersigned hereby requests the Workmen's Compensation Appeals Board to determine and allow as a lien the sum stated below as Total which represents the amount of unemployment compensation disability benefits paid to date Oy and in addition a lien is requested for any further bene u which may be paid up to the amounts stated in paragraph 3. below 1 7-18-67 thru 7-29-67 2 22-67 thru 9 3-67 2. Filed under Labor Code Section 4903 f Dinability benefts at the wackly rate of . 70.00 paid for the period . 3 12-2-67 . - * * 5 31-67- 5 31-67- inclusive $ __2020.00 Ye 207__ at 5. 10.00 per '... day Filed under Labor Code Section 4903 _548.00 .12.00 _548.00 Additional benefits for hospital confrement at the daily rate of $ Hospital 2 paid ..... 1 Egy C Fuets Palta Memorial eee for 1 . 7-18-67 to -. 7-21-67 the period ey 2 12-2-67 24.00 -inclusive $ Tocal $s... 72.00 ees . 2142.00 e thru 22-3-67 3. Further unemployment compensation disability benefits will be paid whenever the employee is eligible for both daily indemnity and additional benefits for hospital confinement which will not exceed $ 0 and s o respectively 18 further benefits are paid amended Notice and Request for Allowance of Lien will be filed by the Department of Employment upon cessation of payment or upon request from the Board undersigned 4. The declares he has delivered or mailed a copy of this document 11 10 to ach of the persons named above and listed below IF OTHER PERSONS SHOULD BE SERVED WITH THIS DOCUMENT e e PLEASE NOTIFY THE DEPARTMENT OF EMPLOYMENT AT THE ABOVE ADDRESS ee re Copies also served on the following representatives and attorneys of record a Smith Parrish Paduck & Clancy . 315 Financial Centor ^ldg Oakland CA = 54612 STATE OF CALIFORNIA Department of Employment wwe RayE DISTRICT RAT Schultz eee eererreee E SCHULTZ NER CLAMAT taht EMPLOYEE'S CONSENT TO ALLOWANCE OF LIEN Mien I understand that the amount shown above 21 Total may not represent the total amount of disability benefits that may compensation be paid on my clum by the Department of Finployment pending the Ikurd's decision on my workmen's compensation claim dental a I consent to the allowance of lien in the total amount paid en my clum by the Department of Employment as shrien on Employment Employment say hoal Notice and Request for Allowance of Lacu filed by the Department of . Bae ata owe Fewer Henry CFusta mer wtecme (amet en ot tae 8 eae ee tenms e . te tate > 4 bs bi . rit SUNFLORIT TO AR LIGATIOLIGANTION PRY HENKY C. IVs 73. VARIOUS Ce 66 DAT 20608 . Oar re le Employer Tear of + . Deployment Insurance Carrier Cort Insulation Co. Inc 155 East 44th Street New York 17 M.I. duet. Western Asbestos Co. Box 3754 Rinson Ann San Francisco Calif 94119 , 1945 1946 1947 1954 1956 1957 1958 1960 thre 1966 Unknown . State Comptonation Insursace 3360 Ozend Avenue Oakland California 94610 Fund MacArthur Co. formerly Vestern Asbestos Box 3784 Tincon Annex San Francisco Calif 94119 The Pullong Corporation Grandview Building Col Inc. A. Joint Venture - 717 North Highland Los Angeles 33 California Marine Engineering & Supply 941 East Second Street Los Angeles 12 California Co. Lawrence Des Laurier L.L. Des Laurier Co. 11119 South Heri^osa Los Angeles 44 California George Golling & E. 2918 Compton Blvd. Gardena California Gunder Fibreboard Corporation 475 Brannan Street San Francisco Calif 94111 Plant Asbestos Co. 1300 - 64th Street Eneryrills Calif 94603 -. 1967 7 1947 . 1947 1947 1947 1947 1948 1948 1949 1950 1953 1954 1955. 1957 1958 1960 State Compensation Insurancs Fund . Unknown Unimovr . Unknown . . Unknown Incured Pacific Employers Group 244 Pine Strect San Francisco California 94104 Industrial Indemnity Co. 350 Sansome Street San Francisco California 94104 . ad Bay Cities Asbestos 251 Fifth Avenue Dailand California Co. Ltd. . 1963 1964 - 1967 1948 American Employers Group Ruas building San Francisco Califorrin Industrial Indemnity Co. 4 { j 3 4 : q 4 4 5 4 F 3 ; 4 d F 7 4 } Puetz v Various - 6 CAK 20668 Pago 2 T. Thorpe & Son Inc. 1351 OcpanAvenue Beryville California 1943 1949 1950 a Pacific Employers Group fi Van 595 San Arsdale l'arris Co. Fifth Street Francisco Calif 94107 beatern Fibrous Glass Products Co. 739 Bryant Streat San Francisco Calif 94107 , - ce 1957 1948 2949 a . The Industrial Insulators Inc. 5521 Armour Brive Houston Texas Corp. John Manville Sales 22 East 40th Street New York 16 M.Y. _. : 1949 . @ 1951. 1932 1953 1957 The Fhilip Carey Mfg Co. Lockland . . Cincinnati Ohio 45215 a ee Armstrong Cork Co. Liberty & Charlotte Sts Lancaster Pennsylvania ~ Hundet Cork Corp. 7101 Tonnelle Avenue North Bergen N.J. oy 1953 1957 : . 1954. 1955 1953 1962 . Thorpe Insulation Company 2741 South Yetes Avenue Los Angeles 22 California California , 1953 Industrial Indemnity Co. Unknownfi . . : Industrial Indemnity Co. . - . Unknown . Travelers Insurance Co. 1956 Webster Strect " Dakland California 94612 General Accident Fire Assurance Corp. P. O Cox 3733 San Francisco Calif Lifo 94120 Travelers Insurance Co. Aetna Casualty & Surety Co. 1330 Broadway Oakland California 94612 Unknown Gay Engineering Corp. 2663 Last 11th Street Loa ingelen 23 California California 1955 Unknown PO.sOe.nsBoCxor9n0i1ng Fiberglass Corp. . Toledo 1 Chio . Muor Maintenance Inc. 2500 So. Atlantio I. Los Angeles Calif . 1955 through 1967 1955 1956 1957 Aetna Casualty & Surety Co. . Continental Casualty Co. 433 California Street San Francisco California California Unknown ~ fuetz v V^/risse- <4GE ZS : Page 3 Corry Dewy ots, Prptucta Los f^gelefs^geles CaCliafolrinifaornia f^geles aan 1956. 1957 Arcorant Int~-ranoC 550 Californiz treet San Francisco wlifornia before 5/2/17 Pacific Deployers Croup 244 line .troet San Francisco California efter 5/1/57 Harold G. Lorentzon Lorentzen Company Company 2257 Market Street Caklend walifornia Owen E. Leinio San Jose Asbestos Co. 1150 Immon way San Jose 25 California 1 C F. Braun & Company 3000 South Fremont Avenue Albu Califomia 2956 Inductrial Indemnity Co. . . 1963 1964 , 1957 : 7 : . : . . , _ 1953 . Argonaut Insurance Company Unknorm : . , ve American Notorists Insurance 417 Montgomery Street San Francisco California Co. Univarenl Insulation Co. . 3221 Riddlefield Food Menlo Park California ee weve meee Stret=< Armstron Contracting 120 North Linc Street . sae . _ Lancastor Sennsylvania Oe Muldoon Caryany Inc. 557 Iact how Avenue Clovis California A. R. Carpenter Inc. . Box 1534 Lacramento California Accurate Inmalation Co. Inc. 900 Louth Cypress Street La Habra California , Wickman Brothers Inc. 3170 at 11th Street Los Angeles California - 1960 Taknown ; Pon. 1962 1963 YY 1961 1962 Travelera Insurance Co. . . a Unknown 1562 _ State Compensation Insurance Pudd 1962 State Compensation Insurance Fund * 1963 Pacific Employers Group , Keller Insulation Carp 1971 North Perced 11 Noste California 1953 Unknownfi . Sy en be toe devnatis Puet v Various - oak 20668 . Pag4e a Metal Clad Inculation Co. Inc. 1964 Industrial Indemnity Co. ve 21759 Western Avenue before 2/15/64 obt Torrance California sedemt Hartford Accident & Indexfity Co. 2150 Franklin Street Nate Oakland California 54312 after 2/15/04 te Insulation Service :, Box 4695 Tulsa Oklahoma ie ne, bt il Metre arias 1964 1965 Fidality & Casualty of F.I. 160 Pine Street San Francisco California before 12/1/64 Great American Insurance Co - 1 Karitime Flana San Francisco California after 12/1/04 Associated Insulation of9 tlds California California 238 South 24th Street hadhi Richmond California Bil 1965 1966 1967 American Employers Group : . be BI et NOTE The California Inspection Rating Eureau advices that they have ' No record of coverage forthese employers during the period applicant worked for them We have written to each much employer advising then of this pending claim and acking them to contact their insurance carriera promptly so that they may be properly represented at the hearing on March 4. 1963 DEPARTMENT OF INDUSTRIAL RELATIONS : DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSAT.ON APPEALS BOARD STATE OF CALIFORNIA rf HENRY C. PUETZ === a (* CASE 66 Oak Applicant va. FHILIP CAREY MPG COMPANY and GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORPORATION Ltd. et al ORDER TAKING OFF CALENDAR Defendants ? By agreement of the parties and GOOD CAUSE APPEARING IS IT HEREBY Ordered That the entitled matter be and the same hereby is taken off calendar and all further action herein suspended subject to being reset upon request of any of the parties hereto RICHARD A. HICKMAN Izdane WORKMEN'S COMPENSATION APPEALS BOARD 4/2/68 bg SHOWN SERVED BY MAIL ON PERSONS ON THE OFFICIAL ADDRESS Date 4/2/68 RECORD By SEAL DIA WEAD Form 80 1967. 11.59 Y FORM 40+ foe. ont - mow (Boe sa  BEFORE THE WORKMEN'S COMPENSATION APPEALS BOARD OF THE STATE OF CALIFORNIA Notice and Request for Allowance of Lien 3-20708 Case Various dutes from of Rate injury 1945thro19u 67gh ,? Gen of ] STATE OF CALIFORNIA {i\bes J DEPARTMEDNEPARTMTENT of ExploYMENT e DEPARTMENT neon DEPARTMENT cenete > . CLAlcast O. Box 1857 Oakland CA Tanta 94604 vere 4 aleaeapereertate va Te eS & PetPs ets ae. ey Pets el AMATE Rt 2 Box 101 GalCl A e 94561 9y 4561 1609114 12 4163_ PLATES & OOCiaL St CURLY MORTIS ee _Jarious ses attached list EMPLOYER sobodes INSURANCE CARBER 4000155 1. The undersigned bereby requests the Workmen's Compensation Appeals Board to determine and allow 29 a lien the sum stated below as Total which represents the amount of unemployment compensation disability benefits paid to date and in addition a lien is requested for any further benefits which may be paid up to the amounts stated in paragraph 3. below 2. Filed under Labor Code Section 490 f 70.00 Disability benefits at the weekly rate of $ . - ok paid for the period --- 012-2-67 01 5 days at .10.02 day inclusive 1.450.02 Filed under Labor Code Section 90 b Additional benefits for bospital con^-nementat the daily rate of 1.0 paid to a: for the period fal .80 6 inclusive $ 450.00 Total 450.00 3. Forther unemployment compensation disability benefits will be paid whenever the employee is eligible for both daily indemnity and additional benefits for hospital confinement which will not exceed s 1505.72 . ee 18. respectively If further benefits are paid amended Notice and Request for Allowance of Lien will be filed by the Department of Employment upon cessation of payment or upon request from the Board ail 4. The undersigned declares he has delivered or mailed a copy of this document on to each of the persons named above and listed below IF OTHER PERSONS SHOULD BE SERVED WITH THIS DOCUMENT PLEASE NOTIFY THE DEPARTMENT OF EMPLOYMENT AT THE ABOVE ADDRESS e r 1. Copies also served on the following representatives and attorneys of scord Smith Parrish Tefuck & Clancy 315 Financial Center Bldg ^ aklandCA 94622 . . STATE OF CALIFORNIA DEPARTMENT OF EMPLOYMENT MAX SCHILLTO DISTRICT MANAGER 410 GADURANT inj EMPLOYEE'S CONSENT TO ALLOWANCE OF LIEN con the understand that the amount shown above at Total may not represent the total amount of disability benefits shat may be paid on my efaini by the Depirinant Depirinant at kumployment pending the Board's decision on workmen's klaim be ent to my compensatum allowance of lien in the total amount paid on my claim by the Department of Employment as shown un any final Notice and Request for Allowance of Lien lihad by the Department of Employnient Employnient DE 28A1 ay 10 471 9070-71 9070-71 9070-71 9070-71 9070-71 9070-71 ser ae " . hls a ... te ... MIE DES ... 6 ae A et Me we ee ork - SO, Year of : .... ... Insurance Cauzise . . 1915 . Unknown Unknown a 19 1554 1907 1533 1957 1933 1960 thru 1533 1557 State Compensa sation Insurance The Corporation The Dudlong Corporation Corporation 1947 UnknowUnnknown Unknown 1547 a Unknown 1947 Unknown wn George Golling & E. 2913 Compton Blvd. Cardona California Gundar Fibreboard Corporation 475 Brannan Street Sen Prancisco Calif 111 94608 . * . Ltd 1947 1947 1948 1948 1949 1950 1953 1955 1558 1954 1957 1900 1563 153 1937 1549 Unknown , Insured Pacific Employers Group 244 Pine Street San Francisco California 94102 Industrial Indemnity Co. 350 Sunsome StrcatCalifornia San Francisco California 94104 American Employers Group Building Russ San Francisco California Industrial Indemnity Co. pwn . hoe , . . e . > . . Vu Vu ! we ole Voot ae TE ta FED Ind SC Ind oo. ~ SC Ind 3. ce eur oPp Ve ite fey tedde, California California . . . ences cori a. 15 15 Co. Co. . 1946 1946 1940 1940 1900 1957 1957 1515 5 Poe Se Pacific EEmployers mployers Creep Industrial Industrial Industrial Indemnity Indemnity Co. Unknown > Unknown > 1949 Industrial Industrial Industrial Industrial Industrial Industrial Industrial Indemnity Indemnity IndemInnidteymnity Indemnity Indemnity Indemnity Co. Insulatos Inc. 1949 Unknown a Chat wee Work 40th Sths Corp. Street 13 N.Y. N.Y. 7 1931 1552 1953 Tavelers 1956 Tavelers Insurance Co. Nabater Oakland Street CalifornCia alifornia 94612 General Accident Fire Assurance Corp. Francisco P.O.Box 3733 San Calif & Life 4120 Travelers Insurance Co. Mandas Cork Corp. Connalle Avenue hurch Borgen X.5 thoupe Insulation Company 2746 Company South Tetes Tetes Avenue ingeles 22 California 1553 1962 1953 Retne Casualty & Surety Co. 1330 Broadway Oakland California 94612 Caksown Engineering 11th Angeles 23 Corp. Street California PP.C.. Ca . ns Corning Corning Piberitas Corp. 1955 1955 through 1567 Drknown Actna Casualty & Surety Co. an Inc. Calif 1955 1958 1557 Continental Casualty Co. 423 California Street San Francisco California 9 Unknown petdas A ba . . . . . o . . { : o4f x 1 r { : \ v . ey n . | rs .t y or al ed : a ( ry ee + we 4 - sh Mes ooPot vt ob : : . |3 4 ae | | af 2586 2586 2586 2586 , . ed . . . . a 23 4 | od re "Ml ' 38 e ? sdepmitnahg 3 wet -eJa]onus. od ot cam Ionia Ionia IoniaIonia IoniaIoIonniiaa Oota Neb otos oy . wae tt vot Loinic Loinic Loinic Loinic Loinic sane : 1953 195319531953 1933 1933 1933 , 193 ud ae Bs - 2 + P _ Me Jwohi . : 4 } p)"e s i ts ha 1Y 4 "3 tsi "}%4y u2 , . ; Group Francisco ie SanSanSan ( Francisco Francisco ie te IndustrIindaustlriIalndustriIandlustrial Industrial Industrial Industrial Industrial Industrial Industrial IndemnityIndemnity Indemnity Indemnity IndemInintydemnity Indemnity IndeImnnitdy emnity Co.Co. Co. Unknown " Unknown Unknown Unknown Unknown UnknowUnnknowUnnknown InsuranceInsurance CompaCnyompanyCompanyCompany Company CompanCoympany oe " sean Down " DownDownDowDnownDowDownnDown OzavelersOzavelers Ozavelers Ozavelers Ozavelers OzaveleOrszavelerOszavelers Ozavelers InsuranIcnseurance Insurance Insurance Insurance Insurance Insurance Insurance Insurance Co.Co. Co. ! LifeonJ ExExExn . CalifornCialaifornia California California California California CaliforniaCalifornia California California Inc. CarpentCerarpenteCrarpenter CarpenCtearrpenter , Inc. Carpentr Inc. 1 : REO F ] A & REO REO , QQkksfti)eS) sore) : al _ 1851 1851 1851 1851 , 1962 1962 1962 1962 . 1582 1582 1582 1582 State State State State State Compensation CompensationCompensatCioompnensation Compensation Compensation CompensCatoiomnpensationCompensation Compensation Compensation Compensation Compensation Insur2 InsurI2nsur2InsurI2nsur2Insur2 == == : i i vt 7) StateState State State State Competation Competation CompetationCompetation Competation CompetationCompetation Competation Competation CompetatiConompetationCompetation My 4 sa on fornia i Y fi Pa ra P| anof 1 3 fornia fornia fornia fornia fornia . J t . ah e nl on . 4 Corp. Corp. Corp. Corp. rn : atwc "> 4 Mo. dl'y California California California California California California California California California Corp. an 19621962 19621962 1553 1553 1553 1553 . . - Pacific Pacific Pacific Pacific Pacific Pacific Pacific Employers EmployersEmployers Employers Employers Employers Employers Employers Employers unknown unknown unknownunknowunnknown " unknown . : - . * * . . : . = 20103 Lo - na pt 20103 cnein mn 20103 - ... L, ... aw? find find find Chauiation Chauiation - me se VSR La vince ome em ee ~ 4 rl fe - ee ee te . Co. Inc. Inc. . . 1534 1534 ociated Insulation of Ciliformia .3 South 24th Street ichmond California 1555 1955 1967 . 7 Ac ident & Infla . . Franklin Struet Cakland California 4012 agter 2/15/34 Fidelity Fidelity Fidelity Fidelity & Fidelity 180 Pine Pine Fidelity FidelitySan FrancisFcroancisco before before before before Great American Insurance Co. 1 Maritime Plazh San Francisco Californil Californil after 12/1/64 American Employers Group 7 r JOlE: me California Inspection Rating Buzatu advises that they have pply pply pply pply pply so that that that ttheythheey y may may be be be properly properly properly represented represented represented at at the the hearing on March March March Oe rte, ee, won DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA HENRY C. FUKTZ Case 65 OAK PO31 Applicent Applicent vs. PHILIP CAREY 170. COMPANY et al and GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORPORATION LTD et al Defendants Order Joining Party Defendant Good Cause Appearing IT IS ORDERED THAT FIREMAN'S FUND INSURANCE COMPANY and GULRANTKE INSURANCE COMPANY be joined as a party defendant herein | Kelam WORKMEN'S COMPENSATION APPEALS BOARD SERVED ON ALL PARTIES LISTED ON THE OFFICIAL ADDRESS RECORD DIA WEAR Form 93 ( 3 FOGLALT FOR 3481 . am + aa ".! . em ew Pense ones @ 20> Pe OF . ED ae ES EY a OE + : weny, ~w-wem + st, eet * -. a re orem ee ny DEPARTMENT OF INDUSTRIAL INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD ee vs Notice of Change Asbestond^' Applicant in PlaceTiom r Te iTmieme of Hearing PHILIP CARTY MFG COMPANY et al and GENERAL ACCIDENT FINL COPPORATION LTD, et & LIFE el ASSURANCE _ Defendants ? NOTICE TO ALL PARTTES You are hereby noti edthat the time and place for the hearing in the above entitledentitled action has been changed to and will be held at March 4th 168 3000 State Building 1111 Jackson Street Oakland California 2:00 P.M.Before Referce REQUEST OF APPLICANT'S ATTOP Hichhar VOLKMEN'S Compensation Appeals Board By Yetorw Date December 1st 1067 Served by mail on person shown . on the of 'ofu'ull address record Duc 12/1/67 By Se - 39 -- om DIA Weat Fabu 14 ney FORMERLY POP 300 16-001 : Ay ts we 0 ot ae re oo n <> DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS STATE OF CALIFORNIA BOARD CASE NO 5 DAK D o \ Applicant VI PHILIP CAREY MFG COMPANY et al and CEMERAL ACCIDENT PIRE CORPORATION LTD 46 & LIFE al ASSURANCE NOTICE OF TRIAL CONFERENCE Defendants ? You are hereby notified that an application for compensation has been filed with the Workmen's Compensation Appeals Board of the State of California You art jurther notified that said application has been set for trial conference at 1 3000 State Building 1111 Jackson Street ete January 8th 1968 Dakland California 1:30 P.M. Before Referee Hic de PARTIES DEFENDANT PETITION TO DISMISS CASE FOR LACK OF PROSECUTION and MOTION TO DISMISS em aA EXTRAXX EXTRAXX XVKIMI XXVKIMI KJM^ RKENKRXXZKLIKY KJM^RKENKRXZKLIKY KJM^ RKENKRXXZKLIKY ALACHASINING ALACHASINING Ne BEE TP ROOK ATK EPO FR BEKENDE PEDROLER BLACKPUK BLACKPUK KO A KOPICKY NA MICKILY MICKILY MAKI XPKY LI DOKKKKKKS^ DOKKKKKKS^ MI^ KE STAC EUR KIC OE ROE YE OK ADI fea 9c oh II NOOR SEK LCA MNT RN OE IE * KINNI ALIR IN KARLIK IEF, KOO IN ALIEN NINN KOMEN AK ACH OTC AEIEK AKA A K BAXIDE BAXIDE BAXIDE KR EY LOI OLX EE OE LA IK XIE K A a MI aay. IT IS IMPERATIVE THAT MEDICAL REPORTS BE FILED AND COPY SERVED ON AS SOON AS POSSIBLE IN ADVANCE OF THE SCHEDULED CONFERENCE OPPOSING party WORKMEN'S COMPENSATION APPEALS BOARD h Reformt Date November 21st 1067 SERVED BY MAIL ON PERYONS SHOWN ON THE OFICIAL ADDRESS RECORD Date 11/21/67 By fc 39 UPC MA & F & Jay H FGESTEL Foom 39 TH mi geoae vas ew ier noe se - # ceed wee .b - wa. . -- - bt ' BEFORE THE EN'S COMPENSATION APPEALS INDUSTRI ACCIDENT BOARD COMAS ^ ~ N OF THE STATE OF CALIFORNIA aon . . Case No. 66 OAK 20669 HENRY C. PUEAZ : 7 " . Applicant ARMSTRONG CORK COMPANY et al and RELIANCE INSURANCE COMPANIES et al . Defendants Dismissing Order Dismissing Party Defendant and NOTICE OF CANCELLATION OF TRIAL COMUN COMUN Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT iin athe STANDARD ASBESTOS INSULATING COMPANY and AMERICAN MUTUAL LIABILITY INSURANCE COMPANY be dismissed as a party defendant in the above entitled case The Trial at 20:30 Conference heretofore scheduled herein on September 15 at 20:30 A.M. been cancelled 196 RICHARD Referre INTUISBL *A *KX A Workmen's Compensation Appeals Board Capin mailed om Sept. 1 , 1957 wes all parties listed on Official Address Record hg Dome 840 ire .a0) awece 1 000 1D 0 of DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS ~- . ~ STATE OF CALIFORNIA BOARD .Z 7 a a a . es e . . . ene HENRY C. PUETZ . CASE NO 66 OAK 20668 7 mo, . a . po. . t. Applicant_ | NOTICE OF TRIAL CONFERENCE oe ARMSTRONG CORK COMPANY et al and and RELIANCE INSURANCE COMPANIES et al ; , Defendant_ - : . 3000 State Building September 15th 1967 1111 Jackson Street Oakland California 10:30 M. Before Referee PETITION TO DISMISS AMERICAN MUTUAL STANDARD ASBESTOS MANUFACTURING & INSLUILAABTIILEIGTYCOCMOPMAPNAYNY and Hickman we ae Tene by a IT IS IMPERATIVE THAT hehe AS SOON AS MEDICAL REPORTS BE FILED AND COPY a) POSSIBLE IN ADVANCE OF SERVED THE SCHEDULED CONFERENCE ON OPPOSING PARTY ; WORKMEN'S COMPENSATION APPEALS BOARD by Date August 15th 1967 SERVED ON ALL PARTIES LISTED ON THE OFFICIAL ADDRESS RECORD Date: By. 8-15-67 So - 46 DIA WEAR Pam at T Bee; Ome Pere 21 PII . Semen ee he PO eeaa _ +se