Document 4QaDkNBrB83q9GVOvmQ8ZVB9j
KC'K
r0: Coi sanding Officer Muv.iL regional Medical Center Pori smooth, Virginia 237Oy
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l abors lory Division Nav/ t-'nviionnuntal !u:aith Center 3333 Viiu1 St. Cincinnati, Ohio 45320
i (IMG CONTRACTOR ANS A 0 3 $ S
4, MAMufACTURIM'J PLANT NAME ANl'i A>'!'HfSS
con n'Acr humue" 5. END IUW AND/OR PROJECT
16, MAM IliAL TO OE TEST LU
10A. QUANTITY SUBMITTED
ia. purcma- ro from on source
8 . s M Pl.T 7 . l w I 0
NUMUER
a. REA SOU FOR SuOMLITAl
9. UAH SUfIMI 1,111
II. O'.IANl l fY REPRESENTED
12. SPEC A \Mt HO AMO/OK DRAWING NO ft RLV FOR SAMPLE ft DATE
i -i. smi'WtN f m i moo IS. DATE SAMPLED AMO SI.U'Ul f f. D UY
16. REMARKS AND/OR SPECIAL IN SI RUCTIONS AND/OR WAIVERS
The test results pertain to samples la through 19a originally submitted on 8 Sep 1977 by L.P,Hackler, Safety Director,EIAVSHIPYDNOR,
The percentages are based on the total fiber content.ifif each sample. The estimated accuracy of the percentages in 2()%
Isaac:
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I,. ENO REPORT OF TEST TO
SECTION & RESULTS or TEST iConlinue nn |./u.n iAl# pji'tr I/ nii'rr tpjte ll re-iuir,;l)
I. OATE SAMPLE RCCEIvtD
2. '"OA7E*Ri:SULTs'REPLii<Tib
3. LAO REPORT NUMUL'R
__ 9/14/77..... _ ________ ___________ l/l?/77__,
4. TEIU PERI'ORMED
RESULTS OF TEST
SAMPLE RESULT
Fiber analysis using Dispersiou Staining
7262-lUr_28
IUQUIREMENTS
Sample
/.' Asbestos Fibers
Sample
% Asbestos Fibers
DATE
la >95
2a <20
3a >95
4 a >95
5a >95
f>a . 20
(.a (cord)
>95
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7.0
TYTED NAME AtlO TITLE OF KSON CONDUCTING 11:
8a 9a 10a 11a 12a 17a 18a
>95 >95 >95 795 >95
50 50
9/30/77
Walter F. Vogl LCDR HSC USN
idlC.Jiiut._________1
' 'i .',2b 1222 S 102-lF-012-0600
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REPLACES DO FORM 1122. I JIJL Oft. V/UIUlCIlIj_IlSS OUtlS9ODLEET7,M .
This is a certified true copy
E.-t. "SMITH------LCDR MSC, USN
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