Document 7OwZLnzdrEOoZk3n87ewm7vLR

FILE NAME Mundet Cork MCK DATE 1978 DOC MCK106 DOCUMENT DESCRIPTION WC Claim of Swartout Pt 2 STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION thebet thebet MAY 28 28 HP HP FILE SIGNED ONGINAL AND SEE PLEASE PRINT OR TYPE NAMES JOHN D. STAFLES APPLICATION COPIES AND ADDRESSES CASE F - te > TI ee at eam Bae ... ... 62 NO 62 LB 19396 POLA POLA Phe * 10634 CercB |. arepieatit California novenns _JC hitier alifoCalir fornin a Cai lifoa rnia wh SEE LISTING ATTACHED -- INPLAYER INPLAYER Social Security No. 49.2-12-3206 49.2-12-3206 EBLOID'S EBLOID'S caoeeie UNKNOWN AT THIS TIME 9,243448 AURS 75 . FARVURKKI KLKRESZ & # . John D. insulator Between and ep heat Staples WEARYET reenineinnny MADE WEARYET WEARYET on & frost DERP^ MADNERP^ MANDERP^ MAN at rent or F^ ROY 24-25 24-25 alleges that while Mate of bicTO employed Los Angeles County & . 1953 March_1_ March_1_ March_1_ March_1_ and FY B e BAT 20 LENIAI Los vicinLEX_ See listing attached attached traployment ALATS SPR^ ^ ^ CITY OK OR PLAST VKLIPE SKIFTE GELUE he sustained injury arising out of ind in the course of the California by 10 followe to abraat brao toss dust fiberglass other irritants dimane nga J^/kralsea ibha "cone Lungs and respiratory system resulting in 1 Unknown XE3FO WHLY Page or joaT NEVI DRIVKOU AND KABSFQVENT KABSFQVENT VESELEF on FOSSU E WIK employer's daks or issuRAREI tow the FOSSU E AQ I^SWOJZTR^ KOP thjorte zfq5 #ALIAU Tierra was TKLF4NI^ IGs^g^uten insurance carrer Since 1962 injury March 1 dite of PERJBG ^ igmena por^ De fua Kozur 4. Was compensatina paid NO U oF aw . Earnings at time of injury . Ma X. ** 1 needed Yea 4. Was medical treatment . Yea VIE DE nt ^ ^francks slagk31 ^ d^ ras DAYS LAST NAPINAL SUSIRINK ... BO have ~ WONINGE WONINGE #1ea The Who furnished treatment GEECE JE basis of pay wi Buate PAY set^ka^ n^zZI MY AIL KATE OF LAS gabe BATA BATAR RBA TARDAZTIO T Dr. George Fralick liability 1444390 application 7. This determine fors is filed to IDE IUM 20 1444390 444 X56 JU 46478 ODE NITEBRG WITH HJAL BUT myas 1. Temporary disability b Permanent disabilesc # no be e Litigation exprax VOS . 11 04 disabilesc TPL ER DU disabilesc Medical treatment.cs TK en X csteveae STATE ANY FIDE M^'s101 yes d Afedical yes PA Oo, ~~ nYWO^ A List 2401 OF 190883 190883 ^ ykjskvi^ k^Iykjskvi^ kINILED the Workmen's WHEREFORE ander II is requested that a time and place be fired for broting and that ; proper ander Workmen's ComCpenosamtiponensation CompensatCoimpeonsantion Laus California an award be mm^^,d,e degranting such relief as may be Dated of California : Wilmington California May 17 1962 LEFT . 4 ; mare Number of witnessa Extimsted time of trish nw, unknown day 2 - 2 * * * * * * *********** { *********** ****** *********** ****** _SILVERNCWIL&LSIHERAMANMS 2 305 North 245 245 BERSOSIY BERSOSIY Avalon Boulevard Wilmington 4-2 TE 5 4-259 95 5 0 California | 45T0tks ROEPLUS ROEPLROUEPLSUS AUR FILAYDALE FILAYDALE BUDILA BUDILA 1 031ST 031ST o en k^randalk^randal inter Geman WITH Mana give en eH SA PE MEME Kee HE be 95 Be SenD be taat de 2 48 200 SINE rate aveve tn treet cook SINE M ANDRE thr ** of 39ury ^/n21Bqf^ **BU149 Hus^,kipp 93alaca riedum SwJ bb I 17.9 4d NUC6121991 4415 balA DAY DEA my DD WeeMM 13 ** PLANE PLANE PLANE de flaghoy asenk^'pr 16k graad 10 km 7 S^'d^ane' kso anekso ad as 12mm The arnven 3 q ^' ; { ? t . yoo JOHN OT S DLES Oct. Oct. Nov. Dee Baker Perkins 1000 Hoan v^ o Seginaw Michigan 56 hours 3. T. Thorpe . 948 E 2nd St. " 360 Los Angelos 12 Calif CO 1954 n Feb Mar . ", 17 Apr. Moy R Juno July Aug Sept. C. F. Breun 1000 Premont St. Alhambra Calif Cost Insulating 2684 2684 2684 In It 288 .. 88 M Sept. Oct. Los Angeles 31 Cali^ J. 7. Thorpe 118 011 Field Constre 62 P.O. Mox 947 Bakersfield Calif ' 40 Hov 011 Field Constr M December J.t. Thorpa F 360 "7 1955 lane Armstrong Contr 299 " - 4bCO E. bendini eb Los_Angeles Los_Angeles Calif PY , re J.T. Thorpe 1967 5 ril Armstrong Contr 6781 8 . y - ne It ly 1956 APR May June July Aug. Sept. Oct. Nov. Doca Oct. Fibor^les Engineering 1409 hr 5933 Telegraph Rd Los Angolos 4 w" 22 Calif BITOMY " i !! " !!td 467 ge 467 tye " " "/ a MMAYAYMAY 26 1902 26 1902 26 1 N AND FII ... Reace Insulation 4563 Valley Blvd. Los Angeles 32 Calif ILFERE ... ILFERE ILFERE 85 .. 1957 Jan. Feb Mar Apr. H June July July July JulyJuly Aur. Sept. Sept. Oct. NOT NOT NOT . Dec.Dec. Piberglas Engineering ti M Armstong Armstong Contr F Insulation Co. x 1958 Reece Insulation J. T. Thorpa 219 1149 R. T. Dinwiddie 71 486 ... Jane Mare Apr. July Aug. Sept. Oct. Nov. Dooe 1959 R. T. Dinwiddio 8627 So. Atlantic Southtt Grte Calif : 657 hrs Fiberglas Engineering 366 Reece Insulation & a 592 1960 Jane Mar. April Reece Insulation Kircher Asbestos P.O. Box 4452 Phoenix Arizona Los Angeles Cork 4190 2. Wachington Wachington Los Angeles 23 33 40 172 June Plant Asbestos 1540 W. 9th St. 1208 " July Long Beach Calif Aug. ny Sept. KE Oct. KE Nov. KE Dece KE Jane Fab Mare Apr. MAY Juno A45 Sopt Oct. Nov. 1961 Plant Asbestos #t cd 872 Mundet Cork Corp. 6116 Welker Ave. 102 Maywood Calif Cul Stete comment 8623 Mettler St. 32 Los halen 5 Celif Fiberrionngineerin Fiberrionngineerin Plant Asbestos Co. 11 140 " 356 NG ot . / bea ' Jan. Feb. Feb. Mar. Mar. EOb M oh 41 Gy " m wal } 281289196262281962 281962 281962 281962 . hin FR me ge - met, - U ENO 1962 U ENO ROFLIF Plant Asbestos Company Company Coast Insulating Armstrong Contr 172 |,, ,, Sditseateabtend ebttins, Pn inh pavesniad dius BEFORE THE INDUSTRIAL ACCIDENT COLOMISSION OF THE STATE OF 2 CALIFORNIA CALIFORNIA 3 CLAIN NO 65 SP 160-171 S&F H JOHN B. SWARTOUT ath Rt FP Applicant PY Ml " 4 VEe 8 KUNDET CORK CORP HARRY A. DUTTON INC el ORDER JOINING A PARTIES LUTTON ASBESTOS C^ DUTTCH ASBESTOS & lt DEFENDANT @ SUPPLY CO WESTERN ASBESTOS CO BAY CITY Na C^ KOBESTOS Ltd CRG LEGULATION CO a 10 10 Inc WESTERN FIBROUS GLASS PRODUCTS CO el ea GENERAL INSULATION & RUBBER CORPORATION 11 CORK CO JOHNS MANVILLE SALES yy ARMSTRONG CORPORATION C. C. MCCRE & CO J. T HE Ts 12 THORPE & SON INC M. R. CARPENTER Poa ESrPCR AETHA INSURANCE COMPANY STATE COMPENSA 13 TION INSURANCE FUND INDUSTRIAL INDEANI- ae SOT 14 TY EXCHANGE INDUSTRIAL INDEMNITY COM- i er FANX FACIFIC INDEMNITY COMPANY LIBERTY 15 fl HUTVAL INSURANCE COMPANY EMPLOYERS MUTUAL Ne 15 INSURANCE COMPANY TRAVELERS INSURANCE COXPANY STANDARD ACCIDENT INSURANCE COMPANY a 16 and PACIFIC EXPLOYERS INSURANCE COMPANY epee at 1818 Defendants ie a GOOD CAUSE APPEARING THEREFOR 21 IT IS ORDERED that the Mundet Cork Corp. Harry k Dutten Ino Dutton Asbestos Cr Dutton Asbestos & Supply Ch Western Asbestos Co. Bay City Asbestos Co. Ltd Cork . Insulation Co. Inc Western Fibrous Glass Products Co. stigh: General Insulation & Rubber Corporation Armstrong Cork Co. Johns Manville Sales Corporation C. C. Moore and Co J. To Thorpe & Sen Inc K. R. Carpenter Astra Insurance Company State Compensation Insurance Fund Industrial Indemnity Ex- Sats change Industrial Indemnity Company Pacific Indeanity Chopany Liberty Mutual Insurance Company Employers Mutual Insurance Company Travelers Insurance Company Standard Accident In- tpi surance Company and Pacific Employers Insurance Company be te and they are hereby joined as parties defendant Py ess ng Pale * Peryiteb es DATED AT SA MANCISCO locate CALIFORNIA 2at . JUN 22 1956 hetnia 32 oka Ge urvis Referea na i mel dg mntrieln, | "4 . 7 | | WORKMEN'S WORKMEN'WORSKMEN'S COMPENSATION COMMISSION OF CONNECTICUT NOTICE OF HEARING | j Edward Campbell / Norman Zolot dsq | 82007 whichey Ave. Hamuan Conn Claimant | V30 i Scovill Manufacturing Co. ' .. .. box 1820 waterbury Conn . 19191919 1919 a 192 = Insured at 1] ow obert ae Keasby V1 7139 -149 W. 19th St. New York N. Y. 19227139 lonecord lonecord19th 192 1925 - No necord 1925 MP 1920 - martfora Accident & Indemnity Co. 1931 - 1932 - Hartford Accident & ludemnity Co. _ 15 Levis St. Hartford Conn Co. White Plains York Co. Acoustos Acoustos 1930 White Plains New York 1930 ~ 1932 = No record t Office of Compensation First Commissioner ConCongresionagl ressional vistrict i Armstrong Cork Co. 1931 Liberty and 1933 1931 = 1933 1609 Standaro 1933 - 1934 M It 1934 - 1938 wo 1 1939 = 1940 = # 1940 - 1941- t 1941 - 1940 11 1942 - 1942 EF 1943 - 1944 2005 1944 - 1945 it 1945 - 19 " Charlotte Lancaster wccident Insurance Co. If " f tt . 1t : 18 " # oT] T n it , ft P it It " ,, " . F " " 19 It 111 West Main St. Waterbury Conn . vl 8 svesters Distributors Corp. i 1934 a 113 cast washington * riureport Conn - 1935-1935 1935-1935 Asbestos Distributors ) Travelers Insurance Co. Co. canc.o 35 - 1 1930 1930 - 1937 1936 = 193 ~ 19 Asbestos 11 " , "ooM Distributors Bridgenort Distributors Ct 28 RO: et " n St 163 Asylum St. Hartfora C U.S.Fidelity & Quaranty Co.Co. . 11 Ef | 1939 - 1940- 1940- 97 80 4 1 ft it can 3e 39 par 11 99 % " 1 . It % 1939 that 1444 It = 1940 - 1941 GeneralAccident rire | = GeneralAcident GeneralAccident 242 Trumbull St. Hartford , Hartford rire & Life Life = It 500 Whalley Ave. NewHaveCnt 1942 1943 L Asbestos vistributors Htfd.accident 4 1943 - 1944 Ma $ 19 H " Htfd.acident Ingemnity 1964 ~ 1945 1945 a It , . ## ... OF 15 Lewis St. HartforCdt Hundet Cork Lompany 7101 Tonnelle ^ vu110 Nieve Jersey 7970 2 10 2 wae semblev semblev ani NIM mee I'm ~ PLAINTIFF'S FYHIRIT \ +9 , 2 Insulation Company 676 Oakwood Ave. West Hartford 1937 1 1939 Mutual Insurance Co. 1938 - 1934 39 " " tp 1949 tt 1939 - = canc.6 12 11 R If # 63 East Center St. Manchester Ct 1940 cos 193 19:30 Glens Falls Insurance Co. 141 Washington St. Hartford i C 1941 1942 1943 New Amsterdam Casualty Co 84 it M w - FT Ly 8 R GT 1945 - F , 1 1946- 9 1947-194 1947-194 1947-194 - 1948 - 1949 1949 - 1950 canc.6 153 4 # 8 ie Milk St. K ul Boston " Pt w M 1 Mass Ct 1946 = 194 1947 - 194 Aetna Casualty and Surety Co. tt It $ Surety -- 111 Pearl St. Hartford Conn - 1958 1950 1951 1952 1953 - 195 1958 1958 195 195 Be Travelers HTT ## 18 Insurance If & tt Co. ti w % 163 Asylum St. Hartford Ct 2943 1944 Rhode Island Covering Co. ; 357 South Main St. Providence R.I. L" 1946 - Employers cin 1948- 1948- St Liability Assurance it M Corp. 132 Temple St. Haven Conn Sec A. W. Bancroft West West St. Heading Masse Co. . 1944 = 1945 + Royal Indemnity H It R 1945 - 1940 # : 1946-1947 1946-1947 1946-1947 oe tt ao 1943 1947 te te is - It 11 1948 - 1940 04 ne ft 17 7/20/ 7/20/4274 /20/42 2 7/20/42 = 195 Church St. New Haven Ct 1949 = ; 1990 ~ Utica Mutual 955 Asylum St. Hartford Ct 1950 Homestead Insulation Co. 45 Granby St. Hartford Conn S Aetna Casualty and Surety Co. 111 Pearl St. Hartford Conn Universal Insulation Co. 614 benuykil Ave. Philadelphia Penna 1960 - 1931 cmployers Liability Assurance Corp. 1931 132 Temple St. New Haven Conn Johns Manville Corp. 22 East Luth 264 new York NY 1922 1925 - 1921-92- 192- 1920 +9 Standaru re nccidunt it lInsurance 10 Co. n 1920 1927 on " It i" 1 111 west main St. Waterbury Conn 1927 192 Johns Manville Inc. of mass ~ Employers Liability assurance Corp. 132 Temple St New Haven Conn Johns Manville Corp. 22 Last 40th St. New York N.Y. 1931 1932 - Standara Accident Insurance Co. 1932 -=~ 18 H ... 1934 1933 ~ t _ 111 mest Main St. Wateroury Conn - 1934 Johns Manville Corp. Nashua New Hampshire , 1933 1934 - Standard Accident Insurcae Co. 111 west rain st Waterbury Conu 1934 1936 1937 1935 ~ Employers Liability assurance Corp. 1937 - ... 18 asurance " 1930 - M " Ft # 132 Temple St. New Haven Conn 1939 1937 1940 1941 1942 1943 8 1940 1938 1941 - 1942 1943 - 3944 Johns Manville Corp. 22 East 40th St. New York H. Employers Liability Assurance 11 P T - 1" M 19 os tt " M t ~ tt 1 17 . " Y. Corp. 9 17 n 1950 1951 Richmond Asbestos Co. Inc. 54-18 43rd 1951 - Hartford 1953 tt St. raspeth L.I. 11.Y. Accident & Indemnity Co. we 1 Respondents entitl ** You and each of you are hereby notified that the matter will be heard with reference to the following questions by the undersigned at his office Room 008 No. 54 Church Street kein Hartford Conn on the 7th day of ilovember 1955 at 10:30 kein Re INFORMAL CONFERENCE - ASBESTOSIS Notice Issued September 29 1955 LEO J. NOONAN Commissioner Acknowledge receipt of this notice at once Iw se@ 4 COMPENSATION " WORKOMEN'S COMPENSATION COMMISSION OF CONNECTICUT NOTICE OF HEARING Edward Campbell Woodtick loed Waterbury Connectiout o Mro Read Office of Compenuation Commissioner First Congressional Distriot TH. Johns Manville 28 East 40th Street New York New York Worked for six years in Conn Robert A. Kensby 139 West 19th Street New York 11 New York Worked about four years in Conn Keasby & Madison 225 Broadway . New York New York Workeda couple of years in Conn and in Albany New York Lotz Asbestos Company Hartford Conn Worked about three years in Conn) Armstrong Cork Company Lancaster Pennsylvania Worked on and off for three years mostly in Conn Asbestos Distributors 113 East Washington Avenue Bridgeport Conn Worked four or five years in Conn Homestead Insulation 45 Granby Street Hartford Conn Worked about a year Co. : around Conn) ' Insulation Company 674 Oakwood Avenue West Hartford Conn Worked about a year around oR eee. Conn en Scovill Manufacturing Co. P.07 Box 1820 Waterbury 1 Conn Worked a couple of years on - asbestos wus installation You and caoh of you are hereby notified that the above- entitled matter will be heard with reference to the following questions by the undersigned at his office Room 608 No. 54 Church Street Hartford Conn on the 31st day of January 1955 7 at 10:30 A.M. geet :* . he o . ~ In re Informal Conference ~ Asbestosis Notice Kindly notice issued Dec. acknowledge at once 16 1954 receipt of this . LEO J. NOONAN Commissioner EXHIBIT