Document 8RNObG2a8dM7w4Oz3E9pDppMo

c V VCM Epidemiological Study - Individual Work History Form A - Workers known to be alive 1667 - S, E. Divine 1. Date of birth 12/11/40 2. Date hired Xl/9/72 Status: 3. Now employed _________Yes 4. Retired (give date) ____ 5. Terminated (give date) 6. If retired or terminated, please state how you know that this man is alive. Job no. Job history with estimated exposure Title Check estimated exposure in ppm *50 50-199 200-500 >500 Fool II-D Operator from 11/17/72 2 CHA Pool to from 12/13/72 NONE 3 HB-2 Alcohol #2 to from 2/13/72 XX * 4 HB-2 Alum. Pwdrg. #2 to from 9/1/73 NONE to NONE 5 from to 6 from * to from to EC 29>7