Document Z4k9LxVeQ7dqdVd4RpedLLzRZ
VCM Epidemiological Study - Individual Work History
Form A - Workers known to be alive
463 - H. L. BERRY
1. Date of birth 11/9/21 i
2. Date hired
5/26/52
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. 1 TEL
2 TEL
3 TEL
4 CHA
5 TEL
6 TEL
7 TEL
Job history with estimated exposure Title
4th Floor
from 6/1/55
2nd Floor
t
to from 6/7/56
4th Floor
to from 6/1/56
"C" Section
to from 7/30/56
4th Floor
to from 3/11/57
3rd & 4th Floor
to from 3/30/64
* Evap. Operator
to from 4/28/64
to
(CONTINUED ON REVERSE SIDE)
Check estimated exposure in ppm
*50 50-199
200-500 >500
NONE NONE NONE XX NONE NONE
*
NONE
EC ?936>
c
. C.
8 TEL 9 TEL 10 CHA 11 CHA 12 CHA
4th Floor Blender "C" Section 02 ETCL-DEA Operator DEA Operator
6/22/64 10/12/67 2/10/69 12/9/72 8/22/73
NONE NONE XX XX XX
FC 2937