Document gEaO31BRLg8BEKgXvxMbvw38L

FILE NAME: Garlock (GAR) DATE: 1945 Jan 16 DOC#: GAR013 DOCUMENT DESCRIPTION: Letter to Insurance Co. from Drs with Attachments X COPY MF KORRIH J. KO'JKO'/ITZ, K, D. Rochester 7, N. Y. January 16, 19*0 5 PLAINTIFF'S j EXHIBIT J frflg g (Anerloan) Lumbermen's Mutual Casualty Co. of Illinois 918 Reynolds Arcade Building Rcoheater, N. Y. q vb: \f am a f' 1 ama a m n aaa aaa4 t) n 1 mVi a M Y Gentlemen: This ^2 year-old, married woman entered the employ of the Oarlock Company on May 20, 1918 and worked there steadily until July 3# 1928 in the t;extil* room, operating a loom and a oreel. She then returned to the same kind of work on September 17# 1928 and worked through June 29, 1929 She was then married and left the company's employ. She had three children. During her married life she is said to have gained weight and to have had some shortness of breath. On December 3# 19**2 she again went to work for the Garlock Company, in the same depart ment, and worked steadily until November 2$, 19*0 o this last date, she resigned "without any explanation". On April 8, 19*0# ehe was seen by Dr. Marsh of Palmyra, N. Y.; at this time she complained.of.pain in the chest, shortness of breath and cough. On Kay 15# 19*0# her chest was x-rayed by.the State Department of Health Ciinio at Newark, N. Y . These films were examined by Drs. J. H. Green, E. 0. Whipple, John MacMillan and me. Dr. Green reports on them as follows: There is infiltration involving the larger part of the right lung. The shadows are muoh denser near the hllua. There is a dense shadow in the left lung near the hilua. The two dense shadows largely obacure the heart shadow. No accurate measurements of the heart can be given. The leaves of the diaphragm are quite high. The right leaf of the diaphragm lies above the oth posteripr rib and the left leaf lies Just below the 8th posterior rib. There are some areas of decreased density in the lungs, suggesting emphysema". On June 5# 19*0# she was again x-rayed by the State Department of Health, this tine at Palmyra, N. Y. This film shows "changes similar to those described in the film of May 15, 19*0 The dense shadows extending out near each.hilum obsoure the heart shadow. There is in filtration involving the larger part of the right lung. The leaves of the diaphragm are high". The diagnosis, made by the State Department of Health on the above two films, was "pulmonary fibrosis*. On or about September 26, 1944, the patient was sent into the Genesee Hospital of Rcoheater, by Dr. Marsh; here, she was attended by Dr. Vern Gler'-nn v. Oarlock Packing Conpany Page 2 'rtln ii. !"hnon. `n '<<-tenber ?7 , 19f-'-, an*-ther chert flln was taken v the h' *.tal. shoved "Inf Miration cf the lunr~, as described ''.n the t'c :revlcus films. In addition, thire In a r-n<nn't.harcx jacket In the rh'h.t pleural npace, extending long the axillary border and over the apey , cane ini' approximately ?$'r cr 30 - ccrv'ressicn of the lung. T'.-e h.enrt Is apparently shifted slightly toward the left side. In addition to the Infiltration described In both lungs in the previous film'-, there is a r-llght increase in the linear markings In the left lung, fron the clavicle to the base". Trie patient died at tho hospital cn :le'-'tenber ?9, 19V*. Autopsy was done by Dr. N. Pop-off, the hospital pathologist. He ' 111 forward a complete report of his findings, both gross and micro scopic. The autopsy material was reviewed by Drn. './hippie, hachillan and pie. It establishes the conclusion that the patient died "an a result of pneumothorax, This pneumothorax wan associated with extensive "ulnionary fibrosia, with emphyseumatous blebs ond emphysema. Sections of the lungs confirm the dlagnoslo cf pulmpnary fibrosis, resulting from prolonged contact with asbestos". It Is Dr. Popoff's opinion that the asbestcsis was "of long duration". The advisability of making.a chemical examination of the ashed lung was taken ur> -with Dr. leroy U. Gardner of the Hdward L. Trudeau Founda tion at Oaranac I.eke, W. Y. He -wrote me: "I would much rather rely cn a histological examination of large blocks of lung tissue made by a competent pathologist than I would expect results from chemical data. At best, the latter is only supporting evidence of any morphological changes that may be present. '<'e have done it on a good many lungs that have proved to have asbestosls, but all one can do la to demon strate that there nay be abnormal Quantities of magnesium. The sili cates that,are detected might readily be due to other inhaled materials". On the basis of the above, It was not thought necessary to have the lung ashed. Conclusion: It is my opinion, in whloh Drs. Popoff, KaoMlllan and hfaipple tell me they concur, that this woman died of apneumothorax, associated with pUknonary fibrosis and osbestdsis; that this process began at some tlr.e after Bhe first went to work for the Garlook Packing Company and steadily progressed; that she v&s, clinically, an advanced case of asbestos Is -when ohe returned to work for the Garlock Company In Deoenber 19^2, and that the process would undoubtedly have gone on to a fatal termination even if 3he had not worked during the period from December 19^2 to November 19^3 Very truly yours, /a/ J. Foskowita, I'. D J: :TG /t/ . J. i. o-'It z , !) ' -r? BEFORE THE W O RK M EN 'S C O M PEN SATIO N BOARD tte o r new york W .C.B. Case N n 7 i e 0 8 2 a I n th e Matter of th e Claim for Compensation U nder th e W orkmen's Compensation L aw of Raymond E. Clemons_________ Chimoni, against S ubpoena Garlock Packing Company Employer. THE PEOPLE OF THE STATE OF NEW YORK Tn George E. Houghton, Superintendent T e x t il e Dept. GarTock PacTcilig"'C6mpahy",""Palmy ra, N. Y. Greeting: W E COMMAND YOU, that all business and excuses being laid aside, you and each of you appear and attend before the W orkmen's Compensation Board of th e State of N ew York, aL...-?i?.^J?..5.^ILSLe_ ..^ : ^ r e e t R o c h e ste r, New York on tKy 2 6 t h day of___ N.QXQjmbQ-T.__________ _ 194_0_, at------- 2.-- o'clock in the-- f w a a f t e r n o o n of that day, in Part._? __ to testify and give evidence in a certain hearing then and there to be held in the matter of the claim for compensation o f ~ I f e J O U Q - A . . C l emon_3------------------------------ , claimant, against Garlock Packing Company __________________________________ _______ ; employer, on the part of---- PJ~a ---------------------------------------------------------- AND FOR A FAILURE TO ATTEND, you will be deemed guilty of a contempt and liable to the penalties provided in Section 119 of the Workmen's Compensation Law and Section 405 of the Civil Practice Act. W IT N E S S : T he W orkmen's Compensation Board of th e State of N ew Y ork, at__5.op.h0 t r New York, the ... day of .......... -- , nine hi tidred and_____ P i f i n t AND BRING RECORDS OF ALL D J 3 T COUNTS Ail IN A IR AND CHEMICAL ANALYSIS OF ALL MATE B . CLEMONS V<ORKSD DURING HER EMPLCYMENT Porro C-24. If.-4 > 1rM i fiH - WORKMEN* COMRfKAATiON O A K O 9TATI m MW w. c. . 7W0ajaj Cam H*_________X attL l. C1m m u 4 m U Im . C antor's H o .-* * ____ HOTICX or DECISION EN DEATH CASK -.-.JUta*-a(L.T*X-l.aiAM & A_CW lm*at 1)5 V. Toatax 9 ). -JPalayzit-laXt.________ (WwtMi C*ETW) McW.-- . Oarloak Puaklng Oo, Pulyt..J.I<------------- ____ Kmptoyer A tty i* LiOlAy i> ^ iT a iirr, srm T i- t. i m r . lumUrmoM Hut. la y n o ld a AroaAa B ld, lo c h . K .T. Yoo u t hereby notified that t t i beerinf bdd before the Workmen's Compensation Board on L L - 2 6 r 4 l............. ....... ... a decision and award of compensation was made in the abort case of T f B.Ol-- CM-----.. - Eohowa: _________ Dw ti Mr* Xlalna Aon 01aoII abort addraaa Xugana Kayaonft CJ s n o o t d it t o Luoi l l * Y on Clot oi na d it t o daughttr aoa daughter i-if-)a 10 9-16-56 10 9-)C-39 10 1.75 .75 *21 OOoOaupaawtoloaanuaLl oonix< mitlo no ,. onotuloo aid aauaal a la tlo * aro found as to tha ohlldron. 1.15 Atty Vs. L. Clay fao o f |4 0 0 .0 0 -lla n - ip a r rto ohooka to bo aaat. Award aada under i r t i o i a ' u to ohlldron in l1'u l l anout |6 ,5 X3.00 to ooTor death b onoflto. ,, t I Claln o f haahand ISayaond I . Clano^a, d la a llc r o d . Caa^ C lo a o l and the employer and inauraoes carrier a r t hereby directed in accordance with the proriaiona of the Workmen'! Compensation Law, to pay such award to the foUowinr persons : .......R a y ro n d ljRJjf.-l-ooaa-j---13i #. Y o a to r -St,. ^ 1* / * * ^ ......................... ....Y a t h o r - a a t u r a l " g u a r d ia n f o r th o u a a a n l..b o jia flt..fif...th .o ..O .W lld r# h ........ sod funeral expenses * yoo.O *0 B ay eo n d * ^ i ^ o n o o a t o p a i d b ^ ^ h ^ a . to.. u n d e r t a k e Employer and earnar a rt directed to pay at once I for ........ weeks at $......25-- from date of death 9 - 3 9 4 4 ..................... to j ............... ...... I t ____,, direct to the ........................... ..... ...................................... and thereafter ($ 1 5 ^ 5 - ..... ..... bl-weekly.) Balance of the award is ordered paid into the A r p t p U Trust Fund as provided under Section 27 of the law. Present value of the award as ordered paid into the A ffrtte Trust Fund as a t ______ __ ___________ ___ la $ ____________ ____ __ Present .aloe does not include funeral benefits. Check to be drawn to the order at -Stats Insurance Fund--A ffrtait Trust Fund Accotai* The A ffrefate Trust Fund la to make bl-weekly payments at the rate of $.................. .......beftnnlnf with .....................................to th e .................... .............. The bore copy of the decision and award it lent you pursuant to law. TAKE NOTICE that the above award or deciaion was duly filed in the office of the Workmen's Compensation Board on the U .otVanwary 1949... 19.. Dated 0 - 31- 4 9 * .....................19.. 7^ B y ................................................ Chairman Reduced 7 /2 1 /8 6 c-41. i-*,, WORKMEN # COM^KH1AT>ON OAJ*D m T f or mm root cL^nL - J M # . . ,, .. I*. Carrier's N<x_iJ_____ HOTXX Of DEOSOM MATH CAJ* , .T , Aster. l u W u u r u t. Ourlodk-Fioklni 0. W ij m , I.T . Atty 1 h , 1. 9 U f iMhiittr, M.T. .. Employe Too i r t hereby notified that at a bearing held before .the Workmen' Compensation Board on H .r J b S r 4 1 ------------- a dedikm and award of tompention waa made in the abore case of ___________ decadent a follows: H a in e Am Cl Xogaaa tayaoaA L a e llle Tara Cle; Tml*fi M o f hubca4 U n o a t I . o;*mm uu# d ia a lltsr;bobzb. abort aAdxsaa |iau*htr L-18-M 15 4.1*5 Alt 1-16-E 15 4 .U 5 d itto daughter 15 4.1*5 Coaoyatlonal e o n d ltlo n , n otlea aad eauusal r e la tio n a r t found aa to tho e h l l f r a . TT77 A tty a. L. Olay fo e of #400. 00-1j|n-eparatji ohaok 4 * imb. Award aada tmdor (Art1el* 41 to o^ildraa(aotj to exoaj* 16, 510. 00) y to aoror death b en efit a. i and the employer and (naoranea carrier ara hereby directed in accordance witb the proriaiona of the Woflamen's Compensation Law, to pay such award to the foOowint persona: To ..EayB8P.d...Swj!.,,Clai4.>na*.jLi5,,!Li_yo*^*f_L .....?~5?L ..*_*.*........... ..... ........ iKtMl ildwi ...jjL thnr.....nataral. and funeral expenses 2 0 0 * 0 0 to 1 a p s o n A..1 .C1 J 1* r Employer and carrier are directed to pay at once $6&5-l*-- for 21?.____ weeks at $.13.<J?5.. from date of death 9--2 9 * 4 4 ___________ to . . U - v ^ r A i ____________II.... direct to the ...........--...................................... ...... ...............and thereafter ( t . - .2 4 .3 5 _______bi-weekly.) Balance of the award ii ordered paid into the Aggregate Trust Fund aa provided under Section 27 of the law. Present value of the award aa ordered peid into the Aggregate Trust Fund aa o f ______ ---------------------------- is f ----------------------------- Present value does not Include funeral benefits. Cheek to be drawn to the order of "Stats Insurance Fund--Aggregate Truet Fund Aecount" The Aggregate Trust Fund is to make bi-weekly payments at the rate of I _____________beginning with __ ___ ____________ to t h e ____ ____ _________ The above copy of the deeieion and award is rent you pursuant to law. TAKE NOTICE that the above award or decision was duly filed in the office of the Workmen's Compensation Board on the 24th ....day of Jobruary.3.949------l*------ Dated 2 - 2 4 - 4 9 a * '-*-................19....... - > Reduced 7 /2 1 /8 6 REYNOLD ARCADI UILDINO ROCHESTER 4. NEW YORK May 3, 1949 TKUKPHONB MAIN 1071 Garlock Packing Company Palmyra New York Attention: Mr. H. B. Pierce RE: Vera Clemons,dec. Dear Mr. Pierce: The amount of the award in this case will amount to six thousand eighty six dollars and fifteen cents ($606.15). This includes all payments to be made for award purposes. 9-32-122 George'A. Ryder comp, claim S u m e r m e n s J f a s i n s u r e d J i f t v 71 c l / 1 o n M c / e s o f 7 1 o t o r , ? u- /'- 'V GARLOCK EM EE RECORD c p . c a IMS NAME Mre, 7era Smith Clemons___________________________________ Clock No. 66o________ ADDRESS 133 Waat Poster Street____ ?al%yr a ^ il?gy *QTk_________Phone No._______________ In Cane of Accident Notify______ Hay Clemona Sana "ddreea____________________________ Ednotion Oraaanar___________ Trade______Hone____________________________ Pate Hired 5-30-18 Height 5 1 U j* Weight_________ ig h lib a__________ Phyacal Examination T e a ________________ Citizenship Jlaier ___ Where Born Macedon C anter Date Born 5*5*02 Single Dependents fPrevious Employment ------- ------- ]1 C hildren Date RATE 1D . 0 0 k II Hour { Week / .Ary rol^ c.h,'rrlPLe ncttr*0cVer ^* r ->//- , jI R0UTJNG-t;' IMITIAL THE GARLOCK PACKINGCOMPANY-FACTORY PAYROLL CHANGES !CtNCIMlMlNtCW^ '' wmc Tara Clepftr.g - : ,iPmirnc O'viC /^: _ . c*.. _Textile _ cuxano 6q ___ 1cost0)tfZ'I^lPi ` Behlrad !FACtOWrOfficeFile .Iob ^ IfllTSr Co 310 Ccer. JQhmn DftC. 3*_19U2 ___J^ __ RECOMMENDATION FOR INCREASE: ' Pbcscnt Rit REASON: PiaHh Nu B<ir Pm Hit Zrrr.-nyr Date ' ;' V. I-v.' - TRANSFER: Ofpapimint Cio.aNo CclingRate - Joa Cede Mach Code BonusHourly CeilingRatej FaOM; I I . TO: . . j ' , - ! ' _________ ! ___________ _____ I __________ - REASON: REMOVD~FROM PAYROLL: reason: laajgnod. lot nfryalcally abla to dotha 'orL. ErrccTivc Date \~ Efuctivc Date ___ _ i_:___ Kovaa^nr ?6. 1Q^1 ..... " ' 7 / ' i; ' -- Emt.Mm _'______ ____ __;___._._._._;___ An> PhcdulTionMg - 7 _______ _____-_t !.?..- .-..v-- Oiw.Sow.____________ __________ __ Ai CcnculMm -- ^ I,;*M DEC 3~ 1943 ~ - - /L~ / / / ' ' ' r Peking Company , NEW YORK v r u 04 5, Nkv. 1 a * * Ooap iM tlo a r (OalM !> IoaM *M af'* WM M i O&MpMQTV. ffar * "MT ilitM M r ftsqr m- M tijM * m ^ e fN . S fMrftwgp e*oeds ih m tbm% b wo* rm wpi fk<W f X 19*8 M * eesi^ p et1 M * la id o f f Im d h w r ser* X9^ > t b * r tlw r th fu v tto N Mtoi p-- < > ir l t e i i t .d |k i l h R l M i t M CvMHPC^flfle w * * fa w i v iw tfe iM n iM OMgMT t o lM b Mkr # lf e t w m i ' hr nnk 8 m m >e S . X9*fc M l; h . M r jMtoHU Tb: praMAjA'MMW- ttm* Nr*. OXbm AIM:- r Swpt--M r 19**.- The Garlock Packing Company PALMYRA, NEW YORK te rn a ry 8 , 19*7 N r. O utrlM V. O m o . A tte n e r * t , 8trang, 1odios. rig h t * O n te , 800 Fo--n l u l l d in g , Itocihaart r * , lew Torte. B it Beynond X. 01-- ano -- U n ite d A dm lnletrm tor o f th o l i t i t o o f T er 1 . (Ha-- , to w -- A r a i Q arlook Feoklng Oo--acy B ear Mr, Ora-- i Tklm l a t t a r v i l i In tro d u ce Mr. Ja --a B. A lad o rf, S ta ff A ttom ay o f o o r Co-- -- y. N r, A ladorf la ta k ln g -- v lth Mr. VUoax o f B a rra , le a oh. Z a a tln g , Wlloa* * E lio , th a questiona lnvolved In th a reo ao t ao tlo n hroqght hy Itr. V IH is a L. d a y In th a Gi-- l a t t a r . L i r la v o f th a fO rugolng, ve v i l i p a re c a te l i l f jrou v i l i g iv a kr. A ladorf a h r la f a-- 0 7 o f th a p re a an t s ta tu a o f th a aubjeot oaaa vhloh you a ra handllng fo r u a. B ili l a t t a r v i l i a la o n arra aa a r a p i/ to youro o f Jtvasmrj e , and la apporti--oa v lth jroor re q u a a t, va anelo-- (A-- r io -- ) X-- heneaos M utual C asualty CO----y U o rfaao 'a Co--a o a a tla n F a lla r l o . TCP,96**,568 oe--rin g 19**j a lio F o llo j l e . TCP,095,115 o o ra rla g 19*5. Althougn I t e . (Ila-- Alad In 19** ih a v-- l i n t s--loyad ty o o r Oo--aay In 19*5. t e r re c o rd o f b a r e-- loy--n t la -- f a llo -- 1 F ir s t e--loyed - B y 20, 1910 R esig n ad - Ju ly , 1928 Be e--loyed R esig n ed - S ep t. 17, 1928 - A sa 29, 1929 Re a--loyed R esig n ed - Leo. 5 , 19*2 - l o r . 26, 19*5 Li n ex t to th a la s t paragraph o f your l a t t a r o f th a 2nd you s ta ta th a t "Mr. Z u re tt baa suggested th a t Inaa--oh -- th a (Assnrloan) L u ab en an 's Mutual c a su a lty Oo--any baa n o t a ffo rd ed you ooveruge under I ta p o ll ay l o . IC S,96^,368 and v i l i n o t be re q u ire d to pay any adg--n t v h lah --y be e n tered In th e a e tla n . \ 2 Mr. O harlea V. Qtraea, A ttornojr a t 1 , you m j imm l t d i t l n U t n d proper to ber th la f i n o r m m a tte n e y v o th e r than th T u te lilin * a M utual ooonaal ta te th daf#n-- o f th a e tle n td fo llo i t through to a oco o lu elcn ". te th la oaoneotlon, l t vae our under# ta ndlng th a t you v are to p ro te o t our In te re # te v lth xaepeet to th la , a e tlo n , v o rklng In oooperation v lth Mr, lardar o f th Inaurano# c a r r ie r , th la la r a f a m d to In you r l a t t a r o f lo v eeb er 18 ISkk, I t la our u aderetandlng th a t th Tarateraana te lle v e d th la to te a eoqpeaeatlen eoe# and v a re v i11la g to aeo ep t l ia M llty xmder th I r p o lle ? aa a r e e a lt o f th p o e t a o r t n p e rfo n e d on Mr. fllnnaa a t th tla e o f b e r d e a th . A lth o ^ b th lite b e n en # a re no lo o g e r o u r In v a n o -- c a r r ie r , th # j --r ta ln ly bar# a in te r n e t In th la oaae and ahould p entitine to cooperate f ttlly In defan-- of th a o tle c v h lch bea te en tro u gbt through Mr. GLay. A fte r you here bad an o p p o rtu n lty to rerlew th oa-- fu rth e r, -- h a ll te glnd to barre your o o a a n ta . Tery tru ly your#, W S QMSJOCK PA C O 0GNPAM7 A eeletent 8oer#tary. KBPtCS teo la h F? ' o/.* C"*:.'.:'. If a* iaji ed employ b u work*d 1 w > r "rtbme<ial prt of ' yt*r tbt ffnbianrksa A _sboetd b w i j / b r i worked for i yser or .ubstutUl prt. tbtufofsnd toother employ/bu, then tb e fo m ,"5" should bt need. la. sitbef !ayt.a':lb' :^ foQowiag th at forms should bs artfully pttptnd sod ankd. . >. 'v*1 ; nibre Votai ?'/,% f'~ l The Garlock Packing Company PALMYRA, NEW YORK Y er* S. C lem one January 10, 19^5 M r. G eo. A. R y d e r, C laim A d ju s te r A m erican LaBherm an* M utual C a s u a lty Co. of Illin o is R eynold A rcade B ld g . R o c h e ste r L , R, Y. R e a r M r. R y d er: R esp o n d in g to y o u r te le p h o n e g ir e you b elo w th e re c o rd o f ahovn on o u r re c o rd s : re q u e st to oar th e em ploym ent M l G o r e m r , f a c t o r y n u r e , we o f th e sh o re s u b je c t p a rty a f i r s t em ployed - May 20. 1915 R esign ed - J u ly 31, 1928 Re-ployed Resigned - Sept. 17, 1928 - June 29. 1929 R e-ea p lo y ed R esign ed - Dec. 3 . 19^2 - Sor. 26. 19^3 tr u s t th e sh o re w ill r e e t yo u r re q u ire m e n ts. T ery tr u ly y o u r , C GARLOCK rA C U R G COMPACT HBPtYKl'zIO I' ' / ' /- irj A /' /'-vvv.e.. --- U ^ ,= / / -^ / /ii- > 3 / -7<J ; COMPENSATION BOARD NCW YORK W .C.B. Case N o. l i & Z . Z A . NDER '/? mani, S ubpo en a ... ^ .'; a . // loyer. STATE OF NEW YORK id e n t n y ra* sting: T a c tile N. Y- D e p t, u ses being laid aside, you and each of you appear and a tte n d b e fo re th e W o r k m e n 's C o m pe n sa t io n B oard o f t h e S ta t e o f N ew Y o r k , a t_ .._ T .9 .....- ? .? ..5 ^ ^ .S . _ tr e e t R o c h e s t e r , N e w Y o r k ____ _ _.... __ ___________________________ ___________ on the 2 6 _ i.il day of___ Ji.Q.Y6_rnbe_C____________ , 194j B_, a t ------- 2 .-- o'clock in the------ 1 i m > a f t e r n o o n of that day, in Part__ ? __ t0 testify and give evidence in a certain hearing then and there to be held in the matter of the claim for compensation of -- 2_C l etnon_3--------------------------------------f claimant, against Garlock Packing Company_________________________________ _________ employer, on the part of___P ^ _________________________________ -------- AND FOR A FA ILU RE TO ATTEND, you will be deemed guilty of a contempt and liable to the penalties provided in Section 119 of the Workmen's Compensation Law and Section 405 of the Civil Practice A ct. W IT N E S S : T h e W o r k m e n 's Co m pe n sa t io n B oard of t h e S ta t e of N e.w Y ork, a t --l i & . c h e a t a r New York, the. f-2nd_.,,day of_______ i.P.YJLTMLi-- , forty-e ignt AND BRING RECORDS OF ALL D JS T COUNTS' IN A IR AND CHEMICAL ANALYSIS OF ALL MAT B . CLEMONS WORKED DURING HER EMPLOYMENT. OF ASBESTOS'* ROOM WHERE VERA O BEFORE THE W ORKMEN'S C O M P E N S A TIO N BOARD T A T I o r N IW YORK I n t h e Matter of t h e C laim for Compensation U nder th e W orkmen's Compensation L aw of W.C.B. Case No.. ___ ________________ Claimant, against Employer. State of N ew Y ork, County of......... ........................... ss. : C ity of.......... ....... ...-- ............... _________________________________________________________ _ being duly sworn, says : that he is over the age of twenty-one years; that on the__________ day of-------------------------------------------- , 194------, he served the foregoing subpoena upon_____________________________________________________ the witness therein named, a t _ __________________________!_____________ by delivering to and leaving with him personally a (Plot* of Servie*) true copy thereof, and at the same time and place exhibiting to him the original with the signature of ----------------------------------------------------------------------------------thereto subscribed, and paying to him the sum o f----------------------------------------------------------- as fee for his attendance ; that he knew the person so served to be the individual mentioned and described in said subpoena as the person to whom such subpoena was addressed. Sworn to before me this___________ day o f____________ __ ________ , 194___ Notary Public Commissioner of Deeds t '^-ca '^->VUL. A^~~ f 3o j ?~ 3 ^ / <?<-f f i*^ C - C b ^ - BEFORE THE W O R K M E N 'S CO M PENSATION BOARD T A T I or NIW YORK W.CB. Case No. I n the M atter of t h e Claim for Compensation U nder t h e W orkm en's Compensation L aw o f Raon_d g. Clemona________ Claimant, S ubpoena against Gar lock Packing Company __Employer THE PEOPLE OF THE STATE OF NEW YORK George E . Houghton, Superintendent Textile Dept. Ga rTock" PcTRTng Cmpai^^nPa linyra> N . Y. Greeting: W E COMMAND YOU, that all business and excuses being laid aside, you and each of you appear ami attend before the W orkmen's Compensation Board of the State of N ew York, a t ^X Change_ S tr s e t Rochester, New York___________________________________________ on the 2 6 t h -- day of---- UQXmbeJ ___________, 194_0_, at____ 2.--o'clock in the___ t f t i a e a * f t a r n o o n of that day, in Part-- i?-- to testify and give evidence in a certain hearing then and there to be held in the matter of the claim for compensation of R a y mo n d S C le m o n a _________________________ _ claimant, against _____________________________________ _____ employer. on the part of-- -------------------------------------------------- :------- AND FOR A FA ILU R E TO ATTEN D, you will be deemed guilty of a contempt and liable to the , penalties provided in Section 119 of the Workmen's Compensation Law and Section 405 of the Civil Practice Act. WITNESS: T he W orkmen's Compensation Board of th e St\ te of N f.w Y ork, New York, the. day of----------- O.Y.I!?9.r , c(n\qio^sarjd nine hi id red and ______?..9_CJrYr_.i8 ^ t ANI^ BRING RECORDS^ OF ALL DST COUNTS IN AIR AND CHEMICAL ANALYSIS OF ALL MAT 3. CLEMONS iiORK-'D D'JRINj HER EMPLOYMENT OF ASBESTOS ROOM* AHRE VERA r,, C ! C 4 t-ir.M i AF<