Document jmR7OJQ5xeEE1ZwMr95r7D68N

FILE NAME: Philip Carey (PC) DATE: 1943-1971 DOC#: PC009 DOCUMENT DESCRIPTION: Worker's Comp Claims 6 j a j 9 J 10 j II j 12 t R i j \I . _ NAME ' H u l s t t e , C iftr a n c ia * 'A , ..* 49 ' :. tlM P L O Y L R : P h ilip Cary o . C,TY L o c k I a n _ _ _ - ^ " " ^ - ^ * i l ---- -p-- - d a t e O F I H J . - ' , 1 / 1 1 / 4 6 . . . U , T N T L ________. . h o u r ;______ ; . ^ ' - J L ^ . 1 O "* N A T U R E o f ' ^ H - _ A s b g s 1i o s i s ; . . I n h a l e d d u s t - f r o a a s h e s t o s . '*v *-- i ~ - . . . - .' W* 0 *> " 1 i . s r w ' n __ i r v . N V \ * * t . * . ~v+^ ________ < 5 ft RISK: DK. 0 IN > > o Z II O O u K 2D h < O =Z DATE _... J . 6 8 4 _______ m a n u a l 4 2 3 3 _ _ _ _ _ H .. co b s M EDICAL. AMOUNT _____ D R O R H O S P I T A L FORM 0 P _ 4 ts T DATE V u / *7 - 'if'iL PATE =" - - *- ' ` ' " -s * N g ^ ^ 3 - 0 5 ~ 6 8 B CO M P E N S A t IO N ' P E R IO D ; . f ,* A M O U N T RAI E i * < . : .-\ y . . n"i\***v vr . ' -J . - .1 77 2 ':_ O 2 N * N* a> N K I N O *n4 N N> J N N \'1 w Ul > ic U (A U Ct ( i .-j v n ) i \ )i i .. j v i { - r i v ' i *n j : i. ij. 1 z 1 1 A * O 0 / \ 0 \0 f \ Q A' *4 * A' f` \ / f t. { ffc ! r- 1 | 1 >'**'* t** 1 R i'i i l i p '- iV i t 'O , 11 <j V ,ilY ) (Ilji1T -^ n d . V - * ` /) / ,? jf 'j / f / iQ I * I _ J u ries a n d tL r o a t.-^ .n x p o a e d -.i'O -d u .'it' in b v a tfc r rftp w causaA Jbijc. ,asbti&tos.-wMah..waa-.put.Jji boaters..----------- 1 r w* *. . Jacobs R ,S K - . 3 6 8 4 . . dr. M AN UAL ^ 233 J ____ m e d i Kc aA lU AM OUNT D R O R M O S I'IT A L EST. * d ate DATE HEC-D. 7 / 8 / 5 8 s s N o _ ^ P ^ Q 5 ~ 6 i> E $ 0 CO M PE N S A T I O N - AMOUNT HA1 E KIND 41R ^ i r? Ig ^ o p f " ' r ......... A ^ .Q ? s * r - c ^ W,, ^ ,/ H___i __ - wj a *' * ^ / ii / *^>^v j * -k ii _ i k c J . ^ i O A r io V ^ ta-.-C} \ x / j o / / , I ----- ... '- j em ploym ent record ____ __Employe,. H u lette,^ C laren ce A. The P h ilip Carey M fg. Co. Ic'fiutfilt* O.ta 6 /1 2 /2 8 s s: No. 2 7 0 -0 5 -6 8 8 0 ciiy L o c k la n d fvi.titc.ri foj Separation S i l i c o s i s a n d a s b a i a L 3 . *4hv j 'xo*a 1j ( (" !i < Cvttttx. B. U. C. No. BUC. Form f *rnd Cat Wk fired iV i* >rr r V t . ' O al ' 7 . > ii/ qsB&assss^Gs ;- ----- ^ti^l/S3 XVj3 0 SSV e NOTlv'jL N H O r ^ Z S S ^ ^ ^ ^ i ^ S S B ? { -ir*ZK- C ~ ^ fr te 'S* **> i J? E d **< -^cv \* --~ *_*?1 <v 1t jSi VKSt *1 _3 8 3 l n - Jf* s*.*i 'V-1t-.%| \*s* 1 : >|rXS% !- S ift i goer/! bg?| V*5- saSjf 1^{ ><3 r* W* * 7 M * y* fcffi *71** -V . A W s t i < *t> * ? ;* . * >V3 - *rfi. vrv " r/r* fir& ti:,t* . * V v-rV. #**;? 7 * S ZZH7 . > */ -I *w {j feg* ww- ^ S f c ^ R f l P S S S Q S S to& vrjfra *QX&AQ> e * * * 2****ftSr. S 3feV/ r.-*,e?*r>iyi?TrX7 r 4<' > v V I M 4 isceefcs#ai.>i53R.C' < i ev5 c | # ^ & * & * & & & !& * & & * ~ r& . II ^ S ^ A- "vjr ^ 3ytte5isSfe' [ r\cttr^r^V*i*?SC**5?6 t* -JOTS* &!re '35Sg$&v ^ ! W a * 'lWprV zmde~y^jH & & 9 rSEl' WMWSW ;" .t 'V\V-;-;C*?-VO ^ 7:!St! :aeii| ra S i r - y y/ ij*a*<. **->:t.-*.5,`-/ a s i j .V v X s ^ . / x p n ] 5 7 7>L~& B -7 ar T T T Vw .f -* 3 T.-- # irV ` t r i# # V3t;`>* c . ' 9 v / v/y.rYr/ V :>'f'>~V ,V<r'/'V`Jcr Cvi .'+jH I * ^ -.-*;-'juv.-;-^.>','i.;ci'-; -ntti?^ /fcc,v..F^WvSlcr jrr^T 9 7 7 ^ % //.'I f 1 Wd' ^ viv' r/'> rT/r//^-i > w 7 * ^ ?* * * & * ?* # \o # 7 ^ > J ^ y r ^ ^ t f I / r ' i". ' ; . ^ , f s > - i'.||<7i A fe;<: r 7 gg!^ V .-s.;*..iy' j L)V. J'.ii' 1 OMIM y 3AVW .*BXMnOMV ,| --VV".*'' OO IUH *>.>*>*'1..a .-.}]1 -- tvj.m o h m o -m o .j jxnoMV 1 *i.*a N.^O i V S N U -iVo'i a 3 H.:;^^v'y?i:.,J' ft ,/ . Hulette, Clarence A. Etr.pieytt: The P h i l i p C a re y M fg . Co A iA t EMPLOYMENT RECORD S. s. No. 2 7 0 -0 5 -6 8 8 0 L o c k ! and Cw*L r ' :'" >;' " ' v '' ;" .V;-:}."** M*m C t i f i l t b | R o b tft fM rcotw :',,"i' ? M l i p c * f E*H/SiT ^ 1 >;q f ^Sffy V 'O acc cry l o c K 'M x ianf l / * $ L & J %. ..^ ifcl^J&g$5a, r?>/P co re o r iw j.Jul v . 196 1 . natuAc * h j. w ^ a u 'j >< noun C->* sc*y **' ** -- " *.'i*~n>t Tg-gZT * r --.rtf** J.'l*-f_\k rowM > ^ ? ' V v ,.-:.''.v, > oatc w e e - o ./ 'ii e d ~ ja i r e e t t*i*rty< ^ 5^ 3*- > ^ f by D i , Ruchlroann wHo s t a te d c l t , ~ha3 pu 1mona ry | **.y emphysema w ith e a r l y a i l l c o s l a p r o b a b l e , ? C l t 'a ' , _____ _ . - * (3 >N) ~V3 UaoVmxSv *1~ u ]p h y si c i a n d ia g n o s e d I t a s pneumonoconioelaur?!,. Z D _ _ j i tH3xJaMjnnnee w Hj[ 1 ~~tm)ITv>jA* ..** - I[I f inw T T 7 *"'*%" 7 |n>| ^ 1 5 l ! l l I 1a " M l 10 I t t i IJ Itl *3 I'm its f M I 1 I to I n I N<& ' |v>4]0; M on, W l a fcaK&flg^, MPUOVKMs P . M ^ " t o .^ < '<^^V *> fcrrv.V l^elcl*nd> y^coWwc .:* ^ ^ g r:r.i?;>a% >grj^; OATS o r IMJ. f a /A \ ^ O ouit > 9 /6 /6 0 &HOUW wctuwnvoj ^ / J /r /t n a t u n c or iMuj.. " ; A sb e to g l ^ .: ^S-T ^w : ygm 1 1 miki ;.- -- 1684 . ^ v ^ ^ ^ ^ sO sc t.'a& iR 'S iC s3 5 2 3 ; **>. * ai*mu. l x J < iw m ^^ N V ^ . ^ W ^ oat* iwc*o. i; C o p ied '(S e a N o ta) | 1 - - a- v -w ;:'. m e d i c a i --j/.-TTl1V *./*< r;*vw C O M PC N *A T IO II fts>**ll 1 OATV I AM OUNT I ON. O A MOSTITAl. -I1' OATC M SV* ' , m i o o * * I AM OUNT 1 .'N A T I . i mino y - M , .i-iyt u J X Z F 'i Iooj ooj L c a E Z ?< * !'<tr -*X T>r <=V.La J u i ^ I L jucJcS 5Z^2 I U tS S J w `.i> >.u%p Wyrv^vA**%T W * m m v m w n w r jx tz w i* r\m e B 9 M ^ 2 < 2 m r 2 *Z-. - w 'jfy aVr _ _ o . ima no noWredge * I i t r a c 'd c l a la no. card-S ae c o rre . -?:ca<.- , ^ ;7^ ^ S p f--^ b r> P frp o g i a (3WTN) -iv3i.l3v y h a -iv .ftd-i < , if r w zw m - iz v. t t w _t_r__n__x_ _t t n .x m..... F r..L. 'M u ,-r- >.-ay ^ Kri-r-i~-~>-gx.*/..v.^^ni- --? .y^jr^Vfrryct. tunxofto <-i> SMV3A TVnMtH V 2!S *s s ** S te g a ll, VMp i.o r M : P a n a e o n oatc o r ih j. q / 7 Q T h eo d o re C o ro o ra tlo n q u it /' r '.'f.V a o o rr . noon fcA " e x i i '* V - c U t M w o:-` O P C in c in n a ti.- 0 c o v; V* -..j" * -r u r o na tu C o r in j. i c S a c _ W o rV in p w i t h ' . . - 'e e m e n t-a t> e :V 6 .i f o r - - - C i .. ^ 19 V eer 1 > ? 0 i3 ~ < 0P .1 5 2 9 6 6 3 c r .r. o>-^yL <7* 1 >.' ." lii $ 1684 manual 1 8 5 2 0 5 :_________ S a n f o r d B l a n k _______ :_____ OATC medical AMOUNT roiM ' *T- . .O ATS r - '-W s > O D -4 oat ecc-t:*?: 6 / 2 5 / 2 1 j a z i 3 ' ' ~ ` a . n o . V ' 7 0 5 - J . o - T Q <16 ::.r- C O M P E N S A T I O N * - r e m o o . *+r AMOUNT H - r ' **' W *jrK M -iV -7i'iA **'V< v V .y -- .........V * r_ i\+ . * s-flpCr .*+** .- < rvt . caii'.is -Ml:: n- K IN O *? V.7*- -- ** r ` .v *'*.w**. L u 'v V . "." H ; . a- -t .'C iv vT- ,, . . *. . * .> %v.ja r*. i f j l ''. <* -- , - -t i.* ,v* : : A# '-v .r . > v t rJiiP A - j S*v ---------------------- ---------------- 1------------------- . . . \ .. - - - ' Sr*;* 1/VfT C l ATM ...----_ I W4' I J LAT: 2/ 3 0 /< 7^ , -. - . f # v- - v ; V :. .~t-' . _ watuwc or imj,.- Worked in a s b e s to s B eater rooa nrf f i b e r (asbeeto Sto rage a rea where * 'th e r e wae~dust iro n 'th e 'asb esto a f i b t - v ^ r m aterial S i l i c o s i s - " .i iii*K>''iVi6a4^>-5sV* manual *`- 1852 ro*M ftn-A irr?#s:riA-rcC O.*-<11/2/66 <--v -i ` 1" L" l J LlL"