Document reJYEnG7r0JXYj6q1NrXkQGBE

FILE NAME: Melrath Supply and Gasket Company (MSG) DATE: 1964 Oct 24 DOC#: MSG003 DOCUMENT DESCRIPTION: Field Activity Report MIH 19003 R E V . 1 0 / -, '> ; j 'sO*:r C O M M O N W E A L T H OF PENNSYLVANIA-. ;.' R E G IO N V I I - PROD. MFG, OR SE R V IC E . gasVftts- DATE . PLANT k DEPARTMENT,OF .. OCCUPATIONAL HEALTH EMPLOYEES .. M A L E ____. FIELD ACTIVITY REPORT ' / A D O R E S * ,;- .T^TO ? FEMALE TOTAL ' 255 ........................................... . MftTi-at.ii ftn p p ly arvi CnsVpit Cq . j Trift. i TC- T io g a S t . l a n d r a m in g o A v e . . P h l l a ; . a p p lic a tio n from :' ';,v:V .SEBSatUMJaSSJtSfl__ T?, m n p u r p o s e : i n v e s t .: s u r v e y ; i n s p e c t .; p r e l i m .; f . u .; C O N F.j .VISIT;.,.. .' ' ' t it l e : P rod . M anager ______ ' _____ r e a s o n : s e l f -i n i t .; o .d . r e p .i c o m p l .; r e o u e s t t s d u r c e ' : * r . ;... . SPECIFIC H A Z A R D OR CONDITION WORKERS EXPOSED _J f U - ^ R V.- R E C O M M E N D A T I O N S ;;V: written- verbal __ AfirOMPI I.MFn___ YES NO IN PROG* QtftftT T/vrMiQr> Hn.t.a ' ? SAMPLES CO LLECTED INO. KINDI DETERM . MADE (NO. * KINDI Apply for ApprnvaT n f a l T O " 0T*P TV* +-AnT a n d r o n i r m i T a t i o n 1 nit's 1 ri ' ' r- '.v' ' r H ^ HftJiai*t.mftTvh j O '' ' .. : '-%y.v\-i,. ?.>.:. i'-1 ___ . : : -TOTAL- V : ,* l-.\\ - . Jf-.* \\z.: >. 0.0* R E P O R T E D , NO* KIND .TOTAL. REHARKS- Appl i cat i on..recei ved .f rom.cormTnr.on 10-1 6-67. ktterhmA i W i a.p . PUNCH CARD 0 YES NO Vf-*-. F O L D E R Q Y E S ; Q ' n o . J . S te llu to ( 0 ) / O'-