Document ymm3erVo5a6jpJLz7ewqw7oj6

S*M AMERICAN BOARD OF INDUSTRIAL HYGIENE ADMINISTRATIVE OFFICE 475 Wolf Ledges Parkway Akron, Ohio 44311 (216) 762-7707 MU'. WORKSHEET FOR RECERTIFICATION BENT0N Axel RONALD REYNOLDS METALS COMPANY E. CIH CERTIFICATE NO.: 1131 CERTIFICATION SPECIALTY: Comp . Prac_ 6603 West Broad Street Richmond, (Cftrt VA <SM| 2326*1 e* cm trlfphonft SIGNATURE: (804) 281-2265 ^. DATE: (X *e,/98& 1. ACTIVE INDUSTRIAL HYGIENE PRACTICE Maximum: 4 points per year Total Points Claimed: 24 Four (4) points will be given for each year of active industrial hygiene practice during the certification period. Please summarize your practice of industrial hygiene for the period covered in the space provided here. DATES NAME OF EMPLOYER 19152=--------- 1987 REYNOLDS METALS CO. POSITION TITLE Technical Mgr. of Ind. Hvs, 2. PROFESSIONAL SOCIETY MEMBERSHIP Maximum: 1 point per year Total Points Claimed: BRIEF DESCRIPTION OF INDUSTRIAL HYGIENE PRACTICE POINTS CLAIMED Technical advisor to Dir. of IH: planning, impIp- 24 menting & maintaining urograms to protect emolo' ee health; indus. hygiene surveys of company facili* ties, provide professional direction to field IH personnel, represent company in professional organizations and health committees, develop IH sampling strategies and supervise Haz. Materials Control Program. One (1) point will be given for each full year of membership in an accepts*5 professional society (except AAJH). SOCIETY MEMBERSHIP CATEGORY INCLUSIVE OATES POINTS CLAIMEO AIHA i_A__IH__A_-_C__V_S______ Full M 1982 - 1987 1982 - 1987 6 6 TX TINER RMC0063926 3. TECHNICAL/PROFESSIONAL COMMITTEE SERVICE Maximum: 2 points par yaar Total Points Claimed: ___________________________________ One and one*haIf (1 *1/2) points wilt be given for each year of service as chairman of an acceptable technical or professional committee (except ABIH) or subcommittee, and 1/2 point for each year of service as a member of such s committee. Committees sponsored by the accepted professional societies as well as those committees listed in ASIH releases are considered acceptable. Active work in local eections of the accepted eocieties will ttlso be approved. SPONSORING SOCIETY ALUMINUM ASSOC. NAME OF COMMITTEE/SUBCOMMITTEE Health comm,, iask Group on Welding STATUS ON COMMITTEE Member INCLUSIVE OATES 1982 r. 1987 POINTS CLAIMED 3 AIHA-Cen.VA.Sec. AIHA Curriculum Committee Respirator Committee Member Member 1987 1983 T-- 1985 * 1% AIHA-Cen.VA.Sec. Board of Directors Member 1982 - 1984 Ik .4 PUBLICATION OF PAPERS Maximum: 4 points per year Total Points Claimed: points wilt be given for publication of an original paper with one author in an acceptable professional journal. 1 point with two authors, and point with three or more authors. TITLE OF PAPER Pulmonary Fibro sis in an Alutninum Arc Welder: A Complex Issue1' 'Transmission of Potentially Haz ardous Actinic Ultraviolet Ra diation Through Fabrics" TTTLE OF JOURNAL CHEST APPLIED INDUS. HYOTFNF DATE OF PUBLICATION 83:291-2: 1983 Ton 1QR7 NUMBER OF AUTHORS 3 * POINTS CLAIMED 1 1 TX TINER RMC0063927 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 points per year Total Points Claimed: 29h(1982-1987) On (1) point wilt be given par one day (six hours) and ooerhelf point for each half day of attendance at acceptable meetings, seminars and educational programs. SPONSORING ORGANIZATION OR INSTITUTION TITLE AND LOCATION OF MEETING/PROGRAM INCLUSIVE OATES OF ATTENDANCE POINTS CLAIMED PLEASE SEE ATTACHED LIST. 6. TEACHING Maximum: 4 points per year Total Points Claimed: *-- One-half (1/2) point will be given per hour of teaching at acceptable meetings, seminars, and educationalprograms(exceptthat claimed as full-time practice under Category 1). SPONSORING ORGANIZATION OR INSTITUTION NCSU ~ Navy Trng, Prog. TITLE AND LOCATION OF MEETING/PROGRAjM Oc. Health Trng,. Raleigh, NC TEACHING HOURS 24 INCLUSIVE DATES' 7/20/82 & 8/17/82 1-/I8/83 POINTS CLAIMED 8 ATHAtCVS Heat Stress Sec. of Refresher Course Richmond} VA, 3 3/24/83 lit V cI VA. Commwlth. Univ. MpH Cnl nf VA VA. Commwlth. Univ. Med. Col. of VA. 3ont. Ed. Dept.; Fundamentals of Asbesi (Respirators) Abater* nt Richmond, VA, MCV Sch. of Prev. Med. Basic Indus. Hvg^ Richmond, VA, MCV ll/:3/87 12/15/87 2-5___ .. 12/07/37 2 1 TX TINER RMC0063928 1982 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 point* per year Total Point* Claimed:_______ 5 __ One (1) point will be given per one day (six hours) and one-half point for each halfday of attendance at acceptable meeting*, wminar*, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION fUIH-AAOH TITLE ANO LOCATION OF MEETING/PROGRAM Joint Mtg. Chicago. IL INCLUSIVE DATES OF ATTENDANCE .09/21-24/82 POINTS CLAIME0 3% Seminar at AAIH-AAOM MTG. IH Management Industrial Hygiene JNIV. OF MI., S-cfeV5i3f:-P.ub.Hlt ^.Discussional Ann Arbor, Ml 09/21/82 10/27-29/82 : V**A* <-'*' t *v * * * Total Points: 5h S' TX TINER ^00063929 Mil'll. 1980 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: S points per year Total Points Claimed: ________^____________________ One (1) point will be given per one day (six hours) and one-half point for each half day of attendance at acceptable meetings, seminars, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION TITLE AND LOCATION OF MEETING/PROGRAM INCLUSIVE DATES OF ATTENDANCE POINTS CLAIMED AM. INDUS. HYG. CONF. Philadelphia, PA 05/23-27/83 4^ Total Points: 4^ TX TINER RMC0063930 :.984 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 points per year Total Points Claimed: 5 One (1) point will be given per one day (six hours] and one-half point for each half day of attendance et acceptable meetings, seminars, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION ALUMINUM ASSOCIATION AAIH-AAOM TITLE AND LOCATION OF MEETING/PROGRAM Mtg. of Task Group on Heat Stress/ Wash., DC Joint Meeting Salt Lake Citv, Utah INCLUSIVE OATES OF ATTENDANCE `06/30/84 09/25-28/84 POINTS CLAIMED 1 3k Seminar at Joint Mte. #5: Hazard Communica. 09/21/84 k Total Points*. 5 TX TINER RMC0063931 1985 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 points per year 5 Total Points Claimed: _______________ One {1} point will be given per one day (six hours) and one*half point for each half day of attendance at acceptable meetings, seminars, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION AIHA-Cen.VA. Sec. TITLE AND LOCATION OF MEETING/PROGRAM Computer Applications for I.H., Richmond,VA. INCLUSIVE OATES OF ATTENDANCE Jan. 1985 POINTS CLAIMEO % Am. Ind. Hvg. Conf. Las Vegas, Nev. 05/18-23/85 4% Total Points: 5 tiner RMC0063932 1986 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 points per year Total Points Claimed: 5 One (1} point will be given per one day [six hours) and one-half point for each half day of attendance at acceptable meetings, seminars, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION TITLE AND LOCATION OF MEETING/PROGRAM INCLUSIVE DATES OF ATTENDANCE POINTS CLAIMED ton. Ind. Hyg. Conf. GA. Tech. Dallas, TX. Asbestos Workshop Atlanta, GA. 05/18-22/86 11/17-20/86 4% 4 Total Points: 8^ TX TINER RMC0063933 1987 6. ATTENDANCE AT MEETINGS AND EDUCATIONAL PROGRAMS Maximum: 5 points por year Total Points Claimed: 5____________ One (1) point will be given per one day (six hours) and one-half point for each half day of attendance at acceptable meetings, seminars, and educational programs. SPONSORING ORGANIZATION OR INSTITUTION AIHA-Cen.VA. Sec. Mc.Crone Research Inst. PCTH TITLE AND LOCATION OP MEETtNG/PROGRAM Asbestos Seminar Richmond, VA. Microscopial ID of Asbestos: Chicago, IL Ann. Conf. San Dieeo. CA INCLUSIVE DATES OP ATTENDANCE 05/27/87 07-20-24/87 09-15-18/87 POINTS CLAIMED 1 4^ 4 Total .Points: 9^ tx tine* RMC0063934 7. ABIH EXAMINATION Total Point* Claimed: _i Sbcty point* will be given for successfully pe**>ng a repeat of the ABIH comprehensive or speciality examination. Indicate location and date of examination. 8. OTHER ACTIVITIES You may lift any other professional activities not covered under Categories 1 7 which you believe may be worthy of consideration by A8IH for recertification. Please furnish sufficient detail to describe the activity. DESCRIPTION OF ACTIVITY EECTUKE Hazard Contmunica. LECTURE Indus. Hygiene LECTURE Right-To-Know SPONSORING ORGANIZATION/ INSTITUTION AND LOCATION AIHA-Tidewater Sec.. Norfolk, VA. VA. SAFETY ASSOC. Norfolk, VA. Nat. Flex. Packaging Assoc. Bloomington, IL INCLUSIVE DATES 05/16/87 05/11/85 06/26/85 REMARKS 2 hrs. 1 hr. 1 hr.' .CATEGORY 1. Active Industrial Hvoiene Practice 2. Professional Society Membership Technical/Professional 3. Committee Service 4. Publication of Papers 5. Attendance at Meetinos/Proorams S. Teachina 7. ABIH Examination 3 Other DO NOT WRITE BELOW THIS UNE POINT SCALE MAXIMUM IN ONE-YEAR. PERIOD 4 ooints/vear 1 point/society membershio/vear 1/2- 1-1/2 points/ committee/vear ^-/2*"2T>oints/~ .oaoer--- 1 ooint/6 hours 1/2 ooint/hour 60 points 4 points 1 point 2 points 4 points 5 ooints 4 points Total R*<Vr*H- POINTS EARNED FOR SIX-YEAR PERIOD Total Farnod- TX TINER RMC0063935