W- YETH LABORATORIES INC.

/- October 16, 1974

Mr. Douglas M. Collins

Materials Branch

Directorate of Licensing

U.S. Atomic Energy Commission

Washington, D.C. 20545

Dear Mr. Collins:

In reply to your letter of September 25, 1974, a list of isotope

users at Wyeth Laboratories is attached. Users #1-12 are currently

using 1-125 (up to 2 mCi), whereas all others work only with C-14

(up to 5 mCi) and H-3 (up to 2 mCi). Other isotopes which are listed

in our license (AEC #37-00401-03) are either used as standards in

instruments or have not been used. I have also enclosed copies of

each user's Radiation Training, Experience and Exposure History Form,

which is used at Wyeth

Sincerely,

Samuel F. Sisenwine, Ph.D. Corporate Radiation

Health Safety Officer

Enc:

Information in this record was deleted iK accordance with the Freedom of fnformation Act, exemptions

FOWA

co52

ISOTOPE USERS

C.W. Beattie

Ivars Jaunakis

N. Buonato D. McCurdy Margaret B. Martin

Joseph Bell

Ruth Gillis

C.D. Wise

B. Tallardy K. Koch

G. Cole J. Kassarich

1. 2. 3. 4. 5. 6. 7. 8. 9.

10. 11. 12.

13. 14. 15. 16. 17. 17. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40

H.B. Kimmel F.W. Janssen

S. Gonzales C. Kick R. Schillings M. Schwartz C. Tio R. Meacham A. Liu

M. Burka

J. Politowski L.J. Lassen

M.G. Farrow L. Wetzel M. Levner

F. Weiner R. Hartzell D. Yang

L. Bauman S. Savini J. Weaker R. Tomarelli J. Tracy

J. Broomhall E. Fluck C. Homon E. Young A. Faris

*� ( �?. '3

i j No.

2. Soc. Sec. No !2 .&¾te of Birth

Occupational qýxos-are - Previous H-istory

3. Previous E~~:1et InvolvinZ Rh.-iiaticn 7zxtos-Lre..

List N'am~e aria Address of

4. Dates of Employrnent (From-To)

5. Periods Q! Exr-osu~re

6. Previous ý-hole 3ody (al~2)

7. Dose His, Insert R-hýcor or Calculate

8.Tye r ri~ng ~ W~here Du~ration Formal Course Or, t*-e J,:'b,

_ fxrained 0 f &~~~g Uv t

(A') Principles and Practices Q ~ C -oo

of Radiain 1-rotection

ýB) Radio:..ct`:vltY Iea~sur~e

mernt, 1:onitocringCE rech

niques an'd Ir.3tru--nt.S

(C) njthe:Tr.ics Basic .to

Use 3n. LleC sr_,~n

of Radioa=ctivit-y

(D) Bjolor,`cal i."fects

Of ?Racj'ia'ticn

9.~~~ L.re.: (A ti e al izotozes)

Isoto~e Ac~ i) Location Duration Use

D -x~

43 cc r c 7": t~ -f -Y

_U. r7t Z

d ,

~~¾ - ~-7 -1/

(A) P er:'trý_ iI½ ". I- c2-

I

Dept .- NO

2 Sc.3e. o. UI~ Z -Date of Ai ~

C4=4pv-tZjfln- !xposure -Previous Hiistory

3. Prqviouz fnz.=teflts 4. Dates of

Invo1viflC iýatl-cn Uxosuare. Empl.oyment

List Nal-e and ..Jdrezz of (From-To)

5. Periods of Exposure

6. Pravious VUnole Body

(RW~

7. Dose k.ist Insert R-'.coi or lacu-a t E

I sot o te Ax'mount (uCi) Location Dura~tion

_1 (OP ) ý__

3 0y1Q-:t

I '~r ~'infcr~ink n in correct a:!.c':-,;t zh ':: b'zt cf -Y

knonall Vn belef M

Dae /dI7 2qWC(1h T:7

(3)~~~ Ta - zaue r7

K A).

-I)

S.Type of 7rai:;inG 'W ~here Duration Foza Cou1%rse On te z

Trained of Twij.j., (-ive title)

(A) PrLncip--ý nd Fracti'. .

of Rndiation Prote~ction poa

~ ~ z~ivt: Ieacure- *i

niq-uic and In.t~run-..ts

Uc le 7 3an- j o.nt'I

of Snic.cAOtivity

(D) Bioiom-icnK Effects

of Rnoiazicri

-rlvr-----------------------------------------

9. (,,,:tuaI Uze of Iz3otopc.q)

2.SOC. Sec. *-.o.

De tAl 3

Date of Birth 7Age

Cccupatioflal _Lxpo.&ure -Previcus Hisý:ory

3. Previous 4.p.::et D~ates of 5. PeriA*ods 6. Previous 7.Dose liist::

'In':olvinz -R-.diulion -Exzosure. Zmlyatof Exrosu~re Whiole 3od-T Iasert Rýcard

List N~ame and Addrezs nf c'omTo r WZalcuJlateý

Em-pl1cy.er

8. Tyre c.1 Training Where Dura ti 3n Formal Course on t*ze To

Trained of .-~:4 (ie t~t~e)

(I.) principles and Fracti;cez ,.Ak

of Radiation :-r~ctcctJiof.l W LL44 ,

n~iques and In~tru-.-nts

of R;a--icactli'ity

9. :~cr1:oe:(Actual U,-e of Izoto~es)

I so-.ope Lr-unt ( u (" )

2.

LCC nt0

LPW L

Dtur.tion use

7 CV fc.' %f-- X .- ccrrect -x z:.:,bs :~

... L~L. . 7

(A) -r3 i- . ' 2 1 7'.

1. Name fFj ept eNoOCK

2. Soc. Sec. N~o. Date of Bir

Occupational Exposure - Previous History

35. Previous Th-:nlo-.-ents

Tieo:f `..rnining

4+. D-2tps of

. Wh cr e Trained

5. Periods of EZqzoz.ure

D~iration of Tra~iný-g

6. 1reV4oUS

;;ce 3 od y

Fo=,aiL Course

7. Dose Hi-,t: Insert R corý or

On t-e ucb

(A ) Irnilz-cPzracticL~s a: 'Idiatic,n - rot-2ct-in

of t~&

Cev~w. 4mj b;) 5 ewey~ev' * ~3o~Me~ ~10.

- (i~ctuý-' lUco cGf 1--oto~res)

isoto;pe A-ýunt (u--i) L.

3ao tkeC.

100-'C -~~-oo tC.

cz-t _4on

5"U

Du rc.t io n

2-Ye1w 3 1 YejgVr 5bftom k 5

Uýýe CWV-Sfc',vj' 4 lich -sk,

cc, tetAbI.$., , -, #Tit lye i $it, . Wý 0)lit

C C.'Cesice-4 b i'c 1ý _I(n rft w -%

- 1%1

rC4 -77

(I

6.

B) 4��.�,�

U.,

C1+

C%'+

1.. 'Nam~e_______

2.- CS-oC Sec. No.______ _______

Ccsupational £--xposure -Previous History

3. Previous Elnoyrments k.Dates of 5. Periods 6. Previous 7. Dose Iiistc Involvi~ni '.ý-,iiation Exposur.e. Employment of Exposure lihole Body Insert Rscord iist N~ame and Addres-s of (.From-To) (Ra4 or Clculte' Employer.

---------------------------------- -- -- ---------- -- -------- - ---- ---- -- -- -- ---

8. Type of~ T-raining Wh ~ere Duraticon -crmal CoArse On '('eJz Trained of7~ai. ---;v2 citle)

(A) Princi-les and Fracticen .

of Radiation .ýrotcction

ment, 1o.aitcz-inz Techniques and Instru~nents

(C) Hathe~atics Basic to rr Use arvi ',easurerr~ent of Radioactivity

(D) Biological' Effects-- C of Ra diatior.

9. Experien~ce: (Actual U~e of Isotoces)

Isotcpe An~ount (uCi) Location 1hxra-tion Use

%/B) (C)

l.Tc,,rt z;!,: t -.;o.c, in ion L cc2rrct a,-4 to-~. t'-. c f

kaol~ ~ and belief.

(A) t~riri~ tLCI c-d 2

Date of Birtil.2ý e

1.Name ( '4J

2.j .SC O.7

Occupational ---xposure

3. Previous nltns Igvolvine -Rýýiation Z.O-osur3. List Nam~e andi *'Wress of Employer

4. Dates of Employmment (From-To'i

5.- Periods of Exp-osure

6. Previous Uoihoe Body (PZ4)

7. Dose Hist Insert R~cor or Cal culate

J fA-T$Vj+4-+e~ -L.

I-lo

V~f SSt3

8. Type of Training. Wh¶~ere Trained

Durat ion of rlrg

Formal Course Ui4ve title)

On tL.-e 1.7-'

(A) Princi-les :ýd Fracticez of Radintior, T.-rotoection

(B) Radioact6i-v'-t,,, 1Ieasur-e~en~t, 1+oritorin=oz TIechniques an 1n3 tru~nent s

(C) Father-tics Basic ~to Use ani -'easuremenet of Radioactlivity.

of Ra,-iaticr,

ye�a

k 0

- - - -- - - - - - - - - - - - - - - - " . - - - -

9. Zxperie~i.;e: (Actual "Wz:e of Isotozes) 4

toociZ

C- (z

P urction

:v'infr7;o-.- lin i., ccr.ect c~z -r 't~ '

L(

Isot-ope

C) (D)

Date of 3irtht-ý"W g

-Previous Hisýtory

1. Namef4•VV/� 7 � $. ,1/

.2. oc. Se c. 7,o.

.

Date of Birth~w!Ae

occupational Zx;posure - Previous H'istory

3. Previous 7n1-;o:.-mezts Invojv-'nZ R-ndJation E-xco-ure. List Name and A'ddrezz of Employer-

4. Dates of Employmenlt (From-To)

5. Periods of Evxposure

6. Previous ad-,oj Body

MalM)

7. Dose Hist:, Insert R!-cor, or Cal.:!alte,

N'ON/

0/2-I7F/F

8. Type off Training Whdere Trained

Duration of r.in

- - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - -

F ormal. ("us ( ive titl'~)

on tý-e JJT

(A) PrinciPios a~nd Pnatc~es of Radiation ýrctcction

mrent, :o~nitcrin.u-.L:ch-niques and. Irnztru-.,-rts

(C) Yathe77nti:cs Basic ,to Use an-, L-eF.cýurement of R:d~ic_=ctivity

(D) B io 1o,--c ai I ff e-Ct s of Radiatiofl

41,1F_7-1L A5

/V e

I,

9. 'Experience: (.ctual U--e of Izoto;ýes)

Isotope iA'c'unt CuCi;) Locatio:, Duration "s

(B, jf ,/

10. 1 c,~r:. v r 1 t> 'c~c infr-oon coi.rect :.dcom.-ct- to '-cOzt of r.

I ' >c>::4%

(A) Aenr.K ci 2 -:c c ~cU1

-, - _ - I' - &. - r .IW

kv V /.-:. r 14 1- h 135

- .5w

RIDI,-?7T':

1. Narneflit :1 ~ k-~~ Pe t. No.

.So.Se c. No . Date of Birth. g _I -- - - - - -- - - --

Occupational Exposure - Previous7 History

3. Previous E~r~o:-rent~s 4. Dates of 5. Periods 6. Previous 7. Dose Hist InvolvinZ Rndiation Exposure. EMployment of Exposure Wihole 3ody I.1aert Recor

List Namre and Ajaress, of (From-To) (METI) or Calculate Employer

eb/4 IL -7/?

S.Type of `2raiiing 'Where Duration Fcra.s Course On t~f e j

Trained of Tr~ining ( ive t'.tlel 0,rD

(A) Principl1es -ýnd Practices

of Radiation 'rrotecti-on

(B) Raciio-ctivity N-eazur~e- Y mernt, Mn~-itcri-±E Tech-Y

niques and Inztru77erts

(C) Mathe7:Ftics 235aic J0

Use arriesuen

of R.ý-dicoctivity

(D Biolo.KcKil Effects

of Ra~ia:ion

9. Experience: (Actual Un:-e of Isotozes)

Izotope A.ýC'nt (Uci) Location Diuration Use

(B) 3

19. u-rtif t: -t t! -ýo'e inforwtion is ccrrect wdcom2.cma tu thea 00. of rýy

Dae -Icr - £ C.~.~

(A) F-rmir'½i ýiYt-. .:

(E TH-1 L:ro':.re no Vto kPr~ _______

I.' Name-

RA .:i

2. c. o.Date ofBit

Occupational E',posure - Irevious History

(-,�/ If,

3. Previous amrio-;=ents Invo3.vinz R_ý-diation Zxposure. List Nam~e ana Address of Employer.

4+. Dates of Employment (From-To)

5. Periods of k~xposu~re

6. Previous '.jihole Body

(Ra-I)

7. Dose His'.Iasert R!ýcor,, or Calculate,

I q(0 Y-presewy'

8. Type of T1raining Where Irained

Duration1 of £~~r

Foral Course On t>*-. JoTb

(A) Princi 2 e C4 rd Fr_-cticez of Radiation !-rctcction

(B Rdioýcti';-,it,' "eas,.r'ernent, Vonic tr:7 e cniques and Ir,3tru7zýerts

(C) )4ather~ntics Basic to Use anci 'easure~nent of R.adioEýctivity

WD Bioloica` Zifect.S of Ra-ii-q'ion

Th� -� r

- � - LDr. �'1- -,

- IoIdr

� �

- i'M.

/'.4-. -. 4 � A

� e'� -r .-- � �

� *�t- �

9. Experience: (Actual t:ýze of Isotojzes)

&SOtope iAnToun.t (uCi) Location D ur:- .i on Use

-T Yt,!ýe0,1

(C) ye

2~~~~~C.~~~l I` l- 'r::f -1 11%;c rc: c ccirr'ct > z;la.

(-- zi1,1 I ief. Date:A

Age

ý< 0r 0'41

'I CUL�4 .�ur.:� - :. !Th. �.C i.'O E ..

(A) Fri~ '-1tJ~2 ~ _______?~7

(C) 1" ;.i1 ~________

wletý

-ýo cf m'Y

1 14.1- 1 C/ 7Y

- T . --- '"- 1 o j (Y

2 C

p o~~zr~ ~ T~oI (Ton) 4,ur.c-- ~d 00s I

(GSiO0os0I JO @- -L-10, a0iT .I-X - 6

~ jo

s ~ ~ u TZ 4-I srib-cu

tOL u 0-jUOTIUTPv jo

(a-~~~ a A" - Xotdu,1

a:,, u..0s as -ino2 -T 0 W;ao uJlodXiezjo 019%~1 , ~ e2nTo,::jz UC 0;4 2aTOA

-s -~ O -6 -f~AJ - -p T9 - - - -$ -O~~ -n taI - -----------

X~o;t~ flOT9J~- 9J~Od~ ~ut;OnoY

---- -------- IZ-5 ------Ov 44111W . JO a;ua

.1j: 4.: Te

iog -qdaa'

*o1 3a~s *DOS Z

P-) -7-3 2J P/J" aummN *i:

S'- - V - r . ,-�r TI'f'2 - ..- '� 2- UI.20.j' OEd

2. Sec. No. 3'Date of BirthK E~Age:I 1 .

Occupationai 1Jxposure - Previous History

3. Previous 7E;-;1o:~ernts 4. Dates cf 5. Periods 6. Previous 7. Dose Kist

Iny.,olvirc R-.diation Zzzxosure. Zmploymriet of -Exposure 'aihole Body Insert R-:cor

List Nam~e anid Address of (From-To) (Ral4) or Calcuite

Employer

8. Type of Train~ing -. Where Duration Formial Course On th-e Job

Traintd o f T r,&i~. C (ive ti-t-e)j 02

(A) Principle~s nnd z-ract-cez

of Radiation ~-_rotcctio.n

(B) Radioý;cLivfit. 1r*eazure-_

ment, IVcnitcin ¶ec:.

niques and In.ztrumn nts

(C) Mathen-tics Basic :to 1A7

Use ani jesuremnert

of Ridioactivitv

(D) 24io1o~ic-iC iE.fects

of Rac_'ietion

9. Exparienc.e: (. Tua Ue of Isotozes)

Isotope A,=cunt (uCi) Location Dura-ti.on Use

(A) C, (100 WY cy51a- rr'

(B)

7'c)

1C~. j ~~~ ~: -C'. lC r2 O flu, c -rr2Ct F11.2 c0:7-10Cýe t0 .~ zx t c

Dnte 1/~L _ ___ ___ ____ ___ ___ ____ ___ __A

tC i'>cl 17h K - _________

-w -�w-'ww ap ~- ~

2. jSoc. Sec. No. --------- -- -- -- ------------

Date of Birth~

occupational Zýxposure - Previous Hfistory

3. Previous EC.et Involv'inZ -R7-.caiiaon -xiosure. List Nam~e and M'ddress of Employer.

4. Dates of Ezploymenet (From-To)

5. Periods .of Exposure Bi1. ody

004)

7. Dose H~ist: In~sert Rs-cor, or Zalculate-

8. Type of '1raining 'aftere Duration ?r-:al Course On teJ Trained of Tra~ii_ (:xe t-t'e' 3

(A) Priricirps -.n =racti:cezs of Radiation :zrot-Cetio-i

(B) Radic.-icý:v_;- t'' 1easure

(C) Matiherrtics :3asic.to Use an,- Veas'.r=.en't of Radioactilitv

WD Biolo.-ican' -o.f-ects

of Radiiaticn

9. Experience; (Actual Uze of Isotcpes)

Isotope AMCrMt (uCi) Location Dura-tion Use

(A)

(B) /0' 0/

~(C)

1.0. c '- r tfi .. : 'c~o:~r~ 1on i5, cor-rect t :).. cf 7y

ow3 --,,,,d be-Lief.

(A) perr~it2j1<-_e 1.C F.ltdZ> ~-~~E

1. Niame I l A ..~ Dept. No. _21'

2. Sec. No. 7Date of Bit g _ý O -- - - - - - - - --- --- - - - - - - - - -F - -

Occupational Z1xposinre - Previous History

3. Previous Emrp3:ý.oMents 4. Dates of 5. Periods 6. Previous 7. Dose Hist;

Involvine *Rý_'Aiation Ezzosure. Zmployrent of Exposure %,Whol3- Body In~sert Rý-cor:

List Name and Address of (From-To) (pal4) or Zacu-1ote

Employer.

8. Type of Training W* here Duration Fornal Cource On ti--e b

(A) Princiries -ýne Pract-ices 3~b of Radiation. 1-rotcctirr C ~ IV

(B) Radio.cz-;:ivt, CpaSur'e- / ment, -cn tc:-- '. h- U c hI niques and. Inzstru-.er~ts

(C) Yathe~r~tics Basic 'to

Use and i'-eas,.re,.-ernt .

of Radic2-ctivity

(D) Biolocic~i' Elifects

of Ra,'ietic.-,

-- -- -- ------------------------------------------------- - -- ------ - -- - -- -- -- ---

9. Experience: (Actual 'Jze of Isotopes)

Isotope iTcunt NCi) Locaticn Duraýtion Use

(A) -,mailr~p~ L/ -,p orne0 ,cp5?uv

-1 1 -Z.

. rz:*: z.' -oc'.c i n:fr .a-o0 1 5. c C r~ e02 LC Ct C±.

kro'ý1-ld 'Z-a tief.

r7 C~ :~i, 1 /71

.. .. r" .. . -.'.: 7:. ': . .. . -... .

1. Name Dner a a M1c r% " 2. So. SeQ ±o. __ __ _____ ____

Dept. No. 12 1

Date of Birth Agc:A'ge

Occupational Lxposure - Previous Hiistory

3- Previous Em!o:-.ents Involving Rý.diation Exiosure. List Name and Address of Employer.

4. Dates of Employment (From-To)

5- Periods cf Exposure

6. Previous ',Fhole Bady (Rai)

7. Dose !Lc t : Insert R'-corz or Calculate:

Smith, Kline & French Labs

Wyeth Labs

7/70-6/7Z Did not work with radioactivity. Observed other work. No measurement taken uf

eposure.

7/73-

8. Type of Training '*%ere Trained

Duration of '•ri" n

Fora! Course (-ive title)

C-i the Jtb I .O i . ,

(A) Principles and Practices of Radiation irotecticn

(B) Radioactivity EeasureE:-nt, Vonitcrinz Tch

niques and Instru;nnzs

(C) Mathe-:atics Basic .to Use and 1'easurement of Radioctiivity

WD) Bio o1ic:! Zffects oZ RadRiation

SKF

Wyeth

2 year

present

Skf and Wyeth as above

SKF and Wyeth as above

SKY and Wgeth as above

9. Expmrience: (Actual U::e of Isotopes)

Isotope Azount (uCi) Location Duration Use

tritium 100 uCi Wyeth present Se7eral b'ochemical assays

(B) f 125 2 uCi Wyeth present Rad2o."-muz-oassav of

(C) (T)

10. .c .... " .. - -'bore ifrmion ir correct co:rlr. *-- ý ,-~.: ̀ Ct Cf n-Y

/ _,,: ./,1 ? ,J97 1' , .-- ._- .. . . .. - e1"7 . /,~ 7-t4

(A) Fe• r:2 ci•-cd•c* ( B c ,r- .. . v" >~ .-r tJ L, . ( f r- :: ? i: . 7 ) _ _ _ _ _._ (z) - 1z i on,,________

Lecture series at vork.

yes yes

.

T__ _ I -

1.Name .PA-PIf- ~c 6~

2. Soc. Sec. No. D

- - - -- - - - - - - - - - - -

te of Birth g

Occupational Exposure - Previous History

3. PreviouF Emplo,.-ments IzivolvinEg is -,,iction --xtnosre. Lfr-t "a:-e and -.idreý- of

4. Dates of Eoovm-ent

(Frcm-To)

5. Periods of -Exposure

6. Frcv4ious Wh.hole 3ody

7. Dose Hinqt Insert Rawcor or -L'cul~a-

:~Ž f >-.I-.'.hccDuration 7 , -r ->:: e -. te

irained of 2ri~:g (:ive title)

~~e /F'

.

0i

ol R

-- -- - - - - - -

-cc tL: t

Isotoro0 "rt ui)Zcrtion Db-t:-ltor.U

(C:;ý - C~e--

( C

- -� - -** -. -*,- *- ., - -,-* J*- - *.- -'" 12 CC22>iu. -'. -.-

-~4 _---- __---

I. Name - DeJ.;",

2. Sec. No. Date of Birth: IrL S C - - - -- - - - - - - - - - - - - -

Occupational Exposure - Previous History

3. Previous Employments Involving Radiation Exposure - List Name and Address of Employer

4. Dates of Employment (From-To)

___________ 9 9

5. Periods of Exposure

6. Previous Whole Body

(RE.'!)

7. Dose Hist Insert Recor or Calculate

8. Type of Training Where Duration of Formal Course On the Job

Trained Training (give title) (yes/no)

(A) Principles and Practices of Radiation Protection

(B) Radioactivity Measi'rement, Monitoring Techniques and Instruments

(C) Mathematics Basic to

Use and Measurement of Radioactivity

(D) Biological Effects of

Radiation

9. Expe•-ience: (Actual Use of Isotopes)

Isotope Amount (uCi) Location Duration Use

(B) , •, , .. .• "".

(C) - .

10. I certify that the above information is correct and complete to the best of my knowle

and bellief.

Date: Signed:

Calculations - ternlssibLe ,ose ,,hoe or;:

(A) Permissible Accurnulated Dose = 5(N-l£) (B) Total Exnosure to Daze (frcm Item 7) (C) Pernissible Doze

C .) y

1. Name F~tl t~i~

2.LSoc. Sec. No. ~~~~~- --- - - - - - - - --- -

Dept. No._____

Date of Birth •g-7

Occupational Exposure - Previous History

3. Previous Emplocments 4. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving 2 -iation -.xosure. _ ::.. of ":8ure Whole 3ody Insert Rcor

Li-t ?- .,r (--- - (RE-M) or Calculate

8. Type o'f Croin.n.h T-ere Duration For-al Course On the Job

Trained of Traix, ing (-ive title) (ees/no)

(A) Prin,-_.ý-. s and ractce5s of -3•-diPtcx z'tecticr

(C F icntv t I e a -are.. ,n , " •c .-.ito- ' -. tcc h

niou--s, and n•'"ens•

(C) tj •ts3sct Uze V:d1easi.:'c!.r-:"t

of _R_ý_-iýatiorn

------------------------------------------------------------------------------------------

9. 7x eriece: (Actual U'.e cf Tistopes)

Isotope Amount (uCi) Location Lurotion Use

(c) >/

I" c.:-_t .. . .. . ... e 2: :• : - cc-co~ ': .c o : ,- . to tl..? .'.t c:f .

C -- ::- . :: - -. z :. " e D .:. i . ,,i :

(}. " .. .. . - ; -. . .t .t . . . . . ..- .

,z. _.r• .!. .. , 'r.2. " " 2 1"3

(3) " 7c :i::i -. 1. ,. --. - ) _ _ __ _ _ _

)

"�-• 77--.......

2. Soc. Sec. No. iN M" t 7 -- -- -- -- -- ------- 4f--Dept. No. 2 2 /5

)ate of Birth:, 1 Y ge -A

Occupational Exposure - Previous H.itory

3. Previous .. iPlo ments 4. Dates of 5. Perioiz' 6. Previous 7. Dose Hi-t

Involving ?x.ýdiaticn Exposure. Employment of Exposure Wihole Body Insert Recor

List Name and; .ress of (From.-To) (REM) or C.aic_ýtc

Employer

8. •Wo r '-, here Duration For.-i.l C~urse On t"e Job

Trained of 'raining eive tite)s/n

(.) 1 .. S 3 3 C r0

-"r. Cn

f _'-or:e f ivSoty--. (D] •i,:Lo£icn~f R.Ji•.'.i n~f-ect ,, , •.1 [

Loc, :-t tjo n

(A:4 (lB (C) 2P

Durcti-on -Y -

100 /*

I00

ct�

-.... ...... . . -.... . -. 4

: : ? lr'. - 4 .. - (:: __

A~ut ('U C4_)Iso3t.oTe

�ADIATTcM&.> � �;TPTE.CB :i7 £7 c:u.

1. Name Lawrence '. Wetzel

2. Soc. Sec. 11o.

Dept. No. 213:,I(

Date of Birth • 3_ Age:_ -

Occupational Exposure - Previous Kistory;

3. Previous Ezmlo.:ments 4. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving R-diation Zxp~osure. Employment of Exposure Whole Body Insert Recor

List Naine and l aidrezs of (From-To) (P.--2) or Calculate

Employer

8. Type cf 2'ra-i ng -. C';here Duration ?c ::;l :ce On t-e e,

Trained of 2ri:.nS (n ve tite) (.,ncj

(A) PrinC §--- .ctices Villanova 1 Semester Radiation No

o , r University Biology

ni.ques -,_ tru.-.cnts

(C) 2:r- i .Villanova 1 Semester Radiation

use CA.: le:ur t University Biology

of, R 3 C vi t o -o i C n

-, -I - - - - - - - - - - - - - -

9. r iri c : (..ceai U:e of Isctopes)

Iso o e A: c.... .t (uCi4 J_ 0iA-1 D-Lrtion

o.

-. f- . .. .

12/11/73

1. r

(B) c� Jr.'

7-

K?77RkDIAT:o:; J:.:.u�, �;7:PIE::c� AVD B:crc:Uw-.. �:Tg�rRY

1. Name MTCHAEL G. FARROW, Ph.D. ___Dept. No. 2133

2.- .Sec. o _Date of Birth: - - - e

Occupational Exposure - Previous History

3. Previous E.i;lo::ments 4. Dates of 5. Periods 6. Previous 7. Dose Hist Involving 7-diation Exposure. Employment of Exposure Whole Body Insert Rcor List Nar.e and ;oJr fs of (From-To) or Czi) or ..- czla Employer

8. •ype nf 2raining w vh ere Duration Fc-=a Course On the Job Trained of Training (give title) (ves/no)

(A) Principles P Practices NO of Rndiation .rotuction University of One Semester Basic Radio

Pittsburgh logical Health

(B) Ra-_ioE~ctiv4it,, 1!easurer.-ent, 'V.•,,i cri -... _ ch-

niques and I...tru-ents I

(C) M.tleýrztics 3asic.zo Use ran "earure~rent of Radioctivity

(D) 3iolo--ic,-l Effects ,, of R=a.i&tion

9. Experience: (.ctuai ,>e of Isotopes)

Isotope Arcunt (u-i) Lc- -i.on Duration Us•e

(.) Tritiated rhymidine lOuCi W.Va. UnLversity 1968-1972 Investigative

-'B) Tritiated Uridine 4uCi " "

2 r. . , , - '- infct--- tjo: - ccrrc' ccz-:.cte to t '-,st cf ri"

12 11173•

(A) P< :: .• i e ,: u . _' .e , :: ... = .: ..

REO Fcra I', tL- 1 2

RADIATTO:: �,!APJ.;c, �X?�TE::cE ;.jD ETO.�U2Q�TZTCR�

1. Name L. Jean Las!zn

2. 5 Sc. - ec - .o -

Dept. 1.

Date of Bit:C3 'ýs

Occupational Exposure - Previous History

3. Previous Emplc::ents Involving Radiation Exroosure. List Na-.e and ;.'re.s of Employer.

4. Dates of Mmployment (From-To)

5. Periods of Exposure

6. Previous 'hole Body

(;a,)

7. Dose Hist Insert Rt€or or Calculate

None

8. Type of 2raining -- eherTrained

Duv-a tion of Training

Formal Course (give title)

On the Job (yes/no)

(A) Principles •nd Practices of Radiation trotection

(B) Ra'ýiozctivity rMeasurement, .onitcrinj. Techniques and Instrurents

(C) Mathematics Basic.to Use and 1:easurement of Radioactivity

(D) Biological Effects of Ra&'iation

N one

9. Experience: (Actual U-e of Isotopes)

Ibotope Azocunt (w; Location Duration Use

(A) (B) (C) *Nonie (D)

10. T c,,rt~ :• '-~ ..... i"~ nc- ini zc ty "

(A -r J•...~* = _

(B ..:- .. . -.. ". s K __ _-__ __,,__

I., Name P a111T o\s/sk~ ,~ _(,ýl1

2. Soc., Sec- 00-o. 0 ------ -- -- -- -- ---------

Dep )No.________

Date of Birth a~ge:

Occupational !Lxposure - Previous History

3- Previous sltet Involvir- R-.i~atiofl Lxposure. List Name and Address of Lmployer --

4. Dates of Employment (From-To)

5. Periods of Exposure

6. Previous la'hole Body SUM)

A Dose liistc Insert Rtcorc, or Caclae

S. 07rience: (Actual UýJ;e of isotozes)

Aro-ant (uCi) 2L50 A-. C j

Location

J100 .4 0

5�b AdC.;

Durat ion

-1ol d

\Al' e r,

.~e YL; Tease,

AM ' i

1Y*% t4 tlFJ' Pe.~y,s

Q Cc -love iancrmt.on is correct T2d cope to- the~ bawt r-*

S~~j wv . -Il (?) c~ '7:rz~. -',:'(r ~ 7 ____

Cup Qn -- riciino e hn s0

- -. �, � - -� -

I

Isotope

I .

yerk 7'O J Phi/'a. PA9

8.Type of Training -. abere Duration Formnal Cource On thie Jý:b Trained of Tra~ining (Qive title) (Yan, ro'

(A) Princiries a-nd Fractices of Radiation !-rctcctiron

ment . ?.:on-itorin Tech- L L5p,+L L& S5Chj't 0,I 14 ~ uc~ if 7lk 40S

niques and Instruenerts e3 lvrt'

(C, W.he~atics Basic .to Ph~ Urse 3n' -easurer~ent of F'-ndicz~ctivity/

of Ra~iaticn

--------------------------------------- -- -- ---------- ---------- - ---- -- -- -- -- ---

1.NameL.2z

2. ~Sec. No. -;---

Date of Birt~h:.

Occupational E--xpos'.,re - Previous History

3. Previous Empicyrrents 4. Dates of 5. Periods 6. Previous 7. Dose Hist.

Involving Radiation Exposure. -mployment of Exposure vhola Body Insert Recor,

List N~ame aund Address of (From-To) (4)or Calculate

Employer

8. Type oif Training .'Where Duration Fcr-,al Course On the Jcb

Trained of T ra i.- -cive ti:"e) (ek

CA) Principles and Fract-ices

of Radiation Protectic'a

(3) RadioactivitY E-easur~e

Mgent, 1'onitorincg 2-,ch

riiques and Iný-trunents

(C) MatheL-atics Basic ,to

Use and Eeasurecent

of Radioactivity

(D) Biological. Effects

of -Radiation

--- -- -- -- -- -- -- -- -- -- -- -- -- -- --- --- -- -- -- -- -- --

9. Experiený:,: (Actual 'J~e of Isotopes)

Isotope Arru~nt (uCi) Location Dur-t-ion Use

(A)

%C)

13. 1 ccrt-f t>t tie nbow., infcrn-ition is correct :ucorm:Lcte to the bezt cf my

know~lec1je and belief.

Iý C -2--.7

Ca-lcu',tion!3 - zri.iiczo2

-e iD'- --- %e bodY:

(A) F r P c ~ e A ci: ~ c ce - 5 1 '

(Elf Tot-,;ý1 ::. xo --zr t o L t- (f ron 1 _ _ _ _ _

(C) rmiz ibio ~ ic7

-"-w- *-�'

- -- -,WM-I , W AM

Dept.No

2.0c. Sec. 0

-----------------------------------

Occupational EZxposure

Dept. No.7

Date of BirthhANN Age~

-Previous H~istory

3. Previous Em;lo.,-ents

Invo1vinZ R-djitiofl Exposure.

List Nam~e and Addrez3s of ;!mmlover

4. Dates of E=plcy!ment (From-To)

5. Periods of Exposure

6. Previous Vlhole Body

(?Z4)

7. Dose Hist�

Insert P.~coror Calcul-ite,

RRD I,.*-.----U-,,.,-"

,,.,I. 2-- 74/~

,4l-" e.* 7'&'. 46 77

8. Type of Training Where Duration Formnal Course On t-e `:'b

Trained o~f Trai:ýin- (-i.Ve -t'-e,

(A) PrincirpIQZ and Fractices of Radiation rocin

(B) Raio-ivt' easur'e- 7/C renet, I c7tc~~~ ec*- */b r

niques an'i Inztrur-r.Pts

(C) mathe----tics Basic to Use ari,'1e;S.remn of Rrdioact-ivity

of -Ra' i-acion l

9. Ex-nerience: (Actual 'JI-e of Isotozes)

Isozope ý.az-o.it (ul~i) Wocntion. L.uratiofl Us e

(A) z 4164( -1 ee Vx/ e

(C)

-O c rt .- t i: ';c-e in 2sr- on i.Ccr--rect 0Ž: --o :: -t of !7--l

ant.' beiele.

(A

C ' _ _ _ _

• • • • • • • • • • • • • •

Na5eJj-m7E5t ai2-De. No. /

2. oc Sc.\o ________________ Date off Birth: Age~

L-----------occupational Z'xpo~t1rcý - Frevious History

3. PrevioUiS E-Flo;.tents involvifl5 R-.iiation E.xposure. List A'atme and Addres-s of Eminlover .

4. Dates Of Zxployment (From-To)

5. Periods of EScposure

6. previous 'Whole Body

(REN)

7. Dose H~ist Insert R,ýcor or ^a!ulate

'm~ount (,C4)

4 5~4'6,J-,e

4 Cb-od

Location Duroýtion

'PC .-fe

W y r

7:o. 1 c-rt-ifs ~ 2eifrto i:j w o~L: h'-z~t C~f 77Y

(A) irJ C i. itc~ e -d_______�-5ZYi3

Isotope

(A) (B)

(D)

"I-S., -.

8. Type ol' Training Where Du~ration Form.al Course On t*-e -z*

Tiraincd of 7-7in ( e title) ( z<

(A) Principr.e.-.-d F-ra~ct-cesf d.~NL~. ~ ~ ~ '.~ ~ of Rdiaton 7Protctin

(B) R.-a d io-nc ti4-v E -au r e menet, roc-

-'- E "L.h niques and Irnstru-.en-ts

(C) Yathezt-ics 3asic.tc' Use ancý 'L'e&.urer~ent of Ra~iioeactivitv

(D) Bioio,,iýca' Eff:'-ects

of RaZc7iaticn

9.Experience- (;ActLial luýe of lootorez)

2. Soc . Sec. Do __________

Occupational Lxposure-

Dept. No. ,-13

ite of Birth

Previous 'History

3.Previous 1:'1oyr.ents 4. Dates of 5. Pros b rvos 7 oe1it

IzivoJ.vinCZ Rý_ii'ation z..xpposure. Employmenet of Exposure ýjibole Body Insert R--cor,

List T.arme and ^Addre~sz of (From-To)(I)o Employer

8. Type of Training Where Duration Formal Course on th-e J7zb

Trained of Tr&i,.in (-ixe title')

(A) Pri-ncipies 'and Fracticen esj" e~e of Radiation -.rortection teF_' 'eae

cnent, 1:o.:-i tor½- Tech- 4

niques and~ Instru~ner-ýts

(C) Vather7ý_tics 3Basic .to e Use anci '-easurem.en~t jf of Rad~io~ctivity

of Ra-'i~tion

9. Experien~ce: (Actual Uze of Isot..ýzes),

Isotope Azcunt (u~i) Location Duration Use

(D)

2.0. 1~ L -' -.'ci.' in: tl.;a wn ii c:J *re , -tcL. o t cz f L/~.e~'. bIif./

(A) F er:7ir:7:2 ncv~tdZ: (B) Tote. *zr to 't _________

2.So.Se.?I. ~ Date of 3irt

- -- ---------------------------- -- -- -- ---

pt. No.

Occupational £--xposure -Previcuz- 1istory

3. Previous Emp1ol.ients, 4. Dates of ~.Periods 6.Peiu 7 oeHs

Involvine _R-ý-iation £xEyosure. Employmnent of Exposure Mhole' Body Insert R'-corý

List- Nam~e and Addre~z of (From-To) (P2~a or OVac..att

Emplioyer

8. 77-ye of 7_ranin.in - Where Duration Fc-_rraI Course On t'--e

Trairncd 0 f -2ri:1i: (evýe tit~e) c,

(A) P ri-nc i r ý,s P - 7 rc t io / S7:t- A PV0Il

of: R;:idiit ion Z-rct wc i.zn-nq

0

( P. -K- c i C, _ t t. - I , :easu r e- 5 '.C S cf Md AW (•-.O Fo

(C 3Z-p"i r Bsic .to Rh P 0C14C-iLA1,

U:ýe an---,

:j_,_c,ýCtivity

(D) 314 o o'ic -- L fEc t- RA V~

9. B:erierce: (A c t, - -e of `Doto;ýes)

Itce -. t(U-i) Loc~ticn Djur~tion TT e

((A

- -- - - -

1, NameA' fz6 -/'0ý Dept. No.______

2. Soc Sec. Nio. ____________ Date of Birth: ~ Age 4

Occupatio'nal _-ýxposure -Previcus Hiistory $Q

3. Previous Emp1o-:mrents 4. Dax~es of 5. Periods 6. Previous 7. Dose H~ist: Invd.)vine Z7-.diation 'Exposure. Fmplvyment of Exposure Whole Body Insert R!-±co,ý:

List Nam~e and Addrezz of (Fzrom-To) (REM4) or

Employer.

8. Type of Training *.Where Duration Formn-1J Course On '%-e jý:

Trained o f Tr-c. i nr'.g ve title

(A) PriLncpir"-s and Pra-c ti

of Radiation L~rco'-ction -. s

MB Radi_-c-._ivity 1Meas'ir~e

ment, N.ic~gTech-~

niques and Inztru~nens

(C) X~the---i~cs 3sic to\

Use 3.n,' 1'ea rement

of R~dio_ý,ctivity

(D) B1olo,:-'c?i` "fects

of _RPad'ia-ticn

9. £`;xperience: ('ct'ii U.ýe of Isotozes)

ILsotope j-.r~o-nt tu'_i)0 LoC at io0. Duration tUse

CD)

10. 1 C-1:f .' i' '..c ini cr=-Yie.- i-:, ccrrect ':d czT_Ž- t .zt cf n-l

C, -. I- i .- C

(A) rn_5eA~i-uU d i~'

(E) T ~I 'r e '

r)-1'1-1

2.Soc. Sec.!, o. DE

Occupational ý,Xpo~iure

3. revou Ezovcnt 4. Dates of 5. Periods 6. Previous 7.Dose list

Invelvine R7-4iiation Exposure. Exployment of Exposure 'Whole Body Insert Rf-cor

List Nam~e anid ^Iddress of (From-To) (a)or Calculiate

Employer

- -- -- ------------------------------------------------- -- ------------- -- -- -- ---

8. Type of TrairninG Where Duiration F7ormall Course On t-e L~

Trained o f T raz (-i title)eZ

(A) PriLncitples ?.rd Practice-S ~~ of Radiation -1rotection(4

(B) padjoac-4vity Neasure

ment,~ L7, //

niques ar, InTr ens 4

(C) Fathe->tics Basic to Use an' e-uý.n of Radiozactivity

WD Biolo.:-ical eýffects

of Radi~ticri

9. Experienice: (A'ctual 'Jze of I~oto;:es)

Isotope Amount (u-i) Locatica Dura-tion Use

L0rI'-ri~ -'c- c.' fcrm-I'-on I' s'r, u- -lyetot.ez3t cfr~

n3 1 -. -d e*Ii/r

�-' .- '-.

.- ,�- �

7' '�

- �cr;.:z�..-�-* j 1 2V1

cA irr'i - AcTýtc D ;

AC) F~ ;, i2i2:

�5f�4/7.

Dept. No. -

ite, of Bit.ý -Ace:~

Previcus H~istory

Z -tle: -7 V

! . -Nam Dep

2.Soc. Sec. .;Io. - -. -- - - - - - -- ' - -

Occupational Z!xposure - Previous History

3.PrviusE~~.yrcn4 . Dates of 5. Periods 6. Previous 7. Dose Eistr

Involvinz- ý-~iition Ex-Dosure. Employment of Exposure W"oe3d Insert Recorc'

List Nar~e and jAdre_-z of(ro-)(fl)r cit'

Employer.

C- Z -1 - F0C, , 1 g

A ~ a~~ 7 44 a9

8. Type off Traininig Where Trained

Duration of riurg

xormal Course ( :ive title)

On '6-e Jcb

(A) Principles and P-ractices of Radiation rrotectipr.

(B) ~~czi I t leasuremernt, Fronlitcrin,= 1Cec*niquez an,-` In~tru-.ents

(C) Mathe. -tics Basic ~to Use andý -easureren~t of Rýýdiconctivity

'I

I,

(D) B3ioioicl-=1 Iffects of Rad1ip'tiorn

9. Exr~eri-_nce: (AIct"21 'U':,e of isotozes)

'.t.cunt (uCli) Locn:2.on

Ce- V J 7 R4Jý_ 4-1

Durcation

, je PL ý

Utse

,4 ~ 'I

Vi

1~ t -- t > :c-ei. rto i:: correct

D? te:

- '---- ;2 �.A2 4-Z . ... 4'�

(A) 1~i-:..c~~e

(C) r xib

Isotope

( 0 (B) I-I

-'4

C

/

p , -

Date off 3irth:i

t _ý t, -. -ý cf !7;,

RAj2V'�u..................- -.

1.? Name ~ ~ ~ Z L

2._ESc,. Sec. o

Occupational. Exposure

3. Previous Em.pioysTents Involving R-ý`ation £xnosure. List Narne and Addresz of Employer-

4. Dates of Employment (From-To)

5. Periods of Exposu~ze

6. Previous ývhole Body 000)

7. Dose H~ist Insert Rcýcor or Calculate

toI j, . ->_D7LA aý A

8. Type of Trainfing Where TTrained

Duration of Trnininc

Forr~al Course (-ive title)

On thre jco

(A) Principles anrd Practices of Radiation ;-rotcctic.n

(3) 2adjo'ctivity INeasur~e

niques and IThstru:7ipns

(C) Matheirw--tics Basic :to Use an.:- 'e~surem'en~t of Radioactivity

(D) Biological Zffects of Ralijation

1c16�t -�

e �.j!no -Y

.ýjI a 14

N 0

9. Experience: (Actua! .1. e of 12o-_opes)

Is~otope ;zrrcxt (uCi) Loc~.tian Durction Use

(A) .g00ýX WY /-'96 9- rra. c e),

(B)

(V)

W.C 1 c.'rtif: t.t W, t> m'e infcrw~;ohi is~ c':rect z.Acomyl:E- to W:.: c &A m~y

kno..zie~e vn6 baief. .

(A) rrr:K Y:~1d c>~ (W c:: ::ou. ~ -

C."-

two-19&q

2

Date of Birth ~' e ~I

- Previous H~istory

RA.- I '-T "

Dept. No. 2' •~

2. Soc. Sec.Jo.c. -L

Date of Birth:

Occupational Exposure - Previous History

3. Previous Em;1ot.%ents 4. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving Rndiation Exposure. Employment of Exposure Wihole Body Insert Recor

List Name and Address of (From-To) (REI) or Calculate

Employer

A/P 1On& e le

- , ,- -• -- --. ---, --' -, --- .- - •- -" '- ----"-"- --....- - --

8. Type of T_2raining - Where Duration Fcrmal C;urse On the Jcb

Trained of Tr-a.inig ,ive tite)

(A) Pr~iciries and P~ractices Vh -~

of Radiation Protection K

(0) Radiozctivit, E-easure

ment, %:onitcring Tech- i/ niques an! Instrum.ents

(C) Mathez7tics Basic ,to Use and .'.ersure.ent / " /

of Radioactivity

(D) Bio3 o.ical Lffects 1/ // of Radiation

9. Experience: (Actual Uzse of Isotopes)

Isotope Ar.ount (uCi) Location Duration Use

(Al .... /

(C) (D)

10. I-. ct c bo-.ne iMfcr.ticr Q ccy'rect =. ccmple- to t.. to .... cf .

kno.,iedj and 7 ...

Dae.t. ..:. ,/..... . ...... ..... d'.

'•,cuiar~or:' - i*r :.2r.:L .t)O:<i •'*: .. ':..: :'.: (A) Pe~r-;i.r-iz-' rc'.:uI",'A.. ?,c:.": .• .

(B) THAI :s.oTcr .to h-to (fr:, --:. ) (C) l._-: : i i_ :e

1. Name IVkP. N ~ V S ( Dept. No. 2~114

2. ý'C Sec. No. 4~Date of Birth: 7jAgg~. .

- - - - -- - - - - - - - - - - -- -- - - -

Occupational -Exposure - Previous History

3. Previous Em£ployentz t+. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving Rrdiation gxposure. Employment of Expo-ure Whnole Body Insert Rscor

List Name and Address of (From-To) (Ri) or Ca;,ulate

Employer

e ,ci A 1 /9 Si?7o AJQ JiJ

8. Type of Training Where Duration Formal Ccurse On the Tbo

Trained of 'r,.zr.g (sive title)

(A) Principles ad Pract:CC cf Radiation •-rctcction

merit, •o•tzn eh

niques and Instru.-.ents

(C) Mathee7tics 3asic.to /C Use and 1:.....r•.ent of Radio-ctivity

(D) BioLoica. 0'- _ects

of Radiation

9. Experience: (Actual U.se of Isotopes)

Isotope Arount (uCi) Location Duration Use

(A) 0 a- /et% A&v- 44

(B) +4o (C) (D"JI.

10. 1 c'rt_. . tc -'ove infcr- iion i.: cc'-rxct t h t c f ry

D:-n'.:ied / en b!7iev ______/______________

tLC.: J .^ J .. ... " .•, ... , , .. : i' ,, j Ga b ua In i el ~ ~ l~ .:: .>>% oy

(A) Per:-.i.K.- Vh e.,_ ,.ctu •ed :,.. L¢< -. (" -I") -v

"(-'[) Tp, .- : r.- ..- i r: lc b::' (f~ ____

RADI=

1. Name

2. Sec- 40Date of Birth:,

occupational Lxposure -' Previous Hjis tory

3. Previo-,is Erployr~entis 4. Dates of 5. P~eriods 6.. Previou.5 7. Dose His:

Involvine Radiation Exposure. Emnployment of Exposure wihoie Body Insert R--cor

List N~ame and Addrezz3 o." (From-To) or Calculor

Employer -

£4��

/a61,'•f 57, �'9Z

A~. Type of Training Wh ~ere Trained

Duration of r z g

FcrT-al CocarseCT i4 V t I:t'.e)

on th~e 1.cb

(A) Princit'les anrd 'Practices of Radiation _Zrotcction

(B Badiozýctivity, Ieassur'ernent, 1?:*oritcr~n= T~echniques and, Inzstru.-ent's

(C) Yather~ptics Basic .to Use 3rG easuremernt

Of Radioactivity

(D ) Bi lo 'i ai £f ects of Ra~iaticn

a

9. Experien~ce: (Actual Uz:-e of Isoto-zes)

Isotope ýjrcunt (uCwi) .ýoc= t i.0. Durz-tio"rE i

(B) J >_ 5 '71- 7 (C)

1O. 1 c-rt 1. z *';Ove i fc:r-7 iCn j.';c ~ a c *-± to t >-: __x' t cf MY know1edi:e &c-:d > i f

Date: / ~ / - , .'

(A)

11--7-:1., 2,

Dept. No.

t7

RADIA C;.- ' 'i . . . . . . . . :. . : ... =. . . : _- ;j ,

1.Name Tu 44TI/ / Dept. No.02

2. Soc. Sec. No. ___ Date of Birth

--------------------------- --- u- --- ---- or----------

Occupational E1xposure - Previous H~istory~

3- Previous E.np2oycments 4. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving R-diation Exnosure. Employment of Exposure 'Whole Body Insert RThcor

List Name and Address of (From-To) (RPa) or Calculate

Employer

&,,ye-7--,- Ld ,3j , 11-,7* -.)

------------------------------------------------------------------

8. Type of Training -- '•ere Duration Formal Course On the

Trained of "- -:ir (five title)

(A) Principles and Practicei C/I' q /7&-1f7of Ra--diation V-rotection/

(3) Radioactivity 1,r;easure- 4 A 0.4 44w /-'qb izent, .:.it-_.. T•ech- v/.Tz•u~ •,v{¢

niques and Instrunents 01-<.

Use and "easurement of Radioactivity

(D) Biologicai Effects

of Radiation

9. Experience: (Actual Utie of Isotopes)

Isotope Amount (uCi) Locntioa Duration Use

(A)5 K a( V * - G dfY

(B) / c t~ c. O ~ A ~ L~ % > (D) wy70 ve VwI 4e.Vj"-:• '•

. I c-'rtif't .... 'e' irýfcrn-ition is, ccrrec;-: best Cf My

Date.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

DC ::Cir ;:ý 1 .

"!.Culp . .. - 7 r . 4S_-e Die.o - c (A) 1erni: ible Acc'-. t ed cz,? = _( ,-._._ __-'_

(E) To'•-l .,- '-,,. _ to - . .( fr. :t . 7) _ _._ _ ( C ) l . .- : ,ih -c - •_-'

NjAge:-

RADI~:17-1.0-P - 2Lm DEX7 Q, J. 1l. Na~ne- Joseph Bell ADept.

1No. 2104

2. 1 S C" Sc. Date of Birth Q..J~ e:~

- - -- - - - -- , -_ 1 ý

occupational Exposure -Previous IH.istory

3. Previous Employment5 4. Dates of 5. Periods 6. Previous 7. Dose Hist

Involving R.-.,iiation Exposure. Erniploym'ent of Exposure ~Whole Body Insert Racor(.

List 1Na.'e and i ddress of (From-To) (RE-al) or Calculate

Employer

JjI~o S

Research Tech.- at Children's Hospital 1967-68.

8. rTy; .:f'_raininUg Wh ere Irained

Duration of Trainin~g

Formal OCurce ( :ve title)

on tte J..m NxSA"&c

Y/0-•S(AFrMrc~ ez Practice-s

of -cte'2ticn

- 4.- '-ý -- ,. 1 A

ath e C,ý aS t e C)n

of zRe-iwc-tivity

(D zc] ji ?L ff-:cts of •2q o _'n

9. Experience: (Actual IOe of loctoyes)

Isat-w- Mut WOLocntion Dra tion Use z. ~#J

W T-.- -l . - 1 -, ..

IV 3.- 0

(A)

1. Name , .- • . V lA

2. Soc. Sec. No.

Cccupational. Exposure

3. Previous Em•ployments Involving Radiation Exposure. List Name and Address of Emnloyer .

4. Dates of Employment (From-To)

5. Periods of Exposure

6. Previous Whole Body

(RaI)

7. Dose Hist Insert Recor or Calculate

n 7'..

Dept. No. - -'

- Previous iHistory

I n m

3

iAP,3- 0- SeR.-c- ,Tofi.

8. Type of Training - Where Duration Fcrmal Course On the Jib

Trained of TrKO '•.. (C-ive tit.e)

(A) Principles and Practices (2j //A. of Radiation Protection,

MB Radiioactivity IEeasurý- § J5E. p-f _

merit, .:onitcrinSg T4 ch- * '-.

niques and Instrur.ents

(W Hathe atics Basic .to f' A, ,.A& L ~ UP

Use anr I1easurement of Radioactivity

(D) Biological Effects k. , j-4 _ 4T 1,

of Radiation 'l C,•, 1,-•-C

9. Experience: (Actual Uze of Isotopes)

Isutope Am.ount (uCi) Location Duration Use 4

(A) soon... - ctL

(C) 4 4- 1,4

(D) p,.-,r . I 0. , .

10. I certify t:-- -t -bo.e infcrmition in- correct ?' d cor-lote to••he boat cf ry

kno'."lM-le and belief. /

Ca,•- cu/..-,cr2 -- c.. c.c. <•. e .. :,- •- ci•,-: Date: 3.i:•. d< ,-- fT 2 ,d,:.. .

(A) Perri,:-;1o Acr,.-lted .c =, ,

(M) To... )::o.o . -7.

(C) I' ,'-in.;-... .h.-___.....___

2. Soc Sec. No. Date of Birth:Y ½~

Occupational Exposure - Previous History

3. Prev~ius Emnjloiments Inv~olving ?R-nciat ion 7Lxposure. List ':t2ro and ~Jiesof

B. Type of 1..i

4.* Dates of Employment (From-To)

e. hr e Irained

5. Periods of Exposure

Duration of 1?rnirz4n-

6. Previous V¶dhole Body

( Ralm)

.vcrral Cource ( dyve title)

7. Dose Hir3t Insert Recorc or -alculate,

On tre jJ-c

of k~~iz.rc t2 ct1zwz

(D) Booi~ f~'t of aito

- -- ------------------------------------------------------------------------ ------- -- -- -

9. Exr'er-iýrnce: ý .-e of I -co; "

Aste .~-.msarnt (UC i L c) c .on D.ir:.tion U -e

(D)

- -1 -- --- --------

'q 4f

a - .- �

�e 'r'/ /�7 �yY 2. Soc. Sec. No.

---------

Date of Birth:J3

p No.

3Q~pational 1:xposure - Previous iHistor:V

-4f Previous , et

List NaxMe and &Acidress of Employer

4~. Dates of &rploymenet, (Froci-To)

5. Periods of Expos5ure Whbole -'ldy

(REN)lxmert R!-cor:or Calculate::

8. T'ype of -7railiflg -.Where Trained

Duration o f T r & L.

zormal Course t I:e t't e)

On th-e J:zb ( :,: -- ' -I-:

(A) Principl-es- -- d Fracti-les of Radiatiorn l-rotection.

h C�,t�c 1 c'

L� 1 � tAA

I- I �

inert, IFonitc-±4nz- Teclniques antd Ir,3truner4.s

%c ."-p~~ics 2ýzi - tc Use an'i Veasurement of RaidioaEctivity

(D) Bjoi~op'icct -E~ffects of Raciatlicn

I

2

I

2

IC.

3. -xei-ience: (Actual o f L~jotozes)

Isotope Am'srr-rt (~uCi) Loc-ntion. Dur-ýtion Use

(A)

C. n I Cuiý7 .C 2riiso i ei Y

(E Tot!-:-"- t

(C)2ci'ir~-X~~c *:'~~c:

4

-A 4ý Ilelp e-lei 1,

11ýý tce-ý -%

rk').-d-ez S I

':' / -" -

l~ Nzae --.'' &(~-Dept. No.

~.So..Szc. No. Date of Birth:

Occupational Z'xposur - Previous 1.stor

3. Previous Emnployiments 4. Dates of 5. Periods 6. 1revicus 7. Dose Hist

ItvolvinCe Rý-.di*ation Exposur-ý. Lmployment of Exposur~e Whole Body Insert Recor

List N~ame and Addre~Zr of (From-mTo) (Ral) or Calculate

£~mployer.

8. Type of Training -. dhere Duration* Formal Coursc On t'he Jizb Trained of Traiiii- (-ivette

(A) Principles !ind Practices of Radiation -.rotection

()Radio-zCtivity ".easure-2 mment, Vonitorin,: Techniques and In~tru77ent-s

(C) Fath1-e:>ýtics 3asic to Use an-ý Ve&surement of Rd~tvt

(D) Bioloý-':a' *-Effects of Rac-ia-.1Oio

9. :C~rience: ('ctuJal1.. :e of Isotozes)

Isotope An'c-unt (uCi) Locatkion Duranti...n Use

kA /1 -1 7, nj C 11 1,

c-