Laserfiche WebLink
•• n umuvm TO CKY OFFICE P.01 <br /> Need/Care Medleal Centers <br /> Need/Care Medkal Group li Chee <br /> 9261 Feisam Ewa_Sui,,a00 <br /> Sacramanro.Canlorma 95826 <br /> �ulep�oae(,5751363.;953 <br /> PRELIMINARY REPORT <br /> EMPLOYEE: <br /> L DATE OF SIRr^H:��y-��j_ <br /> EMPLOYER: <br /> In accordance with 29CFR 1991900aand L192266 ((CCCCu_ational Exposuro to <br /> Asbestos, . Tremol_te, Anthophillte and ActiT-,- te) , anc stardards <br /> ECAC 5208--Asbestos standards, 29CFR 1926.56 and 29CFR 1910, 1001 , <br /> 40CFR763"EPA Worker protection rule, the above named individual <br /> was examined this date JUN1 , The PRE LI: INARY REPORT is as <br /> follows. .d <br /> Examinations Performed: <br /> A. // Examination by Physician. <br /> B• ✓ Pulmonary Function test_nc. <br /> C. .� Posterior/inter_or and L ` <br /> - _ views of the chest. <br /> 1) The employee has been advised of the resorts <br /> inatior., and Of pOSS of the physics'_ &: am- <br /> ible medical conditions that may result c <br /> the above mentioned exposures ie `r :a <br /> problems. . respiratory, gastrointestinal <br /> 2) The employee / IS crysically capable IS NOT <br /> protecti',e resar, _piratory caFable p£ ,,s;ng <br /> lip me. t. <br /> 3) Based on the comiponentS O£ the physical _ <br /> PRELI.SINARY t-s= P . soca *--amination and the <br /> �_ i._c, N'f� CPk appears to <br /> cool health. pe in <br /> 4) This is a PREcI_dINARY r=_ort, Subject to raciecing results c' <br /> Pulmonary test from the Pulmonologist. If xrays were obtained <br /> it is subject to recievirg results from the Radiologist. <br /> 3) The £011owina racommerdations were made, k+�ucs ons CnW I <br /> u <br /> Ht(.[Lt AIFJI`� F�iVll[pl{M� <br /> 6) Work restrictions: <br /> U <br /> Physicians Sig�natur rx Date o£ Eram <br /> _- JCS <br /> shunt) -(t'fu b MD. This Report Expire= <br /> Physicians Name <br /> TOTAL P.01 <br />