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Project Name: <br /> vocation: <br /> Date: <br /> PERSONAL PR + EQUWMENT <br /> Lewd of Respiratory Protection Activity Performed <br /> Used <br /> FWd Dress Activity <br /> MONMRING EQUIPMENT <br /> HNU/OVA/CGT <br /> • Background heading <br /> - Readings above background? <br /> - Location of high readings <br /> Radiation <br /> • Readings above background? Yes No <br /> • If yes,spa*where readings were found and what action was taken <br /> Page 2 of 3 <br /> ROUX ASSOCIATES INC riee�o�rE e+�F.�e�no <br />