ML20133F702

Emergency Plan Implementing Procedures,Including EPIP-1 Re Emergency Director Controlling Procedure & EPIP-6 Re Notification of Emergency Response Personnel & Support Organizations

ML20133F702
Person / Time
Site:	University of Virginia
Issue date:	09/30/1985
From:	VIRGINIA, UNIV. OF, CHARLOTTESVILLE, VA
To:
Shared Package
ML20133F676	List: ML20133F673 ML20133F702
References
PROC-850930, NUDOCS 8510110194
Download: ML20133F702 (21)

Text

m W UNIVERSITY OF VIRGINIA REACTOR FACILITY

-~ \ EMERGENCY PLAN DIPLEMENTING PROCEDURES Revision 1 September 30, 1985 Remove Page No. Insert Page No.

EPLP-1, page 1 of 5 EPIP-1, page 1 of 5 EPIP-1, Attachment 1, page 1 of 5 EPIP-1, Attachment 1, page 1 of 5 page 2 of 5 page 2 of 5 page 3 of 5 page 3 of 5.

Add EPIP-1, Attachment 2

^

EPIP-6, page 1 of 4 EPIP A, page 1 of 4 page 2 of 4 .page 2 of 4 page 3 of 4 page 3 of 4 EPIP-6, Attachment 1, page 1 of 2 EPIP-6, Attachment 1, page 1 of 2 page 2 of 2 page 2 of 2 EPIP-7, page 1 of 10 - EPIP-7, page 1 of 10 page 6 of 10 page 6 of 10 EPIP-10, page 5 of 5 EPIP-10, page 5 of 5 EPIP-ll,: Attachment 1,-page 3 of 8 EIPI-ll, Attachment.1, page 3 of.8.

page 6 of 8 page 6 of 8 page 7 of 8 page 7 of 8 page 8 of 8 page 8 of 8 EPIP-19, page 3 of 3 EPIP-19, page 3 of 3

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O EPIP-1 Emergency Director Controlling Procedure

Purpose:

This is the Controlling Procedure which initiates the Emergency Plan's implementation. Initial assessment of a potential emergency condition is facilitated and the initiation of corrective and protective actions through implementation of subordinate EPIP's is begun.

User: Reactor Facility Director, Reactor Supervisor or most senior staff member present at Nuclear Reactor Facility who is to assume the role of Emergency Director. See Organizational chart, Attachment 2 to EPIP-1.

Entry Conditions to this EPIP:

a. A potential emergency condition is reported to the senior O operator on call, or

b. Another procedure directs continuation of this procedure.

Instructions: Continue through each EPIP-1 steo even after other EPIP"s are initiated. .Go from step to step until otherwise instructed, l

l

1. Initiation of Procedure:

a. By:

b. Date: l

c. Time:

1

2. Identification of Most Probable " Unusual Events" which require immediate action:

EPIP-1 1 of 5 Last update: 09/30/85

O -

V ATTACHMENT 1 to EPIP-1 EMERGENCY ACTION LEVELS

1. Unusual Events Emergency

a. Actual or projected radiological effluents at the site boundary, exceeding 10 MPC for unrestricted areas when averaged over 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />, or leading to an exposure of 15 mrem whole body accumulated in 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />. For air: 10 MPC = 2 x 10-13* pCi/cc; For water: 10 MPC = 3 x 10-7* pCi/ml; Dose rate at site boundary > 0.625 mrem /hr averaged over 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> period.

(Providing no isotopic analysis is perfomed. If analysis is performed the less stringent limitations of 10 CFR Part 20, Appendix B apply.)

(

b. Report or observation of a severe natural phenomenon that is imminent or existing.

c. Threats or breaches of security.

d. Fuel damage accident that releases radionuclides in the confinement area, which may be indicated by the following:

(1) Sustained reading at the UVAR Reactor bridge radiation monitor of 1R/hr or greater after the UVAR Reactor is or has been shut down.

(2) Pool water samples indicating a fission product activity of greater than 1 x 10-3 pCi/ml.

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e. Fire within the Reactor facility lasting more than 10 minutes.

EPIP-1, ATTACHMENT 1 1 of 5 Last update: 09/30/85

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(./ f. Personal injuries that are complicated by radio contamination problems or radiation exposure.

2. Alert Emergency

a. Actual or projected radiological effluents at the site boundary, exceeding 50 MPC for unrestricted areas when averaged over 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />, or leading to an exposure of 75 mrem whole body accumulated in 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />. For air: 50 MPC = 1 x 10-12* pCi/cc; For water: 50 MPC = 1.5 x 10-6* pCi/ml; Dose rate at site boundary > 3.125 mrem /hr averaged over 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> period.

• (Providing no isotopic analysis is performed. If analysis is performed the less stringent limitations of 10 CFR Part 20, Appendix B apply).

b. Radiation levels at the site boundary of 20 mrem /hr for one hour

'OV whole body.

c. Abnormal loss of water from the UVAR Reactor pool, used for shielding or coolant of irradiated reactor fuel, indicated by a drop in pool level of greater than one inch every ten minutes (rate which exceeds the makeup capacity).

d. Loss of radioactive material control, that causes radiation dose rates or ambient radionuclides to increase ambient exposure levels to 100 mrem /hr throughout the Reactor Facility. The resulting increase will trigger an emergency response only if it can't be explained in light of actual operational activities.

O e. Fire thet mey effect reector safety systems.

EPIP-1, ATTACHMENT 1 2 of 5 Last update: 09/30/85

f. Explosion that affects reactor operations.

g. Radiation dose rates in the Reactor Facility that provide an unanticipated sustained reading of 1 R/hr or greater on either the UVAR Reactor Bridge or ground floor experimental area radiation monitors, with the Reactor having been in the shut-down mode for several minutes. These sustained dose rates require the evacuation of all personnel from the Facility.

h. Any other situation or condition determined to fall in this class by the Facility Director or Reactor Supervisor.

3. Site Area Emergency 3

(V a. Actual or projected radiological effluents at the site boundary, exceeding 250 MPC for unrestricted areas when averaged over 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />, or leading to an exposure of 375 mPem accumulated in 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />. For air: 250 MPC = 5 x 10-12*

pCi/cc; For water: 250 MPC = 7.5 x 10-6* pCi/ml. Dose rate at site boundary > 15.625 mrem /hr averaged over 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />.

• (Providing no isotopic analysis is performed. If analysis is performed the less stringent limitations of 10 CFR Part 20, Appendix B apply.)

b. Actual or projected radiation levels at the site boundary of 100 mrem /hr for one hour whole body.

O c. Abnormei continu4no ioss of reector cooient weter from the ovAR reactor pool, used for shielding or coolant of irradiated EPIP-1, ATTACHMENT 1 3 of 5 Last update: 09/30/85

ATTACHMENT 2 to EPIP-1 ON AND OFF-SITE EMERGENCY ORGANIZATION CHART EMERGENCY DIRECTOR ON-SITE H (Facility Director or R. Supervisor, HP, Senior-most R. Operator) +-+ %A E. ORGANIZATIONS (E. R: ster List) Resp: 1) Over all direction of E. Actions 2) Notifications - ~

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i EMERGEtiCY COMLRitCATOR . EMERGENCY COORDINATOR (R. Op. designated by E. Director) 1 (R. Supervisor, Senior-most R. Operator)

Resp: Preparations of Notification Fonns . Resp: 1) Advisor to E. Director 2) Personnel Act.

for E. Director's approval. I 3) Supervisor of E. Actions 4) Det. of safe / unsafe 4- - - - -> areas 5) E.P. Coordination, Review, Training l

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HEALTH PHYSICS REACTOR STAFF 0FF-SITE E. ORGANIZATIONS (HP's or R. Op. (Available R. Operators) 1)HRC designated) Resp: E. actions and

2) State & Local Governments Resp: 1) Surveys of assessment, as

3) Rescue Squad inside/outside of R. requested.

4) U.Va. Police Facility

5) Charlottesville Police 2) Surveys and sampling

, 6) Albemarle Police at site boundary ,

7) State Police . Personnel moniton,ng g

• g 3)an d decontamination

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( EPIP-6 Notification of Emergency Response Personnel and Support Organizations

Purpose:

1. To notify on-site and off-site emergency response personnel of an emergency situation.

2. To notify off-site emergency support organizations that may be asked to provide assistance during the course of the emergency.

User: On-site emergency team member designated by Emergency Director to be En.argency Comunicator.

Entry Conditions: Initiation directed by the Emergency Director and by any of the EPIP's 1, 2, 3, 4 and 5.

O 1. Initietion of erocedure:

a. Initiated by:

Time:

Date:

2. Notification On-Site Emergency Response Personnel:

a. Use all available telephones (or back up radios and L'T's) and personnel to make notifications as rapidly (ano regularly) as possible: ,

(1) call, in order, the individuals not presert at the Facility who are listed in the Emergency Actions list under the heading of " Reactor Facility Staff" and which are also named Q in the followiny list:

EPIP-6 1 of 4 Last update: 09/30/85

O On-Site Emeroencv Res,ense eersonne, Home Teie hene Time Noti +4ed R.U. Mulder, Director 296-6588 J.P. Farrar, Reactor Supervisor (Admin.) 973-3110 J.E. Henderson, Reactor HP 978-7551 P.E.Benneche,ReactorSupervisor(Oper.) 979-3286- l B. Hosticka, Senior Reactor Operator 977-0416 __

G.D. Conley, Senior Reactor Operator 823-2457 R. Ritenour, Reactor Operator 973-2926 T. Nguyen, Reactor Operator 978-4531 C. Cobb 973-4067 (2) record above the time notification has been completed.

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-(3) inform Emergency Director that notification of on-site O e-r9ency response personnei hes been c-nieted.

3. Notification of Off-Site Emergency Support Organizations:

a. Emergency messages will be transmitted with text to be approved by the Emergency Director. Emergency Communications equipment is described in EPIP-17 " Emergency Comunications".

b. Notify off-site support organizations as directed by the Emergency Director giving priority to those whose services may be required immediately. Use the list given on next page.

EPIP-6 2 of 4 Last update: 09/30/85

TIME NOTIFIED ORGANIZATION CONTACT PERSON' TELEPHONE UVA RADIATION J. HENDERSON 978-7551(H)

SAFETY OFFICE B.G. Copeutt 924-8997(W)

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. 978-4666(H)

J.R. Gilchrist 924-7961(W) 973-2402(H)

UVA POLICE 9-911 or 924-7166 Or i

924-7167 v

' CHARLOTTESVILLE- 295-1191 -

ALBEMARLE RESCUE SQUAD CHARLOTTESVILLE 295-1125:

FIRE DEPT.

UVA 924-2231

. MEDICAL CENTER z LOCAL POLICE 295-4151 ENFORCEMENT AGENCIES EPIP-6 3 of 4 Last update: 09/30/85 i

_ __ - _-_ = . r_ _:- :r_1: __ __ _ -_ c:_ .: _:_x__-______.. '

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EPIP-6 ATTACHMENT 1 September, 1985

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O IN m At EnERGENCY ACTIONS UNIVERSITY OF VIRGINIA REACTOR FACILITY In the unlikely event of a radiological emergency at the Reactor Facility the building evacuation alarm will be activated and the UVAR and CAVALIER reactors will be shutdown. All occupants will exit the Facility and the senior individual on site will notify the Director of the Peactor Facility or a Reactor Supervisor. If none of them are present, the senior staff member will be in charge until the Director or Supervisor arrive. In addition to calling the people listed below, the Emergency Director should consult the Emergency Plan's Implementing Procedures (EPIP's).

Reactor Facility Staff Home Telephone R.U. Mulder, Director 296-6588 J.P. Farrar, Reactor Supervisor (Administrative) 973-3110 P.E.Benneche,ReactorSupervisor(Operations) 979-3286

8. Hosticka, Senior Operator 977-0416 G.D. Conley, Senior Operatar 823-2457 R.L. Ritenour, Senior Operator 973-2926 T.L. Nguyen, Reactor Operator 978-4531 C.C. Cobb, Reactor Operator 973-4067 Other Emergency Numbers Office Home dp J. Henderson, Health Physicist 4-7589 978-7551 T. Turley, Radiation Safety Tech. 4-7136 295-2703 B.G. Copcutt, Radiation Safety Officer,U.Va. 4-8997/4-7334 978-4666 J.R. Gilchrist, Radiation Safety Office 4-7850 973-2402 University Police 4-7166/4-7167 If deemed necessary, the following organizations will be called:

Rescue Squad 295-1191 Albemarle Police 296-2112 City Police 295-4151 State Police 29? m Fire Department 295-1125 U.Va, Hospital 4-22 .i32 Nuclear Regulatory Comm. (404)221-4503 Va. Office of Virginia Dept. of Health Emergency Serv. (804)323-2300 Radiological Division (804)786-5932 Following evacuation of the Reactor Facility the evacuees will assemble at the primary assembly area under supervision of a Senior Ooerator. The area will be surveyed with a portable survey instrument and its suitability for o:cupancy determined by the Senior Operator.

Upon notification of an emergency at the Reactor Facility, the Health Physicist and personnel of the Radiation Safety Office will proceed immediately to the Reactor site and at the direction of the E.

Director conduct surveys. They will determine which areas, if any, are unsafe and will issue any specific instructions necessary for protection of personnel. They will also monitor the airborne activity, if any, Q'- until it has dispersed to negligible levels.

EPIP-6, ATTACHMENT 1 1 of 2 Last update: 09/30/85

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It ir anticipated that any radioactive releases will be confined O primarily within the reactor room. However, to ensure that protective and corrective actions are taken in the event that levels of l

-radioactivity exceed the limits specified for unrestricted areas by 10 CFR Part 20 the radiation levels at the site boundary downwind from the reactor building will be monitored. (The wind direction and velocity are indicated by instruments located on the main floor of the reactor building.)

If it is determined that airborne radioactivity releases greater than those allowed in unrestricted areas by 10 CFR 20 have occurred or are likely, as indicated by radiation dose rates exceeding 2 mrem /hr at the site boundary, additional, surveys will be made beyond the reactor site boundary to determine the extent of the affected area. If the affected assumedarea to becannot the area beindetennined the downwind in asector timelya (manner, this degrees) sector is 22.5 area will be and the adjacent two sectors to a distance of 2,000 feet radius from the Reactor Facility. Installations within this radius include the Centrifuge Building, McCormick Observatory, the Filtration Plant, the

• Accelerator Building, the Radio Astronomy Building, the Highway Research Council Building, the Mineral Resources and Forestry Building, the University Maintenance Shops, the Students' Dormitories extending to the entrance to Scott Stadium, the Slaughter Recreation Center and the Special Materials Handling Facility.

Once the affected area has been defined, the University Police will, at the E. Director's request, notify personnel in this area that a release of radioactive materi 1 has occurred and provide instructions to

' 'O minimize the effect on the public. The most likely instructions will be for personnel to remain indoors with all windows and doors closed and

! ventilation systems turned off, awaiting further instructions.

Evacuation of specific areas will also be considered. The University

Police will control access to the affected area.

. In the event that individuals at the reactor site are injured in an accident, the Charlottesville-Albemarle Rescue Squad and University Hospital will be notified. An ambulance with advanced life support

capability will be sent immediately to the scene of the accident. If the condition of the injured patient has been stabilized, the patient will be decontaminated to the extent necessary or possible at the i reactor site prior to transfer to the Emergency Medical Service. The University Hospital is prepared to receive and treat at once any individual who has received a significant radiation over-exposure .

t The Emergency Director will notify the University Police and other organizations of the termination of an emergency.

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! Copies of these initial emergency response actions will be posted in prominent places at the Reactor Facility, the Office of the University. Police, the Special Materials Handling Facility, and the

- Radioactive Waste Management Facility. Further detailed emergency procedures are to be found in the Reactor Facility's Emergency Plan and Emergency Plan' Implementing Procedures (EP and EPIP's).

EPIP-6,2ATTACHMENT of 2 1 Last update: 09/30/85

O O EPIP-7 Notification of State and Local Governments Attachments:

1. Report of Emergency to State and Local Governments

2. Report of Radiological Condition to the State

Purpose:

1. To initially notify state and local governments of the declaration of an emergency.

2. To provide periodic status updates to state and local governments during an emergency.

3. To notify state and local governments of any change in emergency status.

User: On-Site emergency team member designated by Emergency Director h to be Emergency Communicator.

Entry Conditions:

Any'one of the following:

a) Emergency is declared E

b) Approximately 30 minutes have passed since last notification l-

! E c) The status of any notification item has changed l

i or d) Entry to EPIP-7 is directed by the Emergency Director, Note: The initial notification of an emergency to state and local governments must be made within 15 minutes following the declaration of the emergency.

I* Erle-7 O^ ' 1 of 10 Last update: 09/30/85 l

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O Procedure No. 7 of the University of Virginia Reactor Facility Plan and be ready to transcribe data onto your copy of Attachment 2 to EPIP-7."

, c. Go to Step 19.

18. Inform the State tha't a " Report of Radiological Conditions (Attachment 2 to EPIP-7) Will Not Be Sent:

a. Use the telephone system to reach the duty officer at the Office of Emergency Services of the State of Virginia at 1-804-323-2300.

b. The following type of message is recommended:

"This is the University of Virginia Peactor Facility, s Charlottesville, Va. Despite the declaration of an (E. Classification) emergency at our Facility, we will not transmit a report of radiological conditions to you at this time since a release of radioactive material has not occurred and is not projected to occur. Please refer to your copy of the University of Virginia Reactor Facility Emergency Plan and associated EPIP-7."

c. Go to Step 32

19. Obtain Radiological Report Form:

a. Find and obtain copy of Attachment 2_, " Report of Radiological Conditions to the State"; located at the end of this procedure.

Note: The initial report of radiological conditions must be transmitted to the state as soon as possible following the declaration of an emergency involving an off-site release of radioactive material and/or the declaration of a General Emergency.

EPIP-7 6 of 10 Last update: 09/30/85

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5. Radiological Survey Assessment Considerations:

{i A. Portable instruments.

1) Portable instruments should be used which are calibrated quarterly against an NBS-traceable source or laboratory standard.

2) These instruments are best used for detector purposes, but are not adequate for quantitative radiation level measurements.

B. Fixed-Instruments:

1) Fixed instruments should be used which are maintained and calibrated by the reactor staff.

2) Measurement data from these instruments is to be used to project dose rates based on further spectral analysis of any filtered effluent and well-accepted Health Physics dose calculations.

C. Low Background Counter:

1) The low background alpha-beta proportional counter located in the low-background counting room is to be the primary instrument used for determining contamination levels inside and outside the Reactor Facility.

- 2) The, counter is to be calibrated during such use with an NBS traceable source or laboratory standard.

D. Results of Surveys and Recommended Corrective Actions are to be given to the Emergency Director.

6. Terminate EPIP-9, "Radiolooical Surveys":

A. Forward completed EPIP and forms to Emergency Director for review and record keeping.

B. Return to initiating EPIP.

EPIP-9 Last update: 08/15/85 8 of 9

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4. Personnel Emergency Exposure Limits Should a situation occur in which emergency personnel are needed for entry into an area of high radiation that would result in personal exposures in excess of 10CFR-20 limits, for the purpose of saving life, reducing property damage or reducing the risk of exposure to the general public, volunteers will be approved by the Emergency Director.

Recommended limits for emergency exposure are 25 Rem, whole body dose to reduce property damage and 75 Rem, whole body dose to save a life.

According to 10 CFR 20.403, if emergency doses have been received, the Administrator of Region II has to be notified of the occurrence by telephone and telex within 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />. A n

k_) written report has to be sent to the Director of Regulatory Operations (or current title), NRC, Wash. D.C. 20545 with a copy to the Administrator of Region II, within 30 days.

If-10CFR-20 exposure limits are indeed exceeded, the Nuclear Regulatory Commission shall be notified in accordance with 10 CFP 20.403.

5. Terminate EPIP-10.

Tenninated by:

Time:

Date:

O EPIP-10 5 of 5 Last update: 09/30/85

s O NEEP Faculty (to be updated periodically)

Presence Film Badge a.(/) 'if here b.(x) if badge on rack Number Name

1. M-2011 John W. Boring

2. M-2046 Jack S. Brenizer

3. M-2172 John J. Dorning

4. M-2014 Robert E. Johnson

5. M-0003 W. Reed Johnson

6. M-2002 James L. Kelly

7. M-2010 Ralph A. Lowry -

8. M-0002 James L. Meem i

9. M-2003 Dale R. Metcalf

^

O 10. M-2009 Albert B. Reynolds

11. M-0213 Rydin, Roger A.

12. M-0004 Williamson, Thomas G.

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EPIP-11, Attachment 1 3 of 8 Last update: 09/30/85

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(9 s NEEP Students (to be updated periodically)

Presence a.(/) if here b.(x) if badge on rack Number Name M-2158 Akers, Sarah L M-2153 Aschbrenner, Roger A M-2221 Azizuddin, Khawia M-2168 Azmy, Yousry Y t'

M-2111 Blaha, Dean M-2175 Caimano, Steven M M-2165 Chrisey, Douglas B M-00853 Coffey, Bruce E M-2165 Comfort, Gary C M-2176 Cui, Shengting M-0803 Feather, Melvin J M-2146 Felber, Joseph L M-2191 Fisher, John M-2217 Fehr, Mary M-2072 Frenier, David J M-2161 Funsten, Herbert 0 M-2154 Hagemeyer, Derek A l M-2132 Halsall, A.C.

EPIP-il, Attachment 1 6 of 8 Last update: 09/30/85 0 -

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( NEEP STUDENTS CONTINUED:

M-2149 Hancock, James W M-0796 Harrell, John R M-2071 Harvie,-Edwin J 1

j M-0850 Heinecke, Steven H M-2148 Hines, William G M-2112 Holman, Robert B M-2220 Holloway, James P M-2177 Howard, Michael A i- M-2164 Jones, David C M-2129 Keller, Karl S

. M-2125 - Kim, Sung Tae

} M-2142 Ku, Jenq-Yann M-2151 LaPrade, Michael N M-2069 Lutz, Jeffrey M-2036 Marshall, Paul M-2145 McArdle, Kevin R i M-2127 0shaughnessy, Dennis J M-2115 Palmer, Jennifer L l

EPIP-11, Attachment 1 7 of 8 Last update: 09/30/85

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O. NEEP STUDENTS CONTINUED:

! M-2156 Payne, Barry M-2193 John Ramsey 9

M-02192 Ralph Reda M-2178 Reimann, Curt T M-2150 Selby, Lorin C M-2147 Stoner, Kevin J M-2047 Sulcoski, Mark M-0798 Swenson, Bruce i M-2179 Tobin, Kenneth W M-2118 Trevisan, Paolo M-2174 Uddin, Rizwan l -

M-2182 Velasco, Santiago M-2152 Waldron, Caroline E

M-2173 Walters, Mark l

M-0849 Ward, Charles M l M-2160 Wilson, Gary L i M-2119 Wilson, Latresia A M-2048 Yauger, David P l

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()- EPIP-11 A tgchment 1 Last update: 09/30/85 1

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'v 4. Re-entry at Termination of Emergency:

, a) Before allowing re-entry to the facility at the termination of 1

! an emergency complete the following check-list:

1) Emergency situation no longer exists.

2) All pertinent EPIP-s have been terminated. ,

1

3) Health Physics personnel have declared the l building is safe.

4) State, local and NRC agencies have been notified of planned re-entry.

5) The Emergency Director has given general re-entry approval.

'6) As per EP 7.4(2), a minimum of 24 hrs has elapsed since the facility evacuation i was called and therefore the emergency 1 has been properly assessed.

5. Terminate EPIP-19 " Reentry":

a) Forward completed EPIP-19 to E. Director for review and record keeping.  :

4 b) Return to initiating EPIP.

c) Close-out:

Completed By:

Time:

Date:

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EPIP-19 3 of 3 Last update: 09/30/85 i

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