Box 21
Records Inventory Data V\T orJcsheet
Sc::e inslrUClions in PubliciJliof! -//76, lnventOIY and Planniny, before cornplelinfjlhis forrn.
lB. GOVERNMENT/AGENCY lb. DEPARTMENT/UNIT
oLJn 0{- Wo..pPII\'Cf>Y
2. RECORDS SERIES TITLE "'i
OL-D W S !-+DO~U ~Le
3. DATESPAN () LO Co yY\ It'\ e. v-C t D-t
~ r } S;-ecJer
{
Irq7- 2-cx:J5:
4. RECORDS SERIESDESCFUPTION (Describe COnLem i'lnd Ch<lraCl(~rislics of records)
'X-\-e (y\ S De bb (e.,
9€\- ~ lD Of
l +ooku ps ) () LO
~lt Pllt'LClJ Robe.-k
5. ARRANGEMENT
o Alphabetical 0 Numerical
o Other (Specify):
6a RETENTJ(JN ~
o Not scheduled Permanent
o Scheduled Tetention:
o Chronological
-~
C r eo..d-con D {S:~ l.s
BOdIe
& oe-S h cA- wCL I\. +-
OLD
LOYl\n\.e rC lQ (
(no b ,-I-e.
o Alphanumeric
o Appraise for historical value
~
~
6b. SCHEDlILEAND ITEM NUMBER, ORREASONPDRPROPOSEDRETENTION
\ ~, lSb
CL{r\W~
o Audiovisual 0 Micrographic
9. TOTAL QUANTITY [In cubic feet ornumber of itcms I'
o Cubic feel:
o Items:
10. ANNUAL ACCUMULATION (In cubic feel arnumber of items).
o Cubic r ee l:
o hems:
11. .P.REQUENCY OF USE,
o Daily 0 Weekly
.12. RES1RlCTIONS ON USE
o MOnLhly
RECORDS ARE
13. 0 IN POOR CONDIT'JON
14. 0 VITAL (EssemialLO operalions)
15 0 OFFlClAL COPIES
16a NAME OF PERSON COMPLETING FORM
. B YOL0n
o Electronic
Type of items:
o Seldom
o Never
16b. DATE
()~
GRS-2 (1212002)
92-7DD:25 92-lq6 CDC