Box 054
Records Inventory Data V\lorkshe8r
See IflSlIuCliOI1S jn Public iJlIGn '1/76, Jo lIenW,)! aud Planning before cO(J)JJlc ling lhis lann,
~VTIRNMENT/^GENCY lb,
I ,'()\;0 V"\ ~~ WI'R~\'I\~((
~ RECORDS SERIES TITLE \l
V '"' \p v \ \ \( t L f,) I )
3. DAmSPAN \~~ '\J
4. RECORDS SERIES DESCRIPTION (Ii cscribc contenL EJ nu c IIi! 13ClerisLics of recorus)
DEP AR TMIlNT/UNIT
C.iY"''''.~ 1 J" \ It(
~ k~j t> \ \ ~-(.L~{,~ ~
\-. 3v\
~,-"\ \;'-1, \ '<> ~
) c\q ~
~QS)
5. ARRANGEMENT
o AlplJabwcal 0 Numerical
~ Chronological
! 0 Ocher (Specify)
6a. R.ETE!\'TlqN
o Not scheduled 0 Permanent
~ Scbeduled retention
o AlphanumefJc
o Appraise for hisLOrjcal value
~ -5 )) ~
6b. SCHEDULE AND ITEM NUMBER, QRREl\.SON.FORPROPOSEDRETTmON
'~lIS
7. LOCATION ?
Ck-< 'Y\ W i,l ~ ~
! 8. .!J~PJAA T
R Poper 0 AudJOvisual 0 Jv'JJcrograpl1lc 0 EleClrOJ1JC
9 TOT7I.L QUANTITY (In cubleJeel oFnumber of iwms),
'){, CUDIC feel 0 Icems:
Jo. ANNUAL ACCUMULATJON (In cubiC feeL or number of ilems}
1;CUblC [eel, 0 lLems
1]. J7J'cEQUENCY OF USE,
I 0 Daily 0 Weekly 0 Momhly Seldom
12 RESTRICTIONS ON USE
'~ \'\\
RECORDSARE
]]. 0 IN POOR CONDITJON
14. 0 VITAL (EssenLiallO operallons)
15. ')i( OFFlCLAL COPIES
]63. NAJ F PERSON COMPLETING FORM
IN," Yok ,,",,,,,d,, ~ D '~
Type of ilems
o Never
16b, DATE __)
L.l '- t) ~ -() t
I
GRS-2 (J2J20U2)
92-7D~:1S 92.11I6 CDC
fJo xi
16s