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Get DA 285-AB-R 2009

Log 300 Case No. b. Name of Physician c. Name and Address of Treatment Facility 25. PERSONAL PROTECTIVE EQUIPMENT AVAILABLE? Yes CHECK APPROPRIATE BLOCK(S) No Yes No 27. EQUIP THIS PERSON WAS ASSOCIATED WITH? (Enter Item No. from Blk 9) 26. ALCOHOL/DRUGS CAUSE/CONT USED? N/A Yes BAC % a. Seat Belt No Unknown 28a. LICENSED TO OPERATE EQUIPMENT b. Restraint System Yes c. Goggles/glasses/visor No Yes 28c. MSF CERTIFIED d. Gloves e. Ear Plugs Yes 28b. MANDATORY 4hr TRAFFIC SA.

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