IS PAGEli - Hanford Site
IS PAGEli - Hanford Site
IS PAGEli - Hanford Site
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DwReceived+IF R A IN EE S Reference:<br />
INFRMAIONRELASEREQUEST _<br />
WHC-CM.3-4<br />
Purpose<br />
1D Number (include revision. volume. etc.)<br />
SSpeech or Presentation ReferenceReot- -g -z<br />
CC<br />
-0<br />
S ulmar<br />
~ CSumarY<br />
.2 CAbstract<br />
C Visual Aid<br />
C3 Speakers Bureau<br />
(Check<br />
only one<br />
suffix)<br />
Thesis or Dissertation Ust attachments.<br />
QManual<br />
C Brochure/Flier<br />
C Software/Database_____________________________<br />
,a<br />
=<br />
_<br />
M Poster Session<br />
C Videotape<br />
Title ,4'4c6~ 5' ., 7L<br />
Controlled Document<br />
BOther3<br />
/4C<br />
'drCe'd<br />
Date Release Require<br />
Unclassified Category Impact<br />
CoIV77n L /0/1q/\ IUC- Level<br />
New or novel (patentable) subject matter? MNo [3 Yes information received from others in confidence, such as proprietary date, trade'<br />
a2<br />
7E<br />
If *Yes', has disclosure been submitted by WHC or other<br />
company?<br />
secrets, and/or inventions?<br />
XNo C3 Yes (identify)<br />
[3 No rC Yes Disclosure No(s).<br />
Copyrights? ~No C3 Yes Trademarks?<br />
If "Yes', has wnttlen permission been granted?<br />
C3 No C3 Yes (Attach Permnission) 1j<br />
'No [3 Yes (identify)<br />
Title of Conference or Meeting Group or Societ Sponsoring<br />
U O- Title of Jou.rnal<br />
Date~s) of C - Will proceedings be published? CYe<br />
EWill material be handed out? C Yes WNo<br />
CHECKL<strong>IS</strong>T FOR SIGNATORIES<br />
Review Required per WHC-CM-3-4 Yes No Reviewer - Signature Indicates Approval<br />
Name (printed) Signature Date<br />
Classification/Unclassified Controlled<br />
Nuclear Information C _ _ _ _ _ _<br />
Patent-General CounselC<br />
Legal-General Counsel C ______<br />
Applied Technology/Export<br />
Controlled Information<br />
or International ProgramC______<br />
WHC Program/Project C<br />
CommunicationsC<br />
RL Program/Project C 1~1 _Z<br />
Publications Services C ic - "A - +;~~. Al/7<br />
Other Program/Project C3 C _____________<br />
Information conforms to all applicable requirements. The above information is certified to be correct.<br />
Yes No INFORMATION RELEASE ADMIN<strong>IS</strong>TRATION APPROVAL STAMP<br />
Audirences AvialCoItne Stamp is required before release. Release is contingent upon resolution of<br />
Transmit to DOE-HQ/Office ofmadtrco<br />
Scientific and Technical Information<br />
Author/Requestor (Printed /S ignatu re)<br />
C<br />
Date<br />
ens<br />
.2...<br />
Intndea'Audiencea.(<br />
~Internal CSponsor External e..Cy1 -'0.. .(<br />
Responsible Manager (Printed/Signature)<br />
Date<br />
2 Date Cancelled Date Disapproved<br />
PaB-76C0-062 (08/91)
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