Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
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APPOINTMENT OF OPERATIVES TO MOUNT ABRASIVE WHEELS
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Name of Person Appointed
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CONTRACTOR
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APPOINTMENT
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REVOCATION
Appointment Details
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CLASS OR DESCRIPTION OF ABRASIVE WHEEL FOR WHICH APPOINTMENT IS MADE
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DATE OF APPOINTMENT
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SIGNATURE
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DATE OF REVOCATION OF APPOINTMENT