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MEDICAL RECORD CONSENT FORM Authorization To Send And Receive Medical Information By Electronic Mail For use of this form see, MED COM Supplement 1 to AR 40-66; the proponent agency is ECHO SECTION
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DA 7652 is the official designation for Form DA 7652, which is a United States Army form used to request and document military leave. It is used by military personnel to apply for both ordinary and emergency leave.
The Departmental Report on Possible Violations Affecting the Interests of the United States (DA Form 7652) is typically filed by Department of the Army personnel. This includes military personnel, civilian employees, and contractors who have information about any possible violations that may affect the interests of the United States.
The DA 7652 form, also known as the Chemical Use, Storage, and Release Report, is used by U.S. Army installations to report information related to the storage, use, and release of hazardous chemicals. The information that must be reported on this form includes: 1. Identification Information: The form requires the name and address of the reporting installation, as well as contact information for the responsible individual or organization. 2. Chemical Inventory: A complete and accurate inventory of all hazardous chemicals stored or used at the installation must be provided. This includes the chemical name, Chemical Abstracts Service (CAS) number, quantity, and storage location. 3. System or Process Information: The form requires a description of the system or process that utilizes the chemicals. This includes details about the equipment, procedures, and any safety measures in place. 4. Emission Sources: Any sources of emissions or releases of hazardous chemicals must be identified on the form. This may include exhaust vents, drains, stacks, or other points of release. 5. Emission Factors: The estimated emission factors and quantities released to the air, water, or land must be reported. This helps in assessing the potential impact on the environment and compliance with regulatory requirements. 6. Storage and Transportation Information: Details about the storage and transportation of hazardous chemicals should be included on the form. This may involve information related to storage containment structures, secondary containment, handling procedures, or transportation routes. 7. Emergency Response Plans: The form requires information about emergency response plans in place for each chemical. This includes procedures for containment, cleanup, and notification in case of spills, releases, or accidents. 8. Compliance Documentation: To demonstrate compliance with applicable regulations, the form may require the attachment of relevant permits, licenses, and other regulatory documentation. It should be noted that the DA 7652 form may vary slightly depending on the specific requirements of each U.S. Army installation. Therefore, it is essential to consult the specific instructions provided with the form and any associated regulations or guidance documents.
The penalty for late filing of DA Form 7652 can vary depending on the specific circumstances and the policies of the particular organization or institution requiring the form. It is recommended to consult the instructions or guidelines provided with the form or to reach out to the relevant authority or personnel responsible for the form's submission for accurate information on any penalties or consequences for late filing.
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