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Nal Assessment Witness / External Investigator or Adjuster Property / Equipment Damage Section 1 General Information 1.1 Incident Type, Date and Time Information Incident Type Check any that apply Incident Radiation Involved Near Miss Explosives Involved Date and Time Information Note: Date Format 01-JAN-99 Time Format 24 hr: 18:00 Date Occurrence Date and Time: Primary Incident Type Injury Illness Vehicle Environmental Property / Equip Damage External Assessment Secondary Incident Type(s).

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