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CART ADMINISTRATIVE REVIEW OF CASE FILE b6 b7C (leod) Examiner Name: 6D-LA-2 3608l Case ID: UCFN: Report Date: 4/s/osy Admin Reviey Completed By 1ype or Print Ojjicial Name Admin Reviewer's Signature and Date Request Documentation Is the request for examination documented? No If additional communications occurred, were they documented? es No N/A If request was discontinued prior to completion, was all documentation up to that. point retained, and a final report issued documenting the discontinuation? Yes No NA Case Notes (If the case was discontinued before the start of the examination, skip this sectio.. Are all notes in ink? with the exception of sketches No Note: No obliteration, "whiteout" or eraser permitted). Are all corrections made with a single strikeout and initialed by the examiner? Yes No N/A Do all pages of case notes have UCFN or Case ID? Yes) No Do all pages of case notes have examiner's [and technician's] handwritten initials? No Do all pages of case notes have page # of total pages?. No Is each procedure dated? Yes No If procedures are completed by more than one examiner, was each procedure. initialed by the examiner [and technician]? Yes No N/A Is the documentation retained (i.e., 1A envelope)?. No Does the documentation account for total number of pages? Yes No Final Report (i.e. FD302.or Lab Report) contain the following information: Are all the fields filled in correctly on the final report? See EXM-13. Does the Final Report contain the following: 1.Examiner's name? No 2. Examiner's hand written initials on original? No 3. Examiner's Unit? (i.e., CART, NTRCFL) No N/A 4. Examiner's phone number? (acceptable to be included on EC only) No (N/A) 5. UCFN and/or Case ID? No Specimen numbers used to list items? No 7. Evidence control number(s) on evidence list? No 8. Documentation of all processes performed? No 9. Documentation of examination results? 10. Enclosure count? No (N/A) 11. Disposition of evidence, derivative evidence and notes statement? Yes No N/A General: Has the record been closed in the CART Database? Has a peer review been performed and documented? Yes No If CE is sending out AE report, was the AE report administratively reviewed? (HQ only). Yes No(N/A 07/16/2003