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BB-5730.051
FEB 05
ION SPECTROMETRY DEVICE DAILY TESTING LOG amm
FEDERAL BUREAU OF PRISONS
U.S. DEPARTMENT OF JUSTICE Date
3erial No.
-att
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Operator Name/Signature
Random No.
Ks)
7
(b)(7)c
NOTE: Pos tive Alarms Must ALSO Be Logged On "POSITIVE ALARM LOG"
Time
Visitor Name
Inmate Name
Reg. No.
Result
Initials
V ey:
150
7) 5'
Pei-
0
r
II
(b)(6)
IIMI
MES
1 13
t
al.
(This form may be replicated via WP)
Sensitive - Limited Official Use only when completed
(b)(7)c