HomeMy WebLinkAbout30622 / 80-03r�rcn zo, 19so � 3
PLTRPOSE: E}CL'II�7D RETIRE��PP DATES
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Sv�',AS, tr�e Citp oi Oshkosh, c,n the 6th r.ay ci :zcu���, �97S, udcp.r�
a Uniform F�ctension Policy for enployees of the oolice and fire departrTents; and
WE�RF'.7�5, the following fire de�art-mPnt personnel have r.�t the requiresrents
of said Uniform E:ttension Policy and have rec��sted a one-year extension of
their e�loyr�nt:
NEIL STARKE - 6th Recfiiest - Fire Departrnent
Date cf Birth: June 22, 1920
Original Retirer�nt Date Was: Jur.e 30, 1975
Eag�loym�nt E;xtznsion 7.7imugh: June 30, 1981
ROBERT H. FSMER - 2nd Re�uest - Fire De�xlrt�nt
Date of Birth: rlay 23, 1924
Original �tire�nt Date P7as: Jtme 30, 1979
�loy�nt Exta_:�sion Thmugh: June 30, 198Z
AL,OIS KR� - lst Request - Fire Departi'rnnt
Date of Birth: Jime 19, 1925
Original Retir�nt Date Is: June 30, 1980
�r�lo;�rznt E�ctension Through: Jun2 30, 1981
NUrI, ZiIER�'Or.c,, BE IT RFSOLVED by the Co�ion Coimcil of the City of Osh_icosh
that 'rhe foregoing ext.erLSions are here�y g*_�anted.
S'iFSidITTL:i BY
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Januarj 2�� 19g0
i:ayor Schiefelbein & Council tiembers:
t•sy na��e is Rob2rt Elr:�er a m�;,b�r oF the Csh}cosn
Fire Depar���enc, I am pr.e;�ntly serving as a Lieu-
tenant, I have been a Fire Fighter for ?_9 years,
I s•�ill be 56 years o1_d rIay 23, I98p, I�;�
I2nU25t1i1C{ � 1 ye�r extension� to my 57tit birth-
day on Atay 23, 1981.
t%y i�in�3ica1 report is enclosed,
Respnctfully yo��rs,
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P.oSert Flmer
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TH� tv9��li��s EX����1f��'��+��J R���D�tT
PO�ICE AND FIRE DEPA2iZ'1dENT'
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(clan ude) / Date
1. Name (priai) � �CO ,� � �'! � �2'-�Z, Dare of bi . /'�" �3 / %L � AS_ V C
�p c_�: �_
4. Signamre of applican � �'- ( ��
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5• Heighc_� / 6. We;Bhr .� 3 0 ✓ 7, Chest�,.�_
Wichoue ahoea Scripped � �Ordiouy clMhn �
8. Eyes;ghc: Snell;n Tesc: Lefc 20/�._° Rig6c 20/�� .
- Correcced m: I.eft 20% - ltight 20/—
U
Bo[6 20/ �v
Both 20%._,SZ
Colot tesc . /�'.�?�^-��"
9. ilearin R ear /� � S : � 5 � .
S� L. ear�l,t_Discharge? ��� 10. Nocn �/L-_ �
11. Dental sun�ey: Dfark teetfi "O" iE capped or pivor, '7" iE missing; "X" iE carious; "E" if false.
R 8��!�Cij � 4 3 2 1 1 2 i 4(� �y, 7 8 L Perfen a�ixyr
Good cepair�q �tk�
8�.i� C3'i `� f� _2 1 �: 1 2 3 4 5 G�� Py�orrhe+ . - - Neal deania.g
12. Tonsil �-�!�� ��`"Or-
� � 13. Throa� ���=`�"�--
14. T'hyra.l �2""-" 15. Speec 7-'"'-�-^�—'-
1G. Lungs: Check for aschma, rubercvlosia broochici9, chest %-ray fiodingn .� __ /�'� �i` �
17. FIeart: Cardio-vascular ryste .
Pulse tata �1�� Blood pressure: Sysrolir �� DiastoUr . `�� _. . . ..
18. Gastro•intestinal tratt: Checl: appendi<
Check foi gas[ric ulczr �
Gall bladder _ p �
19. Geni[o-urinan•: vener�-i1� diseasz � �'-s"��
20.
Wassezman --
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(vore form) 21. V8[icose . _
22. Hnnd� � . ^� 2-� . . . 23. Feer �l� .
`(fiat oc aher co�irion)
24. Booes aod join: ���G'"'�`� � 2j. Spine��
26. Disabili[ies: (a�ronic catarrh, sinus, fistula, rettal diseases, ataaeous diseases, ecc.) _ _.
27. ILlnrss and injurie '`��'��-r . .
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2B. Operacion� ,:" c ��L-c�--.. °%" .L-y ��y--"'
19. Neuroec tendenciea � J��-c,Z.. � �—
30. Could this man perform duty involviug being on his feet fot 12 hou�-s continuonsly?_�_
31. Could chis man erform du '�
P ry involving lon� hours of duty involving sitting or iiding? �' �� ---�
32 Remark� - � �
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I HERiBY CERTIFY THAT THIS 7S AQTRUE RF.CO� O�� 'fIE 1fEDICAL EXluYfINATIO�i O�THE� ABOVF. EXAhIINEE
AND THAT I HAVE FOI7ND Hf�f � UALIPiED� IC�II.LY Tt THE DUTIES OF ^----��
QUALIFIED l/ `� '��"`"'"''"
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DR. WARREN V. HA9-!N
101-A Alfl�e Bouiavard
OSHKOSH, WISCONSIN
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January 21, 1980
Mr. 6Jilliam Frueh
Members of Oshkosh City Couneil
City Hall
Oshkosh , lIi 5�+901
Dear Mr. Frueh and members of the City Council,
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I hereby request an extension of employment with the Oshkosh
Fire Department beyond my normal retirenent date of June 30, 1g80
to June 30, 1g81.
A statement from my Doctor will be forth coming. i9y appointment
for an examination with him is scheduled for February 5, 1980.
Respectfully,
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/(L`_/. ,,r � f i l >4"'' _
Neil C. Starke
Captain of Inspection Bureau
Oshkosh Fire Department
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�D'p ADELMAN PA D.
t OSH�(OSH, tyISCONSIN 54301
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Starke
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Date 2�5___/80
Y'he above is physically able to
perform the3uties of a fire fighter.
NON REP. �
REFlLL _ TIMES
Thls prz,cripl��on can be fl!ed at
MU�IIEA�POlTER ��JG STOR:S
IOrh 8 Oregon $;s. _ CUO Caape Ave.
410 N. A+.3in y. _ � 17 N. Sawy=r St.
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