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Contact Name(Required) First Last EmailEnter your preferred email address for followup PhonePlease enter your preferred phone number for follow-upMailing Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Name of Worker First Middle Initial Last Your Relation to WorkerSelect One Self Spouse of Worker Child of Worker Family Member of Worker Other DOE SEC Work SiteSelect OneAllied Chemical, 1-1-59 to 12-31-76, Metropolis, ILAmchitka Island, AK, pre-1974, one day presence, exposure to Long Shot, Milrow, Cannikin testsArgonne National Laboratory-West 1951 to 1957 Scoville, IDAmes Laboratory, Iowa State Univ., 8-13-42 to 12-31-89, Ames, IAAtomics International, sometimes Rocketdyne (originally NAA) sites:— Canoga Avenue (Vanowen Bldg) 1-1-55 to 12-31-60, Canoga Park, CA— DeSoto Avenue 1-1-59 to 12-31-64, Canoga Park, CA— Downey Facility (Vandegraaf Gen) 1-1-48 to 12-31-55, Downey, CA— Santa Susana Field Lab, Area IV (ETEC) 1-1-55 to 12-31-88, Simi Valley, CABaker Brothers, 6-1-43 to 12-31-44, Toledo, OHBattelle Labs, King Avenue, 4-16-43 to 6-30-56Bethlehem Steel, 1-1-49 to 12-31-52, Lackawanna, NYBlockson Chemical, 3-1-51 to 6-30-60, Joliet, ILBrookhaven National Laboratory 1-1-47 to 12-31-93, Upton, NYBWX Technologies, Lynchburg, VA 1-1-85 to 11-30-94; 1-1-68 to 12-31-72; 1-1-59 to 12-31-59Carborundum Company, 1-1-41 to 12-31-67, Niagara Falls, NYClarksville Modification Center 8-1-49 to 12-31-67, Fort Campbell, Clarksville, TNColumbia Univ, SAM Labs (Special Alloy Materials), 8-13-42 to 12-31-47, New York, NYCombustion Engineering 1-1-65 to 12-31-72, Windsor, CTConnecticut Aircraft Nuclear Engine Laboratory (CANEL) 1-1-58 to 12-31-65, Middletown, CTDow Madison, 1-1-57 to 12-31-60, Madison, ILDow Madison, 10-1-47 to 6-30-57, Pittsburg, CAElectro Metallurgical, 8-13-42 to 12-31-47, Niagara Falls, NYFeed Material Production Center, Fernald NLO & AEC, 1-1-54 to 12-31-78; 1-1-51 to 12-31-83 (non NLO workers), Fernald, OHGeneral Atomics 1-1-60 to 12-31-69, La Jolla, CAGeneral Electric Evendale (all employees) 1-1-61 to 6-30-70, Evendale, OHGrand Junction Operations (AEC-DOE), 3-23-43 to 12-31-85, Grand Junction, COHanford/Hanford Engineer Works (includes PNNL), 10-1-43 to 12-31-83; 1984-1990 for employees of Kaiser/J.A. Jones, plus certain subs, Richland, WAHarshaw Chemical – Harvard-Denison, 8-14-42 to 11-30-49, Cleveland, OHHorizons, 1-1-52 to 12-31-56, Cleveland, OHIdaho National Laboratory, 3-1-70 to 12-31-74, one dosimeter, Scoville, IDIdaho National Laboratory (CPP), 1-1-75 to 12-31-80, one dosimeter, Scoville, IDIowa Ordnance Plant (IAAP), Line 1, 5-48 to 3-49; Line 1, radiographers, 3-49 to 12-31-74, Burlington, IAKellex/Pierpont, 1-1-43 to 12-31-53, Jersey City, NJLake Ontario Ordnance Works (LOOW), 1-1-44 to 12-31-53, Youngstown, NYLawrence Berkeley National Laboratory, 8-13-42 to 12-31-61, Berkeley, CALawrence Livermore National Laboratory, 1-1-50 to 12-31-89, Livermore, CALinde Ceramics, 10-1-42 to 12-31-69, Tonawanda, NYLos Alamos National Laboratory, 3-14-43 to 12-31-95, Los Alamos, NMMallinckrodt Chemical Works 1942 to 12-31-58, St. Louis, MOMedina Modification Center 1-1-58 to 12-31-66, San Antonio, TXMetals and Controls (aka Texas Instruments), all workers, 1-1-52 to 9-21-95, Attleboro, MAMIT, Hood Building, 3-9-46 to 12-31-63, Cambridge, MAMound Plant, 9-1-72 to 12-31-72; 1-1-75 to 12-31-76; 10-1-49 to 3-5-80, Miamisburg, OHNevada Test Site 1-27-51 to 1-31-92, Mercury & Jackass Flats, NevadaNorton, 1-1-45-10 to 10-62, Worcester, MANuclear Materials & Equipment (NUMEC), 1-1-57 to 12-31-83, Apollo, PANuclear Materials & Equipment (NUMEC), 6-1-60 to 12-31-80, Parks Township, PANuclear Metals, 10-29-58 to 12-31-79, Concord, MAOak Ridge, TN sites:— K-25 site Gaseous Diffusion Plant, beginning to pre 2-1-92— Oak Ridge Hospital, 5-15-50 to 12-31-59— Oak Ridge Institute for Nuclear Studies Cancer Research Hosp. (ORINS), 5-15-50 to 12-31-63— X-10 Oak Ridge National Lab, 6-17-43 to 7-31-55— S-50 Thermal Diffusion Plant, 7-9-44 to 12-31-51— Y-12 National Security Site, 3-1-43 to 7-31-79— Clinton Engineer Works, 1-1-43 to 12-31-49Pacific Proving Grounds, 1946 to 12-31-62, Eniwetok, Bikini, Christmas & Johnston atollsPaducah Gaseous Diffusion Plant, beginning to pre 2-1-92, Paducah, KYPantex, 1-1-51 to 12-31-91, Amarillo, TXPiqua Organic Moderated Reactor Site, 5-2-66 to 2-28-69, Piqua, OHPortsmouth Gaseous Diffusion Plant, beginning to pre 2-11-92, Piketon, OHRevere Copper and Brass, 7-24-43 to 12-31-54, Detroit, MlRocky Flats, 4-1-52 to 12-31-83, Denver-Boulder, COSandia National Laboratories, 1-1-45 to 12-31-96 Albuquerque, NMSandia National Laboratories, 10-1-57 to 12-31-94, Livermore, CASavannah River Site, all employees 1-1-53 to 9-30-72; 10-1-72 to 12-31-90, subcontractor employees only, those in construction tradesSimonds Saw and Steel, 1-1-48 to 12-31-57, Lockport, NYSpencer Chemical/Jayhawk Works, 1-1-56 to 12-31-61, Pittsburg, KSSt. Louis Airport Storage, 1-3-47 to 11-2-71, St. Louis, MOStandard Oil Development, 8-13-42 to 12-31-45, Linden, NJTexas City Chemicals, 10-5-53 to 9-30-55, Texas City, TXTexas Instruments (aka Metals and Controls), all workers, 1-1-52 to 9-21-95, Attleboro, MATyson Valley Powder Farm, 2-13-46 to 6-30-48, Eureka, MOUniv. of Chicago, Metallurgical Laboratory, 8-13-42 to 6-30-46, Chicago, ILUniversity of Rochester Atomic Energy Project, 9-1-43 to10-30-71, Rochester, NYVentron, 11-1-42 to 12-31-48, Beverly, MAVitro Manufacturing, 8-13-42 to 9-30-65, Canonsburg, PAW.R. Grace, 5-1-56 to 1-31-58, Curtis Bay, MDW.R. Grace, 1-1-58to 12-31-70, Erwin, TNWah Chang, 1-1-71 to 12-31-72, Albany, ORWestinghouse Atomic Power Development Plant, 8-13-42 to 12-31-44, Pittsburg, PAWestinghouse Electric, 8-13-42-12-31-49, (some dates 1958-59), Bloomfield, NJWinchester Engineering and Analytical Center, 1-1-52 to 12-31-61, Winchester, MAOtherWork Site Approximate Year Started Working and Year Stopped WorkingFor example: 1967 – 1983 Type of Cancer (Select One or More) Leukemia Lung Cancer (including sarcoma of the lung) Bone Cancer Bone Cancer – Blood Disorders Renal (Kidney) Cancer Multiple Myeloma Lymphomas (excludes Hodgkin’s) Thyroid Breast Esophagus Stomach Pharynx (oropharynx, nasopharynx and hypopharynx) Small Intestine Pancreas Bile Ducts (includes Ampulla of Vater) Gall Bladder Salivary Glands Urinary Bladder Brain Colon Ovary Liver Other What other condition(s) would you like to explore EEOICPA eligibility for? 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