Privacy Act of 1974; System of Records, 14951-14953 [2011-6356]
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Federal Register / Vol. 76, No. 53 / Friday, March 18, 2011 / Notices
requires that all sessions of this meeting
be closed to the public because they will
be concerned with matters listed in
Section 552b(c)(1) of Title 5, U.S.C.
Written Statements: Pursuant to 41
CFR 102–3.105(j) and 102–3.140, the
public of interested organizations may
submit written statements to the
membership of the Strategic Advisory
Group at any time or in response to the
stated agenda of a planned meeting.
Written statements should be submitted
to the Strategic Advisory Group’s
Designated Federal Officer; the
Designated Federal Officer’s contact
information can be obtained from the
GSA’s FACA Database—https://
www.fido.gov/facadatabase/public.asp.
Written statements that do not pertain to
a scheduled meeting of the Strategic
Advisory Group may be submitted at
any time. However, if individual
comments pertain to a specific topic
being discussed at a planned meeting,
then these statements must be submitted
no later than five business days prior to
the meeting in question. The Designated
Federal Officer will review all
submitted written statements and
provide copies to all the committee
members.
Dated: March 11, 2011.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2011–6360 Filed 3–17–11; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
Department of the Air Force
[Docket ID: USAF–2011–0009]
Privacy Act of 1974; System of
Records
AGENCY:
Department of the Air Force,
DoD.
ACTION:
Notice to alter a system of
records.
The Department of the Air
Force is proposing to alter a system of
records notice in its existing inventory
of records systems subject to the Privacy
Act of 1974, (5 U.S.C. 552a), as
amended.
SUMMARY:
The proposed action will be
effective on April 18, 2011 unless
comments are received that would
result in a contrary determination.
ADDRESSES: You may submit comments,
identified by docket number and/
Regulatory Information Number (RIN)
and title, by any of the following
methods:
Emcdonald on DSK2BSOYB1PROD with NOTICES
DATES:
VerDate Mar<15>2010
18:30 Mar 17, 2011
Jkt 223001
* Federal Rulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
* Mail: Federal Docket Management
System Office, 1160 Defense Pentagon,
OSD Mailroom 3C843, Washington, DC
20301–1160.
Instructions: All submissions received
must include the agency name and
docket number or Regulatory
Information Number (RIN) for this
Federal Register document. The general
policy for comments and other
submissions from members of the public
is to make these submissions available
for public viewing on the Internet at
https://www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
FOR FURTHER INFORMATION CONTACT: Mr.
Charles J. Shedrick, 703–696–6488, or
the Department of the Air Force Privacy
Office, Air Force Privacy Act Office,
Office of Warfighting Integration and
Chief Information officer, ATTN: SAF/
XCPPI, 1800 Air Force Pentagon,
Washington DC 20330–1800.
SUPPLEMENTARY INFORMATION: The
Department of the Air Force systems of
records notices subject to the Privacy
Act of 1974, (5 U.S.C. 552a), as
amended, have been published in the
Federal Register and are available from
the FOR FURTHER INFORMATION CONTACT
address above.
The proposed systems reports, as
required by 5 United States Code 552a(r)
of the Privacy Act, were submitted on
March 8, 2011 to the House Committee
on Oversight and Government Reform,
the Senate Committee on Homeland
Security and Governmental Affairs, and
the Office of Management and Budget
pursuant to paragraph 4c of Appendix I
to Office of Management and Budget
Circular No. A–130, ‘‘Federal Agency
Responsibilities for Maintaining
Records About Individuals,’’ dated
February 8, 1996, (February 20, 1996, 61
FR 6427).
Dated: March 10, 2011.
Morgan F. Park,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
F044 AFPC A
SYSTEM NAME:
Medical Assignment Limitation
Record System (August 29, 2003, 68 FR
51998).
CHANGES:
*
*
*
*
*
SYSTEM LOCATION:
Delete entry and replace with
‘‘Headquarters Air Force Personnel
PO 00000
Frm 00058
Fmt 4703
Sfmt 4703
14951
Center, Medical Service Officer
Management Division, Medical
Retention Standards Branch, 550 C
Street West, Randolph Air Force Base,
TX 78150–4727.’’
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
Delete entry and replace with ‘‘All
active duty Air Force members who
develop, as determined by the local
Deployment Availability Working
Group, a medical condition that may
warrant placement on an Assignment
Limitation Code (ALC) in Military
Personnel Data System (MilPDS). This
includes all cases presented to a
Medical Evaluation Board or Physical
Evaluation Board that were returned to
duty and therefore considered for an
ALC. An ALC flags the member in
MilPDS as medical waiver required for
deployments and overseas assignments.’’
CATEGORIES OF RECORDS IN THE SYSTEM:
Delete entry and replace with
‘‘Medical Evaluation and Physical
Evaluation Board packages, Report of
Medical Examination, Report of Medical
History, Narrative Summary, Armed
Forces Health Longitudinal Technology
Application (AHLTA) medical record
documentation, Clinical Record
Consultation Sheet,
Electrocardiographic Record, Pulmonary
Function Testing reports, laboratory
results, commander letters, and
Deployment Availability Working
Group summary. Personally identifiable
information included in the above
records includes name, Social Security
Number (SSN), and date of birth.’’
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Delete entry and replace with ‘‘10
U.S.C. 8013, Secretary of the Air Force;
Air Force Instruction 36–3212, Physical
Evaluation for Retention, Retirement
and Separation; and Air Force
Instruction 36–2110, Assignments; and
E.O. 9397 (SSN), as amended.’’
PURPOSE(S):
Delete entry and replace with ‘‘Collect
applicable medical information and
commander input to determine
appropriate medical Assignment
Limitation Code (ALC).’’
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
Delete entry and replace with ‘‘In
addition to those disclosures generally
permitted under 5 U.S.C. 552a(b) of the
Privacy Act of 1974, these records
contained therein, may specifically be
disclosed outside the DoD as a routine
use pursuant to 5 U.S.C. 552a(b)(3) as
follows:
E:\FR\FM\18MRN1.SGM
18MRN1
14952
Federal Register / Vol. 76, No. 53 / Friday, March 18, 2011 / Notices
The DoD ‘Blanket Routine Uses’
published at the beginning of the Air
Force’s compilation of systems of
records notices apply to this system.
Note: This system of records contains
individually identifiable health information.
The DoD Health Information Privacy
Regulation (DoD 6025.18–R) issued pursuant
to the Health Insurance Portability and
Accountability Act of 1996, applies to most
such health information. DoD 6025.18–R may
place additional procedural requirements on
the uses and disclosures of such information
beyond those found in the Privacy Act of
1974 or mentioned in this system of records
notice.’’
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Delete entry and replace with
‘‘Maintained in hardcopy file folders
and electronic storage media.’’
RECORD ACCESS PROCEDURES:
RETRIEVABILITY:
Delete entry and replace with
‘‘Electronic and hardcopy files are
retrieved by last name and last four
digits of Social Security Number (SSN).’’
SAFEGUARDS:
Delete entry and replace with
‘‘Records are accessed by person(s)
responsible for servicing the record
system in performance of their official
duties. Records are stored in locked
rooms and cabinets and electronic
records are accessible by use of the
Common Access Card (CAC) and site
specific login.’’
RETENTION AND DISPOSAL:
Delete entry and replace with
‘‘Retained in office files for two years or
when no longer needed for reference,
then destroyed by tearing into pieces,
shredding, pulping, macerating,
burning, or deleting.’’
SYSTEM MANAGER(S) AND ADDRESS:
Delete entry and replace with
‘‘Headquarters Air Force Personnel
Center, Medical Service Officer
Utilization Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.’’
Emcdonald on DSK2BSOYB1PROD with NOTICES
NOTIFICATION PROCEDURES:
Delete entry and replace with
‘‘Individuals seeking to determine
whether this system of records contains
information on themselves should
address written inquiries to
Headquarters Air Force Personnel
Center, Medical Service Officer
Management Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.
For verification purposes, individual
should provide their full name, Social
VerDate Mar<15>2010
18:30 Mar 17, 2011
Jkt 223001
Security Number (SSN), any details,
which may assist in locating records,
and their signature.
In addition, the requester must
provide a notarized statement or an
unsworn declaration made in
accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
‘I declare (or certify, verify, or state)
under penalty of perjury under the laws
of the United State of America that the
foregoing is true and correct. Executed
on (date). (Signature)’.
If executed within the United States,
its territories, possessions, or
commonwealths: ‘I declare (or certify,
verify, or state) under penalty of perjury
that the foregoing is true and correct.
Executed on (date). (Signature)’.’’
Delete entry and replace with
‘‘Individuals seeking to access records
about themselves contained in this
system should address written requests
to Headquarters Air Force Personnel
Center, Medical Service Officer
Utilization Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.
For verification purposes, individual
should provide their full name, Social
Security Number (SSN), any details
which may assist in locating records,
and their signature.
In addition, the requester must
provide a notarized statement or an
unsworn declaration made in
accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
‘I declare (or certify, verify, or state)
under penalty of perjury under the laws
of the United State of America that the
foregoing is true and correct. Executed
on (date). (Signature)’.
If executed within the United States,
its territories, possessions, or
commonwealths: ‘I declare (or certify,
verify, or state) under penalty of perjury
that the foregoing is true and correct.
Executed on (date). (Signature)’.’’
CONTESTING RECORD PROCEDURES:
Delete entry and replace with ‘‘The
Air Force rules for accessing records
and for contesting contents and
appealing initial agency determinations
are published in 32 CFR part 806b, Air
Force Instruction 33–332, Air Force
Privacy Program and may be obtained
from the system manager.’’
*
*
*
*
*
F044 AFPC A
SYSTEM NAME:
Medical Assignment Limitation
Record System.
PO 00000
Frm 00059
Fmt 4703
Sfmt 4703
SYSTEM LOCATION:
Headquarters Air Force Personnel
Center, Medical Service Officer
Management Division, Medical
Retention Standards Branch, 550 C
Street West, Randolph Air Force Base,
TX 78150–4727.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
All active duty Air Force members
who develop, as determined by the local
Deployment Availability Working
Group, a medical condition that may
warrant placement on an Assignment
Limitation Code (ALC) in Military
Personnel Data System (MilPDS). This
includes all cases presented to a
Medical Evaluation Board or Physical
Evaluation Board that were returned to
duty and therefore considered for an
ALC. An ALC flags the member in
MilPDS as medical waiver required for
deployments and overseas assignments.
CATEGORIES OF RECORDS IN THE SYSTEM:
Medical Evaluation and Physical
Evaluation Board packages, Report of
Medical Examination, Report of Medical
History, Narrative Summary, Armed
Forces Health Longitudinal Technology
Application (AHLTA) medical record
documentation, Clinical Record
Consultation Sheet,
Electrocardiographic Record, Pulmonary
Function Testing reports, laboratory
results, commander letters, Deployment
Availability Working Group summary.
Personally identifiable information
included in the above records includes
name, Social Security Number (SSN),
and date of birth.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
10 U.S.C. 8013, Secretary of the Air
Force; Air Force Instruction 36–3212,
Physical Evaluation for Retention,
Retirement and Separation; and Air
Force Instruction 36–2110, Assignments
and E.O. 9397 (SSN), as amended.
PURPOSE(S):
Collect applicable medical
information and commander input to
determine appropriate medical
Assignment Limitation Code (ALC).
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
In addition to those disclosures
generally permitted under 5 U.S.C.
552a(b) of the Privacy Act of 1974, these
records contained therein, may
specifically be disclosed outside the
DoD as a routine use pursuant to 5
U.S.C. 552a(b)(3) as follows:
The DoD ‘Blanket Routine Uses’
published at the beginning of the Air
E:\FR\FM\18MRN1.SGM
18MRN1
Federal Register / Vol. 76, No. 53 / Friday, March 18, 2011 / Notices
Force’s compilation of systems of
records notices apply to this system.
Note: This system of records contains
individually identifiable health information.
The DoD Health Information Privacy
Regulation (DoD 6025.18–R) issued pursuant
to the Health Insurance Portability and
Accountability Act of 1996, applies to most
such health information. DoD 6025.18–R may
place additional procedural requirements on
the uses and disclosures of such information
beyond those found in the Privacy Act of
1974 or mentioned in this system of records
notice.
STORAGE:
Maintained in hardcopy file folders
and electronic storage media.
RETRIEVABILITY:
Electronic and hardcopy files are
retrieved by last name and last four
digits of Social Security Number (SSN).
SAFEGUARDS:
Records are accessed by person(s)
responsible for servicing the record
system in performance of their official
duties. Records are stored in locked
rooms and cabinets and electronic
records are accessible by use of the
Common Access Card (CAC) and site
specific login.
RETENTION AND DISPOSAL:
Retained in office files for two years
or when no longer needed for reference,
then destroyed by tearing into pieces,
shredding, pulping, macerating,
burning, or deleting.
SYSTEM MANAGER(S) AND ADDRESS:
Headquarters Air Force Personnel
Center, Medical Service Officer
Utilization Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.
Emcdonald on DSK2BSOYB1PROD with NOTICES
Individuals seeking to determine
whether this system of records contains
information on themselves should
address written inquiries to
Headquarters Air Force Personnel
Center, Medical Service Officer
Management Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.
For verification purposes, individual
should provide their full name, Social
Security Number (SSN), any details,
which may assist in locating records,
and their signature.
In addition, the requester must
provide a notarized statement or an
unsworn declaration made in
accordance with 28 U.S.C. 1746, in the
following format:
18:30 Mar 17, 2011
Individuals seeking to access records
about themselves contained in this
system should address written requests
to Headquarters Air Force Personnel
Center, Medical Service Officer
Utilization Division, Chief, Medical
Retention Standards Branch, Randolph
Air Force Base, TX 78150–4727.
For verification purposes, individual
should provide their full name, Social
Security Number (SSN), any details
which may assist in locating records,
and their signature.
In addition, the requester must
provide a notarized statement or an
unsworn declaration made in
accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
‘I declare (or certify, verify, or state)
under penalty of perjury under the laws
of the United States of America that the
foregoing is true and correct. Executed
on (date). (Signature)’.
If executed within the United States,
its territories, possessions, or
commonwealths: ‘I declare (or certify,
verify, or state) under penalty of perjury
that the foregoing is true and correct.
Executed on (date). (Signature)’.
CONTESTING RECORD PROCEDURES:
NOTIFICATION PROCEDURES:
Jkt 223001
The Air Force rules for accessing
records and for contesting contents and
appealing initial agency determinations
are published in 32 CFR part 806b, Air
Force Instruction 33–332, Air Force
Privacy Program and may be obtained
from the system manager.
RECORD SOURCE CATEGORIES:
Information obtained from military
and civilian medical institutions and
correspondence as related to board
proceedings.
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
[FR Doc. 2011–6356 Filed 3–17–11; 8:45 am]
BILLING CODE 5001–06–P
PO 00000
Frm 00060
Fmt 4703
Sfmt 4703
DEPARTMENT OF DEFENSE
Department of the Army, Corps of
Engineers
Notice of Availability of Draft
Environmental Impact Statement for
the Proposed Honolulu Seawater Air
Conditioning Project, Honolulu, HI
Department of the Army, U.S.
Army Corps of Engineers, DOD.
ACTION: Notice of Availability.
AGENCY:
Pursuant to the National
Environmental Policy Act (NEPA), the
U.S. Army Corps of Engineers, Honolulu
District has prepared a Draft
Environmental Impact Statement (DEIS)
to inform a decision on an application
from Honolulu Seawater Air
Conditioning, LLC to construct a
seawater air conditioning system
(SWAC) at Kaka‘ako on the south shore
of O‘ahu. The applicant’s overall project
purpose is to provide a renewableenergy air conditioning system for
downtown Honolulu buildings. In order
to obtain deep, cold seawater to chill
fresh water that would circulate through
the SWAC system and return it to the
ocean after it has passed through
onshore heat exchangers, the applicant
proposes to construct intake and return
pipelines in adjacent coastal waters. The
proposed pipeline staging and
installation sites are located within the
navigable waters of the United States
and the proposed activity is subject to
the jurisdiction of the U.S. Army Corps
of Engineers. Proposed onshore
improvements and upland
infrastructure are briefly described to
provide an overview of the project, but
their impacts to terrestrial
environmental resources are not a
primary focus of the document.
Of primary federal concern are
potential effects of proposed in-water
construction, including the discharge of
fill material at the offshore pipeline
receiving pit, and operation of the
system on the quality of the human
environment. The DEIS considers
alternative cooling technologies, cooling
station designs and locations, pipeline
installation methods, diffuser location
and depth, and intake design. It
evaluates two alternatives involving
different pipeline alignments. Identified
environmental resources potentially
affected include marine biota and
habitat; water quality; navigation and
other human use; noise; and air quality.
DATES: All written comments must be
postmarked or electronically
transmitted on or before May 2, 2011.
ADDRESSES: Comments may be
submitted in writing to: Mr. Peter C.
SUMMARY:
RECORD ACCESS PROCEDURES:
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
VerDate Mar<15>2010
If executed outside the United States:
‘I declare (or certify, verify, or state)
under penalty of perjury under the laws
of the United States of America that the
foregoing is true and correct. Executed
on (date). (Signature)’.
If executed within the United States,
its territories, possessions, or
commonwealths: ‘I declare (or certify,
verify, or state) under penalty of perjury
that the foregoing is true and correct.
Executed on (date). (Signature)’.
14953
E:\FR\FM\18MRN1.SGM
18MRN1
Agencies
[Federal Register Volume 76, Number 53 (Friday, March 18, 2011)]
[Notices]
[Pages 14951-14953]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-6356]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Department of the Air Force
[Docket ID: USAF-2011-0009]
Privacy Act of 1974; System of Records
AGENCY: Department of the Air Force, DoD.
ACTION: Notice to alter a system of records.
-----------------------------------------------------------------------
SUMMARY: The Department of the Air Force is proposing to alter a system
of records notice in its existing inventory of records systems subject
to the Privacy Act of 1974, (5 U.S.C. 552a), as amended.
DATES: The proposed action will be effective on April 18, 2011 unless
comments are received that would result in a contrary determination.
ADDRESSES: You may submit comments, identified by docket number and/
Regulatory Information Number (RIN) and title, by any of the following
methods:
* Federal Rulemaking Portal: https://www.regulations.gov. Follow the
instructions for submitting comments.
* Mail: Federal Docket Management System Office, 1160 Defense
Pentagon, OSD Mailroom 3C843, Washington, DC 20301-1160.
Instructions: All submissions received must include the agency name
and docket number or Regulatory Information Number (RIN) for this
Federal Register document. The general policy for comments and other
submissions from members of the public is to make these submissions
available for public viewing on the Internet at https://www.regulations.gov as they are received without change, including any
personal identifiers or contact information.
FOR FURTHER INFORMATION CONTACT: Mr. Charles J. Shedrick, 703-696-6488,
or the Department of the Air Force Privacy Office, Air Force Privacy
Act Office, Office of Warfighting Integration and Chief Information
officer, ATTN: SAF/XCPPI, 1800 Air Force Pentagon, Washington DC 20330-
1800.
SUPPLEMENTARY INFORMATION: The Department of the Air Force systems of
records notices subject to the Privacy Act of 1974, (5 U.S.C. 552a), as
amended, have been published in the Federal Register and are available
from the FOR FURTHER INFORMATION CONTACT address above.
The proposed systems reports, as required by 5 United States Code
552a(r) of the Privacy Act, were submitted on March 8, 2011 to the
House Committee on Oversight and Government Reform, the Senate
Committee on Homeland Security and Governmental Affairs, and the Office
of Management and Budget pursuant to paragraph 4c of Appendix I to
Office of Management and Budget Circular No. A-130, ``Federal Agency
Responsibilities for Maintaining Records About Individuals,'' dated
February 8, 1996, (February 20, 1996, 61 FR 6427).
Dated: March 10, 2011.
Morgan F. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
F044 AFPC A
System name:
Medical Assignment Limitation Record System (August 29, 2003, 68 FR
51998).
Changes:
* * * * *
System location:
Delete entry and replace with ``Headquarters Air Force Personnel
Center, Medical Service Officer Management Division, Medical Retention
Standards Branch, 550 C Street West, Randolph Air Force Base, TX 78150-
4727.''
Categories of individuals covered by the system:
Delete entry and replace with ``All active duty Air Force members
who develop, as determined by the local Deployment Availability Working
Group, a medical condition that may warrant placement on an Assignment
Limitation Code (ALC) in Military Personnel Data System (MilPDS). This
includes all cases presented to a Medical Evaluation Board or Physical
Evaluation Board that were returned to duty and therefore considered
for an ALC. An ALC flags the member in MilPDS as medical waiver
required for deployments and overseas assignments.''
Categories of records in the system:
Delete entry and replace with ``Medical Evaluation and Physical
Evaluation Board packages, Report of Medical Examination, Report of
Medical History, Narrative Summary, Armed Forces Health Longitudinal
Technology Application (AHLTA) medical record documentation, Clinical
Record Consultation Sheet, Electrocardiographic Record, Pulmonary
Function Testing reports, laboratory results, commander letters, and
Deployment Availability Working Group summary. Personally identifiable
information included in the above records includes name, Social
Security Number (SSN), and date of birth.''
Authority for maintenance of the system:
Delete entry and replace with ``10 U.S.C. 8013, Secretary of the
Air Force; Air Force Instruction 36-3212, Physical Evaluation for
Retention, Retirement and Separation; and Air Force Instruction 36-
2110, Assignments; and E.O. 9397 (SSN), as amended.''
Purpose(s):
Delete entry and replace with ``Collect applicable medical
information and commander input to determine appropriate medical
Assignment Limitation Code (ALC).''
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
Delete entry and replace with ``In addition to those disclosures
generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974,
these records contained therein, may specifically be disclosed outside
the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
[[Page 14952]]
The DoD `Blanket Routine Uses' published at the beginning of the
Air Force's compilation of systems of records notices apply to this
system.
Note: This system of records contains individually identifiable
health information. The DoD Health Information Privacy Regulation
(DoD 6025.18-R) issued pursuant to the Health Insurance Portability
and Accountability Act of 1996, applies to most such health
information. DoD 6025.18-R may place additional procedural
requirements on the uses and disclosures of such information beyond
those found in the Privacy Act of 1974 or mentioned in this system
of records notice.''
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Delete entry and replace with ``Maintained in hardcopy file folders
and electronic storage media.''
Retrievability:
Delete entry and replace with ``Electronic and hardcopy files are
retrieved by last name and last four digits of Social Security Number
(SSN).''
Safeguards:
Delete entry and replace with ``Records are accessed by person(s)
responsible for servicing the record system in performance of their
official duties. Records are stored in locked rooms and cabinets and
electronic records are accessible by use of the Common Access Card
(CAC) and site specific login.''
Retention and disposal:
Delete entry and replace with ``Retained in office files for two
years or when no longer needed for reference, then destroyed by tearing
into pieces, shredding, pulping, macerating, burning, or deleting.''
System manager(s) and address:
Delete entry and replace with ``Headquarters Air Force Personnel
Center, Medical Service Officer Utilization Division, Chief, Medical
Retention Standards Branch, Randolph Air Force Base, TX 78150-4727.''
Notification procedures:
Delete entry and replace with ``Individuals seeking to determine
whether this system of records contains information on themselves
should address written inquiries to Headquarters Air Force Personnel
Center, Medical Service Officer Management Division, Chief, Medical
Retention Standards Branch, Randolph Air Force Base, TX 78150-4727.
For verification purposes, individual should provide their full
name, Social Security Number (SSN), any details, which may assist in
locating records, and their signature.
In addition, the requester must provide a notarized statement or an
unsworn declaration made in accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
`I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United State of America that the foregoing is
true and correct. Executed on (date). (Signature)'.
If executed within the United States, its territories, possessions,
or commonwealths: `I declare (or certify, verify, or state) under
penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.''
Record access procedures:
Delete entry and replace with ``Individuals seeking to access
records about themselves contained in this system should address
written requests to Headquarters Air Force Personnel Center, Medical
Service Officer Utilization Division, Chief, Medical Retention
Standards Branch, Randolph Air Force Base, TX 78150-4727.
For verification purposes, individual should provide their full
name, Social Security Number (SSN), any details which may assist in
locating records, and their signature.
In addition, the requester must provide a notarized statement or an
unsworn declaration made in accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
`I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United State of America that the foregoing is
true and correct. Executed on (date). (Signature)'.
If executed within the United States, its territories, possessions,
or commonwealths: `I declare (or certify, verify, or state) under
penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.''
Contesting record procedures:
Delete entry and replace with ``The Air Force rules for accessing
records and for contesting contents and appealing initial agency
determinations are published in 32 CFR part 806b, Air Force Instruction
33-332, Air Force Privacy Program and may be obtained from the system
manager.''
* * * * *
F044 AFPC A
System name:
Medical Assignment Limitation Record System.
System location:
Headquarters Air Force Personnel Center, Medical Service Officer
Management Division, Medical Retention Standards Branch, 550 C Street
West, Randolph Air Force Base, TX 78150-4727.
Categories of individuals covered by the system:
All active duty Air Force members who develop, as determined by the
local Deployment Availability Working Group, a medical condition that
may warrant placement on an Assignment Limitation Code (ALC) in
Military Personnel Data System (MilPDS). This includes all cases
presented to a Medical Evaluation Board or Physical Evaluation Board
that were returned to duty and therefore considered for an ALC. An ALC
flags the member in MilPDS as medical waiver required for deployments
and overseas assignments.
Categories of records in the system:
Medical Evaluation and Physical Evaluation Board packages, Report
of Medical Examination, Report of Medical History, Narrative Summary,
Armed Forces Health Longitudinal Technology Application (AHLTA) medical
record documentation, Clinical Record Consultation Sheet,
Electrocardiographic Record, Pulmonary Function Testing reports,
laboratory results, commander letters, Deployment Availability Working
Group summary. Personally identifiable information included in the
above records includes name, Social Security Number (SSN), and date of
birth.
Authority for maintenance of the system:
10 U.S.C. 8013, Secretary of the Air Force; Air Force Instruction
36-3212, Physical Evaluation for Retention, Retirement and Separation;
and Air Force Instruction 36-2110, Assignments and E.O. 9397 (SSN), as
amended.
Purpose(s):
Collect applicable medical information and commander input to
determine appropriate medical Assignment Limitation Code (ALC).
Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
In addition to those disclosures generally permitted under 5 U.S.C.
552a(b) of the Privacy Act of 1974, these records contained therein,
may specifically be disclosed outside the DoD as a routine use pursuant
to 5 U.S.C. 552a(b)(3) as follows:
The DoD `Blanket Routine Uses' published at the beginning of the
Air
[[Page 14953]]
Force's compilation of systems of records notices apply to this system.
Note: This system of records contains individually identifiable
health information. The DoD Health Information Privacy Regulation
(DoD 6025.18-R) issued pursuant to the Health Insurance Portability
and Accountability Act of 1996, applies to most such health
information. DoD 6025.18-R may place additional procedural
requirements on the uses and disclosures of such information beyond
those found in the Privacy Act of 1974 or mentioned in this system
of records notice.
Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:
Storage:
Maintained in hardcopy file folders and electronic storage media.
Retrievability:
Electronic and hardcopy files are retrieved by last name and last
four digits of Social Security Number (SSN).
Safeguards:
Records are accessed by person(s) responsible for servicing the
record system in performance of their official duties. Records are
stored in locked rooms and cabinets and electronic records are
accessible by use of the Common Access Card (CAC) and site specific
login.
Retention and disposal:
Retained in office files for two years or when no longer needed for
reference, then destroyed by tearing into pieces, shredding, pulping,
macerating, burning, or deleting.
System manager(s) and address:
Headquarters Air Force Personnel Center, Medical Service Officer
Utilization Division, Chief, Medical Retention Standards Branch,
Randolph Air Force Base, TX 78150-4727.
Notification procedures:
Individuals seeking to determine whether this system of records
contains information on themselves should address written inquiries to
Headquarters Air Force Personnel Center, Medical Service Officer
Management Division, Chief, Medical Retention Standards Branch,
Randolph Air Force Base, TX 78150-4727.
For verification purposes, individual should provide their full
name, Social Security Number (SSN), any details, which may assist in
locating records, and their signature.
In addition, the requester must provide a notarized statement or an
unsworn declaration made in accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
`I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United States of America that the foregoing is
true and correct. Executed on (date). (Signature)'.
If executed within the United States, its territories, possessions,
or commonwealths: `I declare (or certify, verify, or state) under
penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.
Record access procedures:
Individuals seeking to access records about themselves contained in
this system should address written requests to Headquarters Air Force
Personnel Center, Medical Service Officer Utilization Division, Chief,
Medical Retention Standards Branch, Randolph Air Force Base, TX 78150-
4727.
For verification purposes, individual should provide their full
name, Social Security Number (SSN), any details which may assist in
locating records, and their signature.
In addition, the requester must provide a notarized statement or an
unsworn declaration made in accordance with 28 U.S.C. 1746, in the
following format:
If executed outside the United States:
`I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United States of America that the foregoing is
true and correct. Executed on (date). (Signature)'.
If executed within the United States, its territories, possessions,
or commonwealths: `I declare (or certify, verify, or state) under
penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.
Contesting record procedures:
The Air Force rules for accessing records and for contesting
contents and appealing initial agency determinations are published in
32 CFR part 806b, Air Force Instruction 33-332, Air Force Privacy
Program and may be obtained from the system manager.
Record source categories:
Information obtained from military and civilian medical
institutions and correspondence as related to board proceedings.
Exemptions claimed for the system:
None.
[FR Doc. 2011-6356 Filed 3-17-11; 8:45 am]
BILLING CODE 5001-06-P