Station C - First Aid - Point C-1
For use of this form, see USAIC Pam 350-6. The proponent is USAIS, DOTD.
Candidate's Name______________Rank________Unit_________________
TASK 1: PERFORM MOUTH-TO-MOUTH RESUSCITATION.
EIB TEST SCORE SHEET Station L - Antitank Mine - Point L-2 For use of this form1 see USAIC Pam 350.6, the proponent is USAIS, DOTD. CANDIDATE'S NAME RANK UNIT TASK 1: INSTALL/REMOVE AN M21 METALLIC ANTITANK MINE. PERFORMANCE MEASURES PASS FAIL 1. Used the following steps to install the M21 mine in 4 minutes or less. a. Inspected the mine and equipment. b. Prepared the mine site. C. Inserted the booster. d. Fuzed the mine. e. Emplaced the mine. 1. Assembled the extension rod. g. Armed the mine. h. Camouflaged the mine. 2. Used the following steps to remove the M21 mine in 3 minutes or less. a. Inspected the mine for booby traps and damage or malfunction of the mine. b. Cleaned topsoil from top of mine. c. Attached the band and stop and pull ring assemblies on the fuze. d. Inserted the cotter pin, and spread the ends. e. Removed the extension rod. f. Removed the mine. g. Removed the fuze. h. Installed the closure assembly on the fuze. i. Installed the shipping plug assembly into the fuze well of the mine. j. Removed the closing plug assembly on the bottom of the mine. k. Removed the booster, and reinstalled the closing plug assembly. I. Performed all steps in sequence.
CHECK: PASS______ FAIL______
REASON(S) FOR FAILURE
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SCORER'S SIGNATURE________________DATE________________
Is this a retest? YES______NO______
FB FORM 20-5-R, 17 JAN 97