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SHCLEI FERSBMEL DESUtrniM
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NOTE: Proper protective clothing and a Glenaire 9500 respirator with high efficiency filters was worn during the job.
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DO A 116702 CONFIDENTIAL
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Monitoring for
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Employe ID #_____________ Job Classification
Other Chemicots Present:
Type Sample: Personnel [g-'Xrea Excursion OtherDnte JO*___ Description of task performed during monitoring period indudtng any unusual activities^ _
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Time Started.
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Beginning Row Rote ? >0;
Respirator used Yes Q No
Type?
Ending Flow Rale f ? 7j
Calibration Chock Prior to Monitoring? {3 Yes Q No
Calibration:
Bubblemeler
Q Rotometer
O Other
NOTE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
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Wind, Temp, and Humidity
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Other Chemicals Present:
S N2 09217Person or Area Monitorod/^riAi&&
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Employee ID #Classification <2 Type Sample: [EpFersonnel Area Excursion Other-
___________ Date^T-^r^^-
Description of task performed during monitoring period including any unusual activities^r/xc--& j
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Beginning Flow Rale_t5^?i5^. Respirator used gK^ds N
Type?.
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Ending Flow Rate___ 30 ^
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Calibration Check Prior to Monitoring? Q5 Yes No
Calibration: ,0 Bubblemeler
Rotometer
Wind, Temp, and Humidity
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NOTE: J b descripli n must be concise and complete. Qr
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LOUISIANA DIVISION INDUSTRIAL HYGIENE
DO A 116703 r-nwp xnPNTTAL