Document 44JypKjxo1Z0e21JRMpw1o6Ve

A/ Srf iTA 5^*0000356670 ABERDEEN CHEMICAL PLANT-DOSIMETRY RECORD N 2 001086 w.m. ow vcn ______Shiftoat.JhlzlL S6cial Security No------------------------- .--------------------------------- Job Code Instrument No. / ______________ Start______________ ____ Time /:f*___ AM( Stop. AM(V)PM( ) HAZARD VCM Lead Total Dust Airflow_______________ ^srasj^Taa?0'1 A? 1 ' --Micrograms/M^ --Milligrams/M^ _______________ Sample Time PEL: --Micrograms/M^ 0> <3 Analysis Date Hazard: VCM I ) Lead! 1 Dust ( ) t) N 001086 1.1 came to work atAM ( ) 2. i left work at-------------------------- AM ( ) PM ( ) PM ( ) Firewatch Work? Yes / No (Circle One) 3. I did the regular work of a (enter Job Class)________ 4. I used a respirator.during the following jobs (check one) ' Now Oust Mask Alr-Llna Rasp. Scott Atr-Pak JM Atr Hat 5. The following unusual events may have caused me to be overexposed: 6. Other comments and information (Use reverse side of card) Signature___________ !_:___________________ Please complete and return to Guard