Document 4vRbbwG1Or88jY0kJ5XkgBmgQ
ABD00096764
CONOCO CHEMICALS - ABERDEEN PVC PLANT DOSIMETRY CARD (A)
N2SAMPLE
1179
A
CONOCO CHEMICALS - ABERDEEN PVC PLANT DOSIMETRY DATA CARD (B)
Hazard: VCM (<
Lead
Noise (
_ Mp| _ mo
1179
Date /*//<?/& A
Time Clock (Lead Sampling Only) : IN: 6 Yd AM( ) PM(g^QUT: OtyO AM(><QM( ]
mList areas you spent most time in and estimate amount of time (nearest hour is sufficient) spent.
Area
Time
Area
Time
List most likty causes of possible overexposure to the hazard.
T
2..
3..
Check respiratory protection you used:
^^NNoonnee
(( )) DDuusstt MM^^sskk
pp^^]) Air line Respirator
Signature
jLxz*.^
r PPleleasaesecCoommopleleteteaandnd return to guard
( ) Scott Air-pak