Document 996DeOBONpKm1G2omzJbZz3g7
ABERDEEN CHEMICAL PLANT^fMfMY RECORD NE (0492 a
>Vi\
Name
Shift AfcJ Date T^/sr
yr--7"
Social Secur n ' A/I--tA ~
_Job Code
Instrument No.
Start
Stop
Time 'ycro .AMMrPM('i ___ 'OAMj^QPMf'
Noise Cell No..
Airflow
HAZARD 'VCM
Lead Antimony Total Dust Noise
SAMPLE CONCENTRATION
(Time Weighted Average)
/Z./p -ppM'
--Micrograms/M J
--Micrograms/M --Milligrams/M^
-% PEL
Samnle Time
PEL:
-- Micrograms/M^
115 dBA? . Yes / No
Analyst Analysis Date
ABDU033'8017
Hlazard^VCM i^'Lead { K^Vntimony ( ) Dust ( ) Noise ( )
-g1. I ,cahie to work at
--AM ( ) PM^f)
2. I left workjat ^... 0 /Q&-- AM h/f PM
3. I did the regular work of a {enter Job Class)
4. I used a respirator during the following jobs (check one
-( ') N2 , 0492a
5. The followuro unusual events may have caused me to be overexposed:
6. Other comments and informatior>4Vse reverse^de of car
Signature.
Please complete and return to Guard