Document DG1pDmmx6N178NJx5BQmbg3KN
CTD017929
a^cr/y/ a
F^fersonal [~~1 Environmental
Concentration
Employe* Dept,
_Locatlon/Operatlon
.Classification ^
J-
Punro Used: Bendix C115 Serial #1003
_________
Calibrated
rTIjetSftlx BDX44 Serial #8-77-2322 Checked Calibration Q] Beginning
I 1 Ending
Sampling Medium; f~ipfilter f~~fPad
Screen 1 |
Manufacturer: FZ^Milllpore
.....
Weather Conditions: ( | Hot | | Warm (~>^*Cool ( 1 Steamy
| 1 Humid
Batch j | Rainy | j Dry
windy calm _________________________
Production Rate: . Q Above Normal | t'Normal | | Below Normal
Machine Down
Ventilation:
Comments: Dust Hoods P] Dust Collector 1 cj^tflndows Open 1 | Fans Operating
Air Velocity
Personal Protection: [ | Disposable Respirator P3 Permanent Respirator | |.Power Pack
I 1 White Suit
Face Shield Q, Hearing Protection P^Read Protection
Q-foot Protection Q None Q[
Product in Process: (Furnish) ft'1/`p>
Comments: j | Beard (PJ Smoking
Long Hair
Time Log:
Time Started Pump //. frt)
Flow Meter Reading_ C?</6S7
Time Stopped Pump AREA
J'T/ 7/5i%y/i Flow Meter Reading
TIME READING OUINT
MINUTES IN OUT
TOTAL
SAMPLER:
/O'
TOTAL SAMPLING TIME
_____________ _____________ ___________
Average Air Flow
^ Exposure Time W
CTD017930
1
I
CTD017931
j
Date_ Time_
. . am
AIR SAMPLING DATA SHEET Personal | | Environmental
Sample If '2^> - 7^
Concentration
F/cc
Employee //^/yi~/24^hiJ
M-jV^Employee
.Classification
Dept.
Location/Operation
&LZ<
PL3;
Pump Used: I 1 Bendix C115 Serial #1003
___
fTHendlx BDX44 Serial #8-77-2322
Calibrated
Checked Calibration
Beginning
I fEnding ___
Sampling Medium: QJ'tfilter H3-Pad f~T Screen | | Manufacturer: |~T}-ffillipore f |_________________________
_ Batch *4P/gd'37Xr
Weather Conditions: | | Hot fZ^Warm Q Cool Q Steamy QJ Humid Q Rainy
Dry
I 1 Windy Q Calm Q______________________________________________________________
Production Rate:
| | Above Normal | t/TNormal | | Below Normal
Machine Down
Comments: Ventilation: | | Dust Hoods Q Dust Collector
[T^pWindows Open
Fans Operating
Air Velocity Personal Protection: ( | Disposable Respirator | | Permanent Respirator (
Power Pack
| ^White Suit QQ Face Shield 1 | Hearing Protection [j^"tfead Protection
Protection Q None | |
Product in Process: (Furnish)
Continents: [ | Beard
Smoking
Long Hair
/a ______________________________
Time Log:
Time Started Pump Time Stopped Pump
f/s/'
Flow Meter Reading
_________ Flow Meter Reading_ 7/ 6^;
AREA
TIME READING IN OUT
MINUTES IN OUT
TOTAL
SAMPLER:
CTD017932
TOTAL SAMPLING TIME
______________ ______________ ___________
Average Air Flow '
Exposure Time - /o ,<ro
t/.tc.