Document DGVxqgpdaM1QQQEDKz4M9qNGB

A I N2 0638 Instrument No. Noise Cell No. Job Code .StartStop Time --------- AWf)^)PM( ) 2 '_AM{ )PMftQ Airflow_______________ ___ HAZARD 1 -V-- ------------------ ----------- ---------------------------------------1 VCM SAMPLE CONCENTRATION (Time Weighted Average) 2, 1 -PPM Lead Q --Micrograms/M Antimony O --Micrograms/M Total Dust O --Micrograms/M Noise -% PEL Air Vol. (Litprs) PEL: --Micrograms/M23 4 115dBA? Yes / No ______________________________________________________ ft : VCM (tT^Lei Hazard Lead ( } 1. I came to work at mony { ) Dust ( ) Noise ( ) AM ( 2. I left work at ___ AM ( 3. I did the regular work of a (enter Job Class) 4. I used a respirator during the following jobs (check one) None Oust Mask A na 1 y Analysis rate fi~ J 7$T'.S ( < ) N2 Work? rcle One) Air-Lfne Resp. Scott * Alr-Pak 3M Air Hat I 5. The following unusual events may have caused me to be overexposed: 6. Other comments and informatio/WUse reverse side of Signature Please complete and return to Guard .1 CONOCO CHEMICALS - ABERDEEN PVC PLANT NOTICE OF MONITORING RESULT A NV 0142 Date From: Subject: VCM ( Lead ( Noise ( ///?/<?/1. You are hereby notified that on was as shown below: Ha zard (> .your exposure to the subject hazard TWA Exposure VCM PEL: 1 PPM J?. / PPM Noise Over ( ) Under ( ) 115dBA % of PEL Lead (Micrograms) TOT: PEL: Per M3 Per M3 2. This exposure was above (/t below ( ) the permissable exposure limit. 3. The corrective measures being taken to reduce exposures to this hazard to safe limits are con tained within the company's written plan. This plan is made available for your inspection in the Safety Department at all times and you are encouraged to review it. 4. Please sign and return this notice?) Employee Signature