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Pert n or Area Monjtor __ I- '*-/ti''
N2 05735---------------------- Sample
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Monitoring tor ~ ' _____
Type Sample: f Personnel Q Area
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Excursion Q Other------------------------------------------
Date-- ___V- ~ I: ^----------------
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Other Chemicals Present:
Job Classification___ *'- r *
7"Description of task performed during monitoring period
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/ -,, ineluding any unusual activities-------- V-- ** '-----------------------------------------------------------------------------------------
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Time Started / ' -** _____ I__ ' Time Stoppad J* - * n ^_________
Beginning Flow Rols__U______ Respirator used Yes Q No
Ending Flow Rate________________
Calibration Check Prior to Monitoring? [' Yes [] No
Calibration: [] Bubblem^ter
[] Rotometer
(3 Other
> > ' <'*) > -
NOTE: Job description must be concise and complete.
IOUISIANA DIVISION INDUSTRIAL HYGIENE
fType?___ f_________
Wind, Temp, and Humidity
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Block. (Lhy C.QL. Monitoring for_ <ro
Other Chemicals Present:
Person or Area Monitored.
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Sample N2 05736
Type Sample: [3 Personnel
Area
[3 Excursion [3 Other.
Date. C * < X
Job Classification_____________________________ Description of task performed during monitoring period
including any unusual activities. /A
J>
_____________
_____
Time Started Time Stopped
<B ' ? 0 -4 ~ ) `fZ-o 3 ' ^
Beginning Flow Rate___ -\'J"
Respirator used [3 Yes [3 No
Ending Flow Rate.
Calibration Check Prior to Monitoring? PTYes No
Calibrati n: [3 Bubblemeter
(3 Rojometer
}' Other i*
______
NOTE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
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Type?--------------------------------Wind, Temp, and Humidity
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Block. Monitoring f r_
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Other Ch micals Pretent:
Pers n or Area Monitored.
Type Sample: 0 Personnel
Area
0 Excursion 0 Other.
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Date
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Job Gassification-------------------------------Including any unusual activities.
.Description of task performed during monitoring period .J1
Tim Started.
>* *- .1C' S
a k* Time Slopped_____ w.-.i/1____
rrBeginning Flow Rate. srEnding Flow Rate.
Respirator used 0 Yes
Calibration Check Prior to Monitoring? 0 Yes 0 No
Calibration: Q Bubblemeter
0 Bolometer
P Other. ^r(S<'S,
NOTE: J b description must be concise and complete.
0 No
LOUISIANA DIVISION INDUSTRIAL HYGIENE
*O* Wt' 1 / */
Type?. Wind, Temp, and Humidity
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Monitoring for.
Other Chemicols Present:
Person or Area Monitored.
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Sample ^0 05776
Type Sample: Q Personnel (2f~Area Excursion Other.
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Job Gassification--------------------------------
.Description of task performed during monitoring period
including any unusual activities.
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Tim Start d_ Time Slopped____ 'o~ ? .
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Beginning Flow Rale__ sj5
Respirator used 0 Yes Q No
Ending Flow Rate. Sc
Co!ibrati n Check Prior to Monitoring? Yes 0 No
Calibration: 0 Bubblemeter
0 Bolometer
0 Other__ 0;/ `V's'Zl---------------------------
NOTE: Job description must be concis and c mplete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
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Type?. Wind, Temp, and Humidity
Form filled in by.