Document J3ZZ4xm0Vojn6oEBr8eEdwQ5Z

Organic Vapor Monitor No. 3510 Analysis Service Request (Pre-paid for 3 compounds) Customer Name (Print) Company rlUJ LSB Monitor Number City- State - Zip Telephone Important -- Please record all sampling Information. Place sealed monitor and this form in return mailer. Sampling Date Sampling Time Temperature Relative Humidity rf> (%> Please circle up to three (3) compounds irom the list below. OVM Analysis Service Acetone Acetonitrile Acrylonitrile Allyl Alcohol Ally! Chloride Arttyl Acetate iso-Amyl Acetate n-Amyl Alcohol sec'Amyl Alcohol Benzene Benzyl Chloride Bromoform Butyl Acetate iso-Butyl Acetate sec-Butyl Acetate tert-Butyi Acetate Butyl Alcohol Iso-Butyl Alcohol sec-Butyl Alchol tert-Butyi Alcohol Butyl Ceilosolve Butyl Glycldyl Ether p - tort Butyl Toluene Camphor Carbon Tetrachloride Cedosolve Cellosoive Acetate Chlorobenzene Chlorobromomethane o - Chlorostyrene 0 - Chlorotoluene Chloroform 1 - Chloro I - Nltro propane Cumene Cyclohexane Cyclohexane! Cyclohexanone Cyclohexene Diacetone Alcohol o - Dichlorobenzene p - Dlchlorgbenzene Dichiororrtdthane (Methylene Chloride) Diiaobutyl Ketone (DIBK) Olmethyl Formamide (DMF) Dloxane Enflurane Eplchiorohydrln Ethyl Acetate Ethyl Acrylate Ethyl Benzene Ethyl Bromide Ethyl Ether Ethylene Chlorohydrin Ethylene Dlbromide (EDS) Ethylene Dichloride (EDO) Freon 113 (1,1,2-Trichforo, 1,2,2-Trltiuoroethana) Furfural Halothane Heptane Hexane laophorone Mesityl Oxide Mesltylene Methyl Acetate Methyl Acrylate Methyl Butyl Ketone (MBK) Methyl Celloeoive Methyl Cellosoive Acetate Methyl Ethyl Ketone (MEK) Methyl isobutyi Ketone (M1BK) Methyl Methacrylete Methyl Propyl Ketone Napthaiene n-Octane Pentane Perchloroethylene Phenyl Ether Propyl Acetate Isopropyl Acetate Propyl Alcohol Isopropyl Alcohol Isopropyl Ether Propylene Dlchlorlde (PDO) Stoddard Solvent Styrene 1,1,2,2-Tetrechioroethane Toluene 1.1.1- Trichloroethane (Methyl Chloroform) 1.1.2- Trlchloroethane Trichloroethylene Vinyl Toluene Xylene Because of their high vapor pressures (low boiling points), the starredO compounds are best sampled initially with the 3M #3520 Monitor (with Backup Section). Subsequent sampling may be done with the 3M 3500/3910 Monitor if determined, by #3520 results, that contaminant concentrations are within the 3500/35to capacity limits. Form 23116-B-PWO 3M "Action" 200 Paper Analytical Services Occupational Health and Safety Product* DMsionttM Building 230-B, 3M Center St, Paul, Minnesota 55144-1000 3H 103125 3M OrganlcVaporMoniwT'fJoTSSI 0 Analysis Service Request (Pre-paid for 3 compounds) Company Monitor Number Date City-State-Zip Telephone Important -- Please record all sampling Information. Place sealed monitor and this form in return mailer. Sampling Date Sampling Time Temperature Relative Humidity (F) <%) Please circle up to three (3) compounds from the list below. OVM Analysis Service Acetone Acetonitrile Acrylonitrile Ally! Alcohol Ally! Chloride Amyl Acetate Iso-Amyl Acetate n-Amyl Alcohol sec-Amyl Alcohol Benzene Benzyl Chloride Bromoform Butyl Acetate ieo-Butyl Acetate Sec-Butyl Acetate tert-Butyl Acetate Butyl Alcohol lso*Butyl Alcohol SeC-Butyi Alchol tert-Butyl Alcohol Butyl Cellosolve Butyl Glycldyl Ether p - tert - Butyl Toluene Camphor Carbon Tetrachloride Cellosolve Cellosolve Acetate Chlorobenzene Chlorobromomethane o Chlorostyrene 0 - Chlorotoluene Chloroform 1 - Chloro -1 - Nltro propane Cumene Cyclohexane Cyclohexanol Cyclohexanone Cyclohexene Diacetone Alcohol o Dichlorobenzene p - Dichlorobenzene Dlchloromethane (Methylene Chloride) DiiSObutyl Ketone (DIBK) Dimethyl Formamlde (DMF) DiOxane Enflurane Eplchlorohydnn Ethyl Acetate Ethyl Acrylate Ethyl Benzene Ethyl Bromide Ethyl Ether Ethylene Chlorohydrin Ethylene Dibromlde (EDB) Ethylene Dichloride (EDC) Freon 113 (1,1,2`Triehloro, 1,2,2-Trlfluoroethane) Furfural Halothane Heptane Hexane Isophorone Mesityl Oxide Mesitylene Methyl Acetate Methyl Acrylete Methyl Butyl Ketone (MBK) Methyl Cellosolve Methyl Cellosolve Acetate Methyl Ethyl Ketone (MEK) Methyl Isobutyl Ketone (MIBK) Methyl Methacrylate Methyl Propyl Ketone Napthalene n-Octane Pentane Perchloroethylene Phenyl Ether Propyl Acetate isopropyl Acetate Propyl Alcohol Isopropyl Alcohol Isopropyl Ether Propylene Dichloride (PDO) Stoddard Solvent Styrene 1.1.2.2- Tetrachloroethane Toluene 1,1,1`Trichloroethane (Methyl Chloroform) 1.1.2- Trichloroethane Trichloroethylene Vinyl Toluene Xytene Because of their high vapor pressures (low boiling points), the starred(*) compounds are best sampled Initially with the 3M #3520 Monitor (with Backup Section). Subsequent sampling may be done with the 3M 3500(3510 Monitor If determined, by #3520 results, that contaminant concentrations are within the 3500/3510 capacity limits. Form 23116-B-PWO 3M "Action" 200 Paper Analytical Services Occupational Health and Safety Products Dlvisk>n/3M Building 230*6,3M Center St. Paul. Minnesota 55144*1000 3H 103126 4U