Document Lg7ZGdDQMxmRVzqRq7QqNww3d

ABERDEEN CHEMICAL PLANT-DOSIMETRY RECORD N 2 001036 n,TM 6U> C3HM. ________r n,,. 0-^-9* Sdcial Security No._____________ ____ Job Code y ________ Start Stop Instrument No.____ Time___ (l: ^___AM{ ) PMtrl -6JH____ ) Airflow______________ _________________ HAZARD VCM Lead Total Dust SA^LE.?m,iI3.AJ)'0N (&, 1 - PPM o --Micrograms/M --Milligrams/M^ Sample Time PEL: --MicrpgrSms/M^ Analyst^ d Analysis Date / f Hazard: VCM ( ) Lead ( ) Dust ( ) ( ) N 001036 I came to work atAM ( ) PM ( ) 2. I left work at ------------------------- AM ( ) PM ( ) Firewatch Work? Yes / No (Circle One) 3. I did the regular work of a (enter Job Class)_______ 4. I used a respirator during the following jobs (check one) None Dust Mask Atr-Una Rasp, Scott Alr-Pak 3M Air Hat 5. The following unusual events may have caused me to be overexposed: 6. Other comments and information (Use reverse side of card) Signature_______________________________ Please complete and return to Guard