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DOW CHEMICAL U.S.A. HEARING CONSERVATION PROGRAM
TO:.
DEPT.:.
f DATE:____________ & -/
Your recent audiogram has been reviewed by Dr. Seidemann and his associate (audiologist). Your hearing at this time is:
Q -^Within normal limits in__ noise-induced notch in Has not progressed.
7-
ear(s). Except for ear(6). Has progressed
Need recheck. Please call Ext. 8292 for an appointment.
Showing significant change or abnormality requiring complete audiological workup. Dr. Seidemann and his associate will be in the Medical Department on---------------------------------- -----from 8:00 a. m. to 4:00 p. m. to render this service.
Please arrange your work schedule so that you can be in the Medical Department ait the time specified below. If this appointment cannot be kept, please notify the Medical Depart ment as soon as possible. (Ext. 8292).
On the day of this examination, it is necessary that you either wear ear protection at all times or remain out of noisy areas completely until you have been checked.
Appointment:. Date
Time
Abnormal
Has progressed
Has not progressed
hearing loss in_______________________ hearing loss in_______________________ loss of sensitivity in higher frequencies. Joss of sensitivity in higher frequencies.
.ear (e). jeer(s). .ear(s). .ear(s).
Enforce hearing protection in the presence of excessive noise in order to avoid further progression of loss.
Q Should wear hearing protection when in the presence of excessive noise to avoid loss of hearing.
cc: Plant Superintendent
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00 076474 CONFIDENT! Al
May remain at present work environment Transfer out of present environment
Your recent examination reveals an abnormality that we feel is not related to your work environment, but which should be discussed with your personal physician for possible further Investigation. Copies of results will be mailed to your physician upon request. The medical staff is available for further discussion, if desired.
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Audiogram results will be reported at later date. .
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Regarding your recent health examination:
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Q All test results of your recent examination were normal. No follow-up Is necessary at this time.* .,
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AUDIO
TON OMETRY
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DR'*. EXAM
Rpt Date:
Physically suitable for wearing respirator.
May remain at present work environment
Transfer out of present environment
Your recent examination reveals an abnormality that we feel is not related to your work environment, ' but which should be discussed with your personal physician for possible further investigation. Copies of results will be mailed to your physician upon request. The medical staff is available for further discussion, if desired.
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LOUISIANA DIVISION CHLOROTHENE PLANT PERSONNEL EXPOSURE DATA SHEET
NAME
classification
DATE
n/r-M ^/lf/77
TIME
COMPOUNDS MEASURED
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' 00 0 764 77 conftdfnttai.
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CONFJDFNTTAl
NAME
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DATE
//f/78
The following are the results of your exposure surveys for 77/ 077c /?77 */"
Vinyl Chloride Ethyl Chloride Alpha-Dichloroethane Alpha-Trichloroethane EDC Beta-Tri Chloroethane
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1ST QTR 2ND QTR TBX&EBBRr
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HC1 (annually) Clj (annually) !Joise (annually)
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SIGNATURE 'rtViA^s .j. DATE $- / 7' 7&
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It is my opinion that I have been properly trained with regard to the hazards of vinyl chloride and precautions for its safe use. Signed Date: 8-/7-
Df> 076479 conftdfnttAi,
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1 have been given a review of the hazardous chemicals used in this block and understand the hazards involved and the proper handling of these chemicals. S igned Hate: 3 V 7~ 7^. _
00 076480 confidential
It is my opinion that I have been properly trained with regard to the hazards of vinyl chloride and precautions for its safe use.
T4 5 S' 6& ~ Signed
Date: <?- 7- 7?
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D 076481
CONFTDFNTTAI
I have been given a review of the hazardous chemicals used in this block and understand the hazards involved and the proper handling of these chemicals.
Signed:
Ac^nnMJ.O^
Date: - 7- ? ^ _______________
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N i> T i NETH
*'v ' 2 FILE
94
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UN 1 TUBE 1-339 is : 20. 7 11 29 79
ENSITIUIT1ES 300 2
TINE
0.11 1.05 1.11 1.22 1.34 2.01 2.42 3.43 4.31 5.23 9.04 13.43
3RER BC
0.0476 U 0.1177 T 0.1474 T 0.3347 u 1.4041 T 1.5585 T 32.1735 T 2.5977 TS 0.1992 TS 3.2843 z> 0.0399 1.2242
RRT
0.811 0.105 0.111 0.122 8. 134 8. 201 8.242 0.348 0.431 U.528 0.904 1.343
RF
1.000 1.000 0.221 0.221 0.322 1.000 1.000 0.251 1.000 0.253 1-. 300 0.428
C NRHE
0.2330 < 0.5887 0.1629 uinvl: 3.3699 uinyl: 2.2687 U2: 7.7928 t 418.8928 i 3.2602 R-TRi: 0.9964 1 4.1547 edc: 0.1997
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ISITIUITIES 380
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TIME
8. 13 1.35 ;% t i< 4i :. 22 1.34 2. Ci 1 2.42 3.43 4.31 5.27 9. 03 3.42
HREfi BC
0.1140 U 0.2270 T Ci.2717 T 0.3412 T 2.3134 T 0.9361 T 69:8508 T 15.3873 T 0.2828 TS 12.7161 T 0.8297 US 2.6889
RRT
0.013 8.105 8.111 a. 122 8. 184 8.201 8.242 0.348 0.431 8.527 0.983 1.342
RF
1.000 1.880 0.221 8.221 8.322 1.000 1.808 0.251 1.880 0.253 1.000 0.428
C NAME
8.5701 1 1.1351 1 0.3803 uinyl: 8.7886 uinvl: 3.7328 U2: 4.6896 ! ' 345.2544 1
19.9386 a-tri: 1.0144 1
16.8859 edc: 8.1488 1 5.7544 B-TRi:
INST 2 METH 2 FILE 39 PUN 2 TUBE 1-457 SENSITIUITIES 308 2
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