Document QX22QdDb6zw2MKZ62y2L0J066

Please fill out the upper portion of this questionnaire and return it to the registration table by the end of the day or mail it to: J. A. Kvikstad; 3M, 3M Center, OH&SP Division- Bldg. 220-7W-02, St. Paul, MN 55144. Retain the lower portion as your record of attendance so that you may submit it and receive one point toward ABIH Certification. Thank you. 1. Do you feel comfortable with the use of diffusion samplers? Is this a result of the seminar? 2. What primary method do you currently use for personal air sampling? ___________ 3. Do you plan to use 3M Diffusion Samplers in your monitoring program? Please Check One Always Back-Up Only Initial Screening In Conjunction With Other Methods Comments: 4. For which compounds do you desire diffusion samplers? Give priority rank (1_ for high to JO for low). ____ ____ ____ ____ Sulfur Dioxide Amines Carbon Monoxide Formaldehyde ____ ____ ____ ____ Hydrogen Sulfide Isocyanates Ethylene Oxide NO^ ____ Phosgene ____ Other (specify) 5. Did the program, as presented, meet your needs? If not, how should it be changed? ____________________ 6. Have you attended a 3M sponsored Diffusion Air Monitoring Seminar in the past? 7, Other topics that should be considered for seminars. ____________________________ This hereby certifies that ___________________________________________________ has attended the 3M OH&SP Seminar entitled: , 1. . "Field Applications of Diffusional Air Sampling" Beaumont, Texaj> Ma/Lch. 2,1913 3M 105833