Document VjdgKew17Zm19M1ezXVwVgN8K
Certairifeedl
pl-*MT N*ME
INDUSTRIAL HYGIENE MQNr SING DATA SHEET
LOG NO. -aatgL*
EMPLOYEE NAME
T^Tlc
JOj TITLB/ENVIl
AL LOCATION
ItANUFACTURIN
CONTAMINANT
/
FIBERGLASS
a ASBESTOS
TOTAL OUST
SILICA DUST
a ASPHALT FUMES
VINYL CHLORIDE (MONOMER)
FORMALDEHYDE
D PHENOL
PCB
q/noise
SAfcPUNO METHOD
OPEN FACE
CLOSED FACE CYCLONE
a CLOSED FACE a CHARCOAL TUBE
IMPINGERS. TWO IN SERIES SILICAL GEL FLORISIL TUBE
CLOSED FACE AUDIO DOSIMETER
SAK*U
0.8m mcef, meufore filter
5)1 PVC FILTER
&ASS FIBER-SILVER MEM F1LTEI 150 mg- CHARCOAL SODIUM BISULFITE 300 mg. SILICA GEL ISO mg. SKC FL0RHL TUBE GLASS FIBER FILTER
SOdbt 85dba U 90dba
n dupont U P4000 PU*
n OUPONT U P2500 PUMP
n dupont LJ PI00A PUMP
EQUIPMENT
n msa lj PULP
n dupont 0376 LJ DOSMim
n oupont d381 u dosimeter
EXHAUST SYSTEMS/RBMARKS
j--| FUNCTIONING ^ NORMALLY
n NOT FUNCTIONING LJ NORMALLY
WEATHER CONDITIONS
OUTSIDE TDyp
WIND DIRECTION
WIND VELOCITY
SUNNY CLOUDY HUMID
FOG
SHOWERS SNOW
F MPH
CNTRL pu*r
\ %N* SDIIALNC
SAAVLC NO.
MILITARY TIME
START
STOP
TOTAL MINS
LPM/CC
VOLUME LITERS
ANALYSIS RBULT
\ \
G RAIN PTLY. CLOUDY
airborne CONCENTRATION
DIO EMPLOYEE WEAR RESPIRATORY
IF SOMETIMES WHEN?
YES
NO
SOMETIMES
-mCNTRL NO DOS SERIAL
CELL
START (TIME)
STOP
f'Q?//:/o
TOTAL MIN
OIO 0#*LOYEE WEAR HEARING PHU'IELIT
IF SOMETIMES WHENT
H^yes
no
SOMETIMES
REVIRATOR MAKE ft MODEL
i63 8hr corn %
MAKE ft MOOEL
COMMENTS/SKETCHES
01-16-0056 12/81
I
CTD016711
CertainTeedB
\ PLANT NAME
INDUSTRIAL HYGIENE MONr 'RING DATA SHEET
l/J
LOC NO.
SAI^L* TAKEN BY
______ PATE OF TEST _u lmn
_______________________________________________________________________________________
d.
JOm THTJC/ENVIRONMENTAL LOCATION
MANUFACTURING PROCUCT
CONTAMINANT
FIBERGLASS ___ASBESTOS,____________________ ~G TOTAL DUST SILICA, _DLIST " _ ASPHALTIfLM_ I________ I "___VINflT CHLOR|pi_(MONOMER^
FORMALDEHYDE-_____________ " _ ~phenol, ~_____~_____________ "d rel
SAHNUNP METHOO
OPEN FACE
CLOSED FACE _ CYCLONE______________________
' CUJSED_FACE__-_
'P~ CHAJlCOAL_IUBE_"ZZI_
IMPWciRS^ TWO JN JERIES_ ' SILICAL_c|r-___________
FLORisa tube
F!CLOSED^ FACE________________ AUDIO DOSIMETER
SAEVUNG MSMA
0.8ft MCEF, MOUTORE FILTER
" Ifi PV<f FILTER
p__ CUS^FtBaSLVEX MEM FU.1EI o- " jib'mgT CHARCOAL " ~ P~ SODIUM JISULFlTE_- -_ P_ ~ JOO~mg7 JILICAGEJ._______ I50~mg. sicC FLOWSIL TUBE P CLASS _FIBER_FILTER_______
O'fodbl " p, 85db~ _ 9tobT
n DUPONT UP4000 MW
n DUPONT u P'2500 PUMP
n DUPONT up200a pukt
t DUPONT 0376
d3SI
' dosimeter
EXHAUST SYSTEMS/REMARKB
n FUNCTIONING ^ NORMALLY
n NOT FUNCTIONING LJ NORMALLY
WEATHER CONDITIONS
OUT*DC TEVR
WIND DIRECTION
WIND VELOCITY
r
CNTRL
PUft*
\ SAKRLE NO
SERIAL NO
MILITARY TIME
START
STOP
USH
TOTAL MINS
SUNNY roa
Q CLOUDY G HUMID showers mow
LPM/CC
VOLUME LITERS
ANALYSIS RESULT
X
RAIN ptly. cloudy
AIRBORNE CONCENTRATION
DIO PPLOYg WEAR ROHHATORT
IF SOMETIMES WHEN?
REVIRATOR MAKE A MODEL
YES
NO
SOMETIMES
CNTRL NO DOS SERIAL
CELL
START (TIME)
STOP
TOTAL MIM WaAdnoQutrtfwpnu.MT| 8HR CORR %| C"IMWVir"tTMm p--i* tJY-
J4c\
l
^
\>/o_ /pr U37 I fcJ
lYEE WEAR HEARING PHUI'ECO
IF SOMETIMES WHPfl
' uMimAKrE&AuMmODnEL
a/n YES
NO
SOMETIMES
COMMCNTS/SKKTCHE8
01-16-0056 12/81
CTD016712
- :v tL I PUfctHl-U
j f'.M
\* i
89 ri Ot 70
h?
60.
:-0
86 66
64
CTD016713
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i 60
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96
Cr*L
: 98
:
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94
6'/,r:EFIiMHCE 9.SVEI
! |
I
94
CTD016714
-'"` I t 0',-! j, i 95-. ' !
"4
0.00,.: 7- 0 0 ' :4
L 0.
- `O0,i 7 jlr
! 1.0: -
jit-
U0 c. ..00 . = `90-1 - DE>
lOrflr = ;T& DB
-0.00 . 01 m 7 DB
1. T 0.0 * | .'."7 7.
: 0 tM 7 iE = W) DB
, 40,00 / = 9`S'B DB
I. J0.00 - 93;: DB
L b0.C'0 , = '?7 DE
L bB,07 : - 9S DB
L ,90.00 - = 9*7 DB L '99.00 :. =9 3 6 9 DB
94
CO MRU r013009 93
3BB DQ8BL1 MB 95
L E 0 = 9930 DB L- E U/oU - 00 i. DB L FI n.;p.5:. -9B99.0 IiB
L E .! '-e
Tig
,9b
4l'B BOUStlMU Cl
L HDD -
i'E
l. DODC t.0 11 = 9q k 3 DB
L DQD' 95 "1f -9b96, 7 DB
L DOD' 90 j1 = ^-"96,, 1 DB
90
5DB DDUBl^fHt,
97
LuSHIH - 9 4,4* 7jE: LO3HfK90 =9`<94,.7 OB
LQoHfiF:5 1 = '*94.1 DB LDSHfi1-90 > =^3-9 DB
90
1
iia ME1 efb&Imii
nr.
70
tr-lj fz< (.J
69 b bl b1
80
60
90
94
i
CTD016715
. c.
94
9r
4
40 9E
94 96 Q5
91 91
9b 9b 9b
96 ^6
93
be:
9b
96
94
95
95
94
95
96
95 96 96 Cl6
1*4- F9'iNl
10U
99 9?
9h
vr.u
LDSHfi
L- ORRlM^
94 94 . U 99 . ^ '4 7.
94 91
94
AjU ML FRU6QN it
CTD016716
CertainTeedH
INDUSTRIAL HYGIENE MONT TING DATA SHEET
PLAhfT NAME. _
i<TjU)
EMPLOYEE NAME
L9C ^1
SAM'TP^-U' 1-T1AKEN BY^C
1 iJgSPPAARRTMENT/UNC
DATE Of TE3T
d [Inlu^tLi
X TITLE/ENVl WONMENTAL LOCATION
MANUFACTURING PRODUCT
CONTAMINANT f
--S
SAMPLING METHOD
FIBERGLASS ASBESTOS TOTAL DUST SILICA DUST ASPHALT FUMES VINYL CHLORIDE (MONOMER) a formaldehyde PHENOL PCB
O7 NOISE ~G
OPEN FACE
CLOSED FACE CYCLONE CLOSED FACE CHARCOAL TUBE IMPINGERS, TWO IN SERIES S1LICAL GEL FLORISIL TUBE CLOSED FACE cy AUDIO DOSIMETER
SAMPLING MEDIA
G 0.8m MCEF, MUJUPORE FILTER
Q SM PVC FILTER
GLASS FIBER-SILVER MEM FILT5F ISO mg. CHARCOAL SODIUM BISULFITE 300 mg. SILICA GEL ISO mg. SKC FLORISIL TUBE G GLASS FIBER FILTER
yG 80db. G SSdbi G 90db>
rj DUPONT U R4000 PUKP
P2500 pump
r-i DUPONT LJ P200A PUMP
Q MSA U PUMP
n DUPONT D376 u DOSIMETER
n DUPONT o3Sl u DOSIMETER
EXHAUST SYSTEMS/WEMAWKS
r-i FUNCTIONING ^ NORMALLY
n NOT FUNCTIONING U NORMALLY
WEATHER CONDITIONS
OUTSIDE TEMP
WIND DIRECTION
WIND VELOCITY
r
\CNTRL PUMP NOL SERIAL NC
SAMPLE NO.
MILITARY TIME
START
STOP
**H
TOTAL MINS
G SUNNY
POO
G GCLOUDY
HUMID
SHOWERS SNOW
LPM/CC
VOLUME LITERS
ANALYSIS RESULT
G RAIN G PTLY. CLOUDY
AIRBORNE CONCENTRATION
\
DIO P.PLOYEE WEAR RESPIRATOR?^
IF SOMETIMES WHEN?
RESPIRATOR MAKE * MODEL
YES
D NO
SOMETIMES
CNTRL NO
START ITfMEl
r--71
STOP
rGTALM{( nMwmgy 8HR CORR % eowmtp on lp-
TIE
3ID OdPLOIYEE WEAR HEARING PROTECTTT
7YES
NO
SOMETIMES
/ IF SOMETIMES WHEN!1
___________________MMAAKKEE Ha MOOtl
>TZ^*-
f/fj
COMMENTS/SKETCHESi
ps? y7
/Q . -?
%3
01-16-0056 12/81
CTD016717
CertainTeedH
INDUSTRIAL HYGIENE MONIT->RING DATA SHEET Mt HP,------as*aMmPp., t.k-fn ayy---------------------apaaretepocr-nyr
V~W I
*=r
OPARTMENT/UNE
/y^LcX--'
JOB TITLE/PtVl ROMM EKTAL LOCATION
MANUFACTURING PRODUCT
CONTAMINANT
FIBERGLASS _o___ ASBESTOS____ ' "total dust
SILICA DUST _ __ASPHALT _FUMES____________________ _ __VINYL] CHLORIDE_(MONOMER^ ' "formaldehyde
g PHENOL_
PCB
"/^NOISE
trSAMVUNG METHOD
OPEN FACE
_
'
closed face
CYCLONE______ CLOSED FACE'
_ _ CHARCOAL_ TUBE_____________ ] ___ IMPINGERSa TWO JN _SEIUEs"
" SILICAL GEL ~
FLOR1SIL TUBE
CLOSED_ FACE______
fe] AUDIO DOSIMETER^
SAMNJNG MEDIA
0.8*1 MCEF. mUTORE FILTER
5*1 PVC FILTER
GLASS FIBER-SILVER MEM FILTEI P 150 mg. CHARCOAL P__ SODIUM _B]SULFITE_ p"_ll~mg. SILICA cel]
ISO mp. SKC FLORHL TUBE
Q GLASS FIBER FILTER_______ ' 0Odb* "SSdb." " 90dba
JR4000 pu*s>
n FUNCTIONING U NORMALLY
OUTWOC TEMF
CNTRL FUK*
NQ.
RIAL NC
X-
1P2500 pu*s
n DUPONT Urt00A PUM
LJPU*r
EXHAUST SYSTEMS/REMARKS
n DUPONT 0376 U DOSIMETER
n DURONT 0381 ^ DQDMrrU
n NOT FUNCTIONING '"J NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
O CLOUDY HUMID SHOWERS SNOW
. RAIN FTLY. CLOUDY
SAKM NO.
MILITARY TIME
START
STOP
TOTAL MINS
LPM/CC
VOLUME LITERS
ANALYSIS ROULT
AIRBORNE CONCENTRATION
X
PIP PuFLOYEE WEAR REJ1RATORT
IF SOMETIMES WHEN?
1RATOR MAKE A MODEL
YES
NO
SOMETIMES
CNTRL NO DOS SERIAL
(fti 19/9*i I Mf
DID EMPLOYEE WEAR HEARING PROT1
START (TIME!
///o W:
TOTAL MtM wkadoutwkmji.'t 8HW CORR % COHVimB BBi HVB.
/(of
3L4_
IF SOMETIMES WHEN?
MAKE B MOOD.
0^Y| YES
NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016718
CartainTeedlSi
INDUSTRIAL HYGIENE MON1' 1RING DATA SHEET
j)
LOC NO.sSaAmMpPlLeE TtAaKkEeNn byPATE or TEOSTATE^F Tl
ypAHTMEW/UNE
1
JOyriTLE/PWtROfiMEWTAL LOCATION
MANUFACTURING PRODUCT
CONTAMINANT
a FIBERGLASS a ASBESTOS "a" TOTAL DUST _SIUCA_ DUST_____ ASPHALT fvMES a' _V_INYL_ CHLORIDE_(MONOMERJ. "o' _FORM A LDEHYDE^ ~_______ ~ "a" PHENOL
PCB
"noise"
a
a
SAMPLING METHOD
open face
a CLOSED FACE _CYCLONE______
cIoseB'face ___ CHaRCOaL_ TUBE_____________ | _~IMPjNGERSL TWO JN JERIEs"
silicaiTgel
FLORISIL TUBE CLOSED_ FACE______
g-`-AUDIO "dOSImItEr"
SAMPLING MEDIA
0.sit MCEF. MIJLLEPORE FILTER
5(1 FVC FILTER
GLASS FIBER-SILVER MEM F1LTEI ISO mg. CHARCOAL
_ JO'yyM JHSULFITE_
a___lqp_mg^ siuca~gel~ _ ~ _ ""
T50 mg. SKc"FLORIStTTUBE __ GLASS JF1BER_FILTER________
P'Todbi ~ a~ 8 5db~ G 90dbi
1-1 DUPONT U P4B00 PUk
n DUPONT
U PlSOO PUMP
` p200a PUMP
EQUIPMENT Q MSA UPUMP
1 DUPONT 0376
n DUPONT D38I DOSIMETER
EXHAUST SYSTEMS/REMARKS
n FUNCTIONING NORMALLY
OUT9DE TEMP
I-) NOT FUNCTIONING NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
RAIN PTLY. CLOUDY
PUMP SERIAL NO
MWU NO.
MILITARY TIME
TOTAL MINS
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIO EMU.OYEE WEAR RESPIRATOR?
YES
NO
SOMETIMES
CNTRL NO DOS SERIAL
m.
START
DIP Efc^LOYEE WEAR HEARING PROTECT*
YES
NO
SOMETIMES
"T^gDMgTlMES WHEN?
RESPIRATOR MAKE ft MODEL
(TIME!
STOP
TOTAL MIN HDOUTCWl 8HR COHR % gQWVKWTgP BMIPB.
\&j$.MPA/M \23bl %.o
IF SOMETIMES WHEN?
-MftlffiAJdgBBk
COMMENTSi>SKET^MES
01-16-0056 12/81
CTD016719
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016720
01-16-0056 12/81
CTD016721
jb ja o
-- L _ l---------
CertainTeedSi
INDUSTRIAL HYGIENE MONI RING DATA SHEET
LOC NO.
SAMPLE TAKEN BY
DATE OF Tl
_Lz
EMPLOYEE NAME
- fri&un
OEgARTMENT/UNE
ENVIRONMENTAL. LQCJ
r if w
MANUFACTURING PRODUCT
CONTAMINANT
FIBERGLASS
a ASBESTOS a TOTAL DUST a SILICA DUST D asphalt fumes a VINYL CHLORIDE (MONOMER)
FORMALDEHYDE o PHENOL
D PCB
NOISE
SAMPLING METHOD
a OPEN FACE
CLOSED FACE
D CYCLONE
CLOSED FACE CHARCOAL TUBE IMPINGERS. TWO IN SERIES S1LICAL GEL FLOR1SIL TUBE . CLOSED FACE
AUDIO DOSIMETER
SAMPLING MEDIA
0.8)1 MCEF, MILUPORE FILTER
Sji PVC FILTER
GLASS FIBER-SILVER MEM F1LTEI ISO mg. CHARCOAL SODIUM BISULFITE
a 300 mg. SILICA GEL
150 mg. SKC FLORISL TUBE o GLASS FIBER FILTER
jd 80dbi 85dbi D 90dbi
n DUPONT U P4000 PUM>
H FUNCTIONING LJ NORMALLY
OUTSIDE TEMP
jp2500 pump
n DUPONT upI00a pump
EQUIPMENT
qWEA U PUMP
EXHAUST SYSTEMS/REMARKS
NOT FUNCTIONING
] DUPONT 0376 'dosimeter
i DUPONT D3SI
'dosimeter
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY POG
CLOUDY HUMID SHOWERS mow
RAIN PTLY. CLOUDY
GNTRL PUMP NO. SERIAL NO
SAMPLE NO.
MILITARY TIME
TOTAL MINS
LPM/CC
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIO ObffLOYEE WEAR RESPTRATORT
YES
O NO
SOMETIMES
---"--"--I2F ^SO--M---E--T--IME---S----W----H--E---N---?---
RESPIRATOR MAKE & MODEL
NTRL NO DOS SERIAL
CELL
START
M 3 Aj:
>ID CmJLoYEE[ WwcEaAiTffHhEeAaRrIiNnoG PROTECTN
(TIME)
STOP
TOTAL MIN rudoutruult 8HR CORR 1 eowvCTTa BM ItVB.
l?7c Ln Vnl
IIFF SSOOMMEETTIIMMEESS WWHHEENN??1
'
----------wake
A`
MOOEL
CJ YQ
O NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD01
i^rtainieegaa
___ .PLAKpiftME______
EMPLOYEE NAME
INDUSTRIAL HYGIENE MON' TRING DATA SHEET
LQC NO,
S^MPL* TAKEN BY
DATX OF TEST
LMm'
EPARTMENT/UNE
JOB TITLE/environmental location
MANUFACTURING PRODUCT
fyJuLw
CONTAMINANT
FIBERGLASS _g__A_SBESTqS____
~a~ TOTAL DUST
SILICA OUST _ _aspha_lt_fjumes________________ ~_VINYlT CHLORIDEJMONOMER^
__FORM ALDEHYDE^ "_____
_ _ _:q_>henol__: ~__ 2___ z
" PCB
US NOISE
SAMPLING METHOD
open face
a CLOSED FACE CYCLONE
CLOSED FACE CHARCOAL TUBE IMPINCERS, TWO IN SERIES SILICAL GEL FLORIS1L TUBE CLOSED FACE AUDIO DOSIMETER
SAMPLING MEDIA
0.8ft MCEF, M2LUF0RE FILTER
5ft PVC FILTER
GLASS FIBER-SILVER MEM FILTH
ISO mg. CHARCOAL
jopZ's.C___ SODIUM _BISULF1TE_
5___
Jijjca2geI_
150 ms. SKC FLOR1SZL TUBE
C^S_FI.E3_QLIFZ_____ ^SOdbj" riTsdb* G 90dft
n DUPONT UP4000 PUfc*
n FUNCTIONING LJ NORMALLY
OUTSIDE TEMP
i DUPONT JP2500 PUMP
n DUPONT *"* p200a pump
EQUIPMENT
Q MSA `"'PUMP
i DUPONT 0376 1 DOSIMETER
EXHAUST SYSTEM&REMARKS
n NOT FUNCTIONING LJ NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
i DUPONT o38i 1 DOSIMETER
RAIN PTLY. CLOUDY
NO. SpWALf
SAMPLE NO.
MILITARY TIME
TOTAL MINS
LPM/CC
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIO EMPLOYEE WEAR HESPTRATORT
IF SOMETIMES WHEN?
RESPIRATOR MAKE A MODEL
YES
NO
SOMETIMES
DOS SERIAL
START
m
DID EMPLOYEE WEAR HEARING PROTECTS
ITIME1
STOP
TOTAL MIN wkaoout
LSS
IF SOMETIMES WHEN?
flan caws COWVCTTfDBBALtVlL
[ZL %!*
MAKE a MODEL
JQ) YES
O NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016723
CertainTeedEi
PI OUT NAME
NDUSTRIAL HYGIENE MONITOR G DATA SHEET
p
l.OC NO.
awiyTAKEN BY*'
PATE OF TEST.
(.Mb
l3L
JOB TITLE/ENVIRONMENTAL LOCATION
ARTMCNT/UNK MANUFACTURING PRODUCT
CsO>Nt4TiA*iMiuINiuAiMNTr
*
Q FIBERGLASS
a asbestos a TOTAL DUST SILICA OUST a asphalt fumes
__VINYL_ CHLORIDE_(MONOMER^
FORMALDEHYDE
O PHENOL
PCB
0^ NOlSE_
SAAVLINC METHOD
OPEN FACE
CLOSED FACE
a CYCLONE
CLOSED FACE CHARCOAL TUBE IMPINGERS. TWO IN SERIES SILICAL GEL FLORISIL TUBE CLl OSED FACE Zb*aAiUDIO DOSIMETER
SAMPUNC MEDIA
0.8*1 MCEF. MIUJPORE FILTER
D 5*1 PVC FILTER
GLASS FIBER-SILVER MEM FILTEi ISO mg. CHARCOAL
SODIUM BISULFITE 300 mg. SILICA GEL
ISO mg. SKC FLORISIL TUBE _GGLLASSS FIBER FILTER
SOdba SSdba U 90db
r-| DUPONT U R4000 PUMP
n DUPONT
up2500 pukb*
n DUPONT UP200A pum
qMSA uPUMP
EXHAUST SYSTEMS/REMARKS
FUNCTIONING
NOT FUNCTIONING
3 DUPONT 0376
n dupont d3&i *"* DOSIMETER
OUTSIDE TEMP
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY FOG
CLOUDY HUMID SHOWERS SNOW
RAIN PTLY. CLOUDY
GNTTIL PUMP NO. SERIAL NO
SAKPLI NO.
MILITARY TIME
TOTAL MINS
LPM/CC
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIO O^LOYEE WEAR RCOTRATORT
IP SOMETIMES WHEN?
RESPIRATOR MAKE A MODEL
YES
NO
Q SOMETIMES
CNTRL NO- DOS SERIAL
S~~TART
07? 15^//1/3661
(TIMI-E--!
S---T--O---P----
T.OliTi-A---LSMMIlNi 1 m--.-O--jQ.RUi ITIm.Wi Tl.1i 8HhrHMCOWRNH M%Ac---o----r--n----u"a"n u
I -Si\4lC/\ //fT I rK.? 9//
DID ofeLQYEE wsfcn HEARING PROTECT* IF SOMETIMES WHEN?MAKE I. MODEL
YES
NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016724
CertairifeedB
INDUSTRIAL HYGIENE MON1 ~)RING DATA SHEET
(V \
LAffT NAME
LOCNO. SAiMNPP4h-f^cTTAAKKEIMN jByY----------------- OPAftTfgC O?Fr 'TEST_____
rsui.
<z.y*EMPLOYEE NAME cy^tm. JOm TITLgEENNVIRRONMENTAL LOCATION
Myj 1 pfcpAKTMEHT; LI N
'\
MIAANUFACTTUURR1i:NG PRODUCT
CONTAMINANT
FIBERGLASS _ASBESTOS____
'a total dust
SILICA DUST _ASPH ALT_FUMES______________
IQ I _YJNYL~ CHLORipj~(MONOME r
" FORMALDEHYDE ~ PHENOL_ PCB
NOISE
SAAVUNG METHOO
O OPEN FACE
CLOSED FACE
a_ _CYCLONE_____ "5 CLOSED FACE'
charcoal_ tube_____________ ] IMPINGERS^ two jn _sewes_ ' SILICAL gel"
FLOR1SIL TUBE
K CLOSED^ FAC_E______ AUDIO "DOSIMETER""
SAAVUNO MEDIA
0.8(1 MCEF. MILUPORE FILTER
5J1 PVC FILTER
GLASS FIBERS1LVER MEM FILTEI 150 mg. CHARCOAL ___ SODIUM JHSULmE__________ P__ jOo'nst SIUCA~GEL~_____ ~ " "iso mg. SKC~FLORHL tube ~" ___ GGLLAASSS _FIB_ER_FILT_ER_______ '_______Tioiojdb_ SSdba 90db*
n DUPONT up4000 piin*
n DUPONT u P2500 puiiP
n DUPONT LJ p200a pump
qMSA
'-`pun*
t DUPONT D376 J DOSIMETER
EXHAUST 3VSTEMS/REMARK8
n FUNCTIONING LJ NORMALLY
OUTSIDE TOP
n NOT FUNCTIONING LJ NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
O SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
. DUPONT 0381 1 DOSIMETER
RAIN PTLY. CLOUDY
PUMP SERIAL NO
SAK^LE NO.
MILITARY TIME
START
STOP
TOTAL MINS
VOLUME UTERS
ANALYSIS RBULT
AIRBORNE CONCENTRATION
DIO EyLOYEE WEAR HESPtWATOffT
IF SOMETIMES WHENT
ROTIRATOR MAKE A MODEL
YES
NO
d SOMETIMES
DOS SERIAL
START mMEL _ STOP
cmiw41 ^ 1 ii-i^i ^
DID EMPLOYEE WEAR HEARING PROTECT*{ IF SOMETIMES WHENT
YES o/^o
SOMETIMES
TOTAL MIN WA6WWIA1 8hr CORN % coHvnnaBMLJVB.
73 M3
MAKE A MODEL.
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016725
. Y ' i. N r.tlt
J ri
H
pi'i Pij:: ot.o
L u P P fc. r h : -
.; n p
.It ; Lil'.l rlHE-K
n
..i PH:'1 IP FnriCE
Mil PL E R h T E
PTPiJjpV =
Oi.
L.nGP'P'j -
fv:
PHtlPLES = iHTEPRUfjrrj
SITE
.;.ii Yci
- vie
a ;.tv
M 1 F.l P . 4'P
1
DHTE
PJ3ER
I
JMHPL.E Ii 13 l R PI.I'I I UN 1 DE BY
CPI
60
15\
% % * % i_.it;
*
S: 'r. if * * * t + +. ++
4 l'; > * t t ?. t * * * * t-* * t $ T $ T t-* * * *
CTD016726
tr
* * * 00* if +
10.
cy
C| -
1 0`
;r *
, r : F' I 5
1. ft. CuV' - j :' ne
0. 'i 0 ' - 1 IV PE: ; . ft Pi , - i 0. DB
;. . fin = 1 0 HE:
1 . i Pi. ij Pi . - 9!- ne
L c. ft. Pi Pi j - '~*i 1 i E:
L' .70,00.' = 9 ne
L. 7 3.7 7 - 9n 5Ft
L',40 , @0 - 3't DB
!_ : 5B . 80 j
St: DB
L t.0.00' = 8" DB
L " 60.. E7 > = 3i. DB
U' 90 I 00 ' = 80 DB
L'. 9 ,00 ' = fc.i. HE:
. CDMP'.jT 0TIQH'
3DB POUBL MG
L L
t t
0 If
= SO
i '? C= -
4 DB `.4
DB
L E O'. 35 ' =
3 DB
1. t. O' -ft =
DB
4DB I'UUBL M*j
i. :L.- = O r 3 JE-
i. 00 3' .-:0 i = ` l . 1 DB
PCD' 35
* * 1 . 0 IiB
;. nnit- on = < . 9 . K DB
5DE mi EL MG
i.LOHfl = 90 :_r:3H0' so ; = L 0 '3 H H 35 p = L r 3HH'' 90 : -
4 DB
'`0.4 "Pi. 1
; ,^
HE: DB DB
CTD016727
01-16-0056 12/81
CTD016728
01-16-0056 12/81
CTD016729
i___________________ PLAWT KAMI
INDUSTRIAL HYGIENE MONITORING DATA SHEET
LOC NO. 5A*F" TAKEN DY
DATE OF TEST
/ EMPLOYEE NAME
^7?'l j7
Jq4 TITUC/ENVIRONMENTAL LOCATION
__________
MANUFACTURING PROOUCT
CONTAMINANT
SAkTUNG METHOD
FIBERGLASS _O__ASBEST0S_______________________ ~0 TOTAL DOST ____ SILICA, DUST____________________
~ _ASPHALT_FU M ES_ ~ ~ ^_ VJNYlT CHLORipj~(MONOMER^ ~Q _ _FORM A L DEHY D E______ ~
~g_"pjiiNOL_~_______IIIZI.II
' PCB~
~0^~N0isE
a
OPEN FACE
a CLOSED FACE
_ CYCLONE______________________
CLOSED f"aCE_JZZ.Z.T
oTarcomt
' jMPlNGERS^ TWO JN 1|R.1ES_
`cf sjucAL_GEL_:_::::_::
FLORISIL tube
. closed, face________________
: AUDIO DOSIMETER
SAMPLING MEDIA
0.8V MCEF, MUXITORE FILTER
"sjT Pvc" FILTER
.GLASS, FIBER-SILVER ME*^ FU.TEI. a__ is?_mg^ CHARCOAL p~~ SOuiuM *BISULFJTE_:_::_. P~ " J00_m|7 SILICA~G EL___"____^
Tso-mgTlicc'FLORISIL TUBE
a clas?ssjrJ.BJ3-ULTJB________
IIIjSJ'8?0*db1 ~ dTSilba" 90dbi
n oupokt u R4000 pu*
FUNCTIONING
OUTSIDE TEMP
CKmiN PUMP NO. SERIAL NC
(#{05
> DUPONT J P2500 pump
J P200A PUMP
0MA `-'pump
i dupont 0376
b OUPONT 0381 J DOSIMETER
EXHAUST SYSTEMS/REMARKS
|-i NOT FUNCTIONING LJ NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOQTY
SUNNY
POO
CLOUDY HUMID SHOWERS SNOW
RAIN PTLY. CLOUDY
SAMPLE NO.
MILITARY TIME
TOTAL MINS
W tf /(j m.
fSL.
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DID ENyLOYEE WEAR REgfRATORT
20
IF SOMETIMES WHCNT
RESPIRATOR MAKE & MODEL
YES
NO
SOMETIMES
CNTRL NO OOS SERIAL
START
a& 99-fa1 4U I t- io
DHID EWLOYEE WEAR HEARING PROTECTT
fTIMEl
STOP
TOTAL MIN BMaptfrimwiT SHR COBH % etmVBWTWB AM L1YIL
1 2- -511.^7 U m.u I ?
IF SOMETIMES WHEN?
MAKE D-MOOEL-
Q YYEeS
NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
/
CTD016730
C6rtS!!n:!3GCJ! 1
INDUSTRIAL HYGIENE MONITORING DATA SHEET
PLANT NAME
UiIIAma)
LOC NO,
SAMPt
AKEN OT
DATE OF THTT
V EMPLOYEE NAME
-r*vch*-r(?{):
DEPilRTMENTf LI NE
JOQ TITLE/CNVIRONMENTAL LOCATION
MANUFACTURING FPRROOOOUU<CT
CONTAMINANT
SAMPLING METHOD
FIBERGLASS a____ASBESTOS,_______________________________ TOTAL DUST _SILICA, DUST___________________________ ~ ~asphaLt_f_u _ ~VTNYL_ CHLJ>r[dJJMONOMER}] ~ ~FOR M A LDEH Y D E~_________III_ a- phInol "
PCB
~VT NOISE
OPEN FACE
G CLOSED FACE _CYCLONE_________ ]___ CLOSED^ fACE____ ~ ~~~~~~ ' _ ~CHARCOAL, TUBE~"_~"___ " ' B~ " lmILngIrs7 two jn IIries. ~
[aiisiLicAfcEL,:____zzzzzzz
a florisTl tube CLOSED FACE d AUDIO DOSIMETER
SAkVUNG MEDIA
0.8/J MCEF. M1LUPORE FILTER
"O 7(7 PVc" FILTER
_a GLASS^ FIBERSILVER MEM FU-TO
TT_750_m|7 CHARiC0AL _ _ ~
iLI SODIUM _bjsulfite_ "____ '
JT ~ JOO^mgT jilica^geL^_________"
mj7" ISO
SKC-FLOWSIL TUBE
a__ GLABi' FIBER FILTER_________
Cfisdbi Cj90Ub
n DUPONT u R4000 PU**
n OUPONT u R2S00 pump
n DUPONT U P200A puw
qMSA UPUMP
n OUPONT 0376 l"J DOSIMETER
i OUPONT 0381
pi FUNCTIONING LJ NORMALLY
OUTSIDE TEMP
n NOT FUNCTIONING NORMALLY
WIND DIRECTION
EXHAUST SYSTEMS/REMARKS
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
RAIN FTLY. CLOUDY
CNTRL PUMP Na SSEERRIIAAL tNC
SANTLE NO.
HVj)
MILITARY TIME
START
STOP
Xu JK
TOTAL MINS
90/
m.
UPM/CC
12k.
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
2ir
DID EK*LOYEE WEAR RESPIRATOR?
IF SOMETIMES WHEN?
RESPIRATOR MAKE & MODEL
YES
NO
SOMETIMES
CNTRL NO QOS SERIAL
START
o<& ini?) 1 i I %b
DIO Q*LOYEE WEAR HEARIN^ PROTECTS
1YES
Q NO
G SOMETIMES
(TIMEl
STOP
TOTAL MIN W*Q8MTRMSM _SHR CORR % cgnYtrm bm hy&
I z-3i 13?/1^
<34.6 &1.
IF SOMETIMES WHEN? '
|
MAKE a MODEL
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016731
CerteinTbodi 1
EMPLOYEE NAME
INDUSTOIAL HYGIENE MONITORING DATA SHEET
\1
LQC NO. -SAM
EN P*
,0
patc or tict
h\is>V''
PEPARTMENT/UNE
JOB TITLE/ENVIRONMENTAL LOCATION
Of&jSAfaL. (jLyuS
MANUFACTURING PRODUCT
CONTAMINANT
FIBERGLASS ASBESTOS
a TOTAL DUST SILICA DUST
ASPHALT FUMES _ __VIN YL_ CHLORl_DJ_(MONOM_ER2_
FORMALDEHYDE PHENOL PCB
XI NOISE
a
SAUVUNG METHOD
OPEN FACE
a CLOSED FACE
cyclone
CLOSED FACE CHARCOAL TUBE IMPINGERS. TWO IN SERIES SILICAL GEL
FLORISIL TUBE CLOSED FACE O' _ AUDIO J)OSIMETER_
SA***UNG MEDIA
0.8(1 MCEF, MILUFORE FILTER
5(1 PVC FILTER
GLASS FIBER-S1LVER MEM FlLTEJ ISO mg. CHARCOAL
SODIUM BISULFITE 300 mg. SILICA GEL
ISO mg. SKC FLORISIL TUBE GLASS FIBER FILTER
80db. 85<lb. U 90db
n dupont u 1*4000 puw
pi FUNCTIONING NORMALLY
OUTSIDE TEMP
n DUPONT u P2500 pump
. DUPONT J p200a puw
Q MSA l-JPUP
EXHAUST SYSTEMS/REMARKS
NOT FUNCTIONING
1 DUPONT D376
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
i DUPONT D38I J DOSIMETER
RAIN G FTLY. CLOUDY
CNTflL PUMP NO> SERIAL NO( 'F
SAATLE NO.
SHE W-
'jOWl Sf&g
MILITARY TIME
START
STOP
)\-b0
TOTAL MINS
B1
212&
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIO 0*LOYCE WEAR RESPIRATOR?
IF SOMETIMES WHEN?
RESPIRATOR MAKE A MODEL
YES
Q NO
SOMETIMES
QOS SERIAL
START fTIMEl
STOP
TOTAL MIN WABOWiifiULi Stiff CTRR ft 2UIEtlUIUIUk
m 114^ i ?.ti
DID EFWUOYEE WEX~R HEARING PRO ILL IT
2YES
NO
SOMETIMES
r-Z-.3& zq.
IF SOMETIMES WHENr?? ___ /
ill
t&LZ ^4MAKE D MODEL
CQMMENT3/SKCTCHES
01-16-0056 12/81
CTD016732
cerec;n*ocq:
l-LAMT NAME
EMPLOYEE NAME
INDUSTRIAL HYGICNE MONITORING DATA Sllll l
V/
LOG NO.
JAH
taken dy
ly
,,nrt or nriT . __
1
ocpartmcnt/line
JOB TITLE/ENVIRONMENTAL LOCATION
fllnvnJL <>L*. . j
MANUFACTURING PROOUCT
CONTAMINANT
SAPVLING METHOD
FIBERGLASS
OPEN FACE
ASBESTOS
TOTAL DUST
CLOSED FACE
SILICA DUST asphalt fumes
1
CYCLONE CLOSED FACE
VINYL CHLORIDE (MONOMER)
CHARCOAL TUBE
FORMALDEHYDE
IMPINCERS. TWO IN SERIES
PHENOL
S1LICAL GEL
Q PCB
FLORISIL TUBE
/CLOSED face
NOISE
0 AUDIO DOSIMETER
o
SAMPLING MCOIA
0.3JI MCEF, MILUPORE FILTER
S|i PVC FILTER
GLASS nBER-SILVF.K MEM FU.TEJ 150 mi. CHARCOAL SODIUM BISULFITE 300 mg. SILICA CEL 150 mg. SKC FLORISIL TUBE GLASS FIBER FILTER
08Odb SSrtht U 90dtai
n DUPONT U R4000 PUfcff*
n DUPONT u P2S00 PUMP
1 p200a puhp
qMSA LJ PUMP
1 OUPONT 0376 J DOSIMETER
i-i PUNCTIONING *"* NORMALLY
OUTSIDE TEMP
n NOT FUNCTIONING UJ NORMALLY
WIND DIRECTION
EXHAUST SYSTEMS/REMARKS
WEATHER CONDITIONS
WINO VELOCITY
SUNNY
POO
CLOUDY HUMID SHOWERS SNOW
i OUPONT OiHI J DOS!METER
RAIN PTLY. CLOUDY
CNTfll^ NO. SERIAL NO
SAMPLE NO.
(*ot 3
MILITARY TIME
START
STOP
TOTAL MINS
UK <9^5
LJ6_ 2a. IH 4:14 2
LPM/CC
VOLUME UTERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DID P^LOYEE WEAR RESPIRATOR?
w
IF SOMETIMES WHEN?
RESPIRATOR MAKE A MODEL
YES
O NO
SOMETIMES
CNTRL NO | DOS SERIAL
CELL
7
START (TIME!
STOP
TOTTAL MIN
out
f.70 I JW\m Im?
LOYErEr uWiECAiBR uHErtAaRmINfGt MPRilOTECT*
<IrPwSOuMmETuIMrEeSuWiuHnENx?l
8HR CORR % coMxt*wm oma icvp.
\/&.t\ fez>1MAiA/vKEa.AuMAnOmDEL
YES
NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
OTD016733
CertairifeedB
INDUSTRIAL HYGIENE MONIT^IING DATA SHEET
$
PfcAHT KAME-t-- ^SUc.
LOC NO.
SASSIt. TAKEN BY
DATE OF TEST
it
BWjQYg NAME
qjfrARTMEMTlUNE____________________'
JOS TITLE/ENVIRONMENTAL LOCATION
Cffc fui&. \kf^
manufacturing proouct
CONTAMINANT
FIBERGLASS ____ ASBESTOS____
TOTAL DUST SILICA DUST _ _ _ASPH ALT_FUM ES^_______________
\TNYL_CHLORIDE_(MONOMEr ' ~ JFORMALDEHYDE____________
PJENOL______________________ " "PCB
NOISE
SAIWTUNG METHOO
OPEN FACE
CLOSED FACE _CYCU)NE______
CLOSED FACE' ___ CHARCOAL, TUBE_____________ ' ___ impingersT two jn "seriIs_ ' silicaC gel
FLORISIL TUBE _ CLOSED. FAC_E______ O^AUDIO DOSIMETER-
MMUNG MEDIA
O.Sp MCEF, MLUFORE FILTER
Sfi PVC FILTER
(IASS FIBER-SILVER MEM FU.TEX ___ _1 S__5fc. CHARCOAL _ _ SODIUM _BISULFITE__________ _Cf _ JOO~mT l[llCA_GEJ.________ ' ISO nig. SKC FLORI9L TUBE GLASS FIBER FILTER________
'j^80dbi~'cr SSdbi 90db
n DUPONT U R4000 RAP
n DUPONT U F2S00 PUKS*
n OUPONT u p200a puk*
1 OUPONT 0376
1 OUPONT D3&1 J DOSIMETER
pi FUNCTIONING 1-1 NORMALLY
OUTSIDE THkP
n NOT FUNCTIONING LJ NORMALLY
WIND DIRECTION
EXHAUST 3YSTEMS/REMARKS
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS
RAIN PTLY. cloudy
CNTOL NO. SERIAL NC
SAMPLE NO.
MILITARY TIME
TOTAL MINS
LPM/CC
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DIP EMM-QVEE WEAR RESFTRATOR7
IF SOfcOTIMES WHEN?
YES
NO
SOMETIMES
**TRL NO DOS SERIAL
CELLSTART JT1ME1
STOP
TOTAL MIN iWADOtr
o%b\9m\ n<4 1 f.ii-11 a I 3^W
DIO EXyUQYEE WEAR HEARING PROTECTT
d YES
NO
SOMETIMES
IF SOMETIMES WHEN!
COMMENTS/SKETCHES
RESPIRATOR MAKE At MODEL
8hr corn *
m.
fro
WMg ft MPPB.
01-16-0056 12/81
CTD016734
CertainTeedSi
VtMfrlOYEE NAME
INDUSTRIAL HYGIENE MONI RING DATA SHEET
K
IOC NO._____SAMPfc&JAKgN BY-*
PATT-gF TCT
Vi
OEP^TTMEMT/UNE____________________
JOB TITLE/ENVIRONMENTS. LOCATION
MANUFACTURING PROOUCT
CONTAMINANT
FIBERGLASS o ASBESTOS
TOTAL DUST
a SILICA DUST
ASPHALT FUMES
VINYL CHLORIDE (MONOMER)
Q FORMALDEHYDE
PHENOL
a PCB
. NOISE
a
SAK9LING METHOD
OPEN FACE
CLOSED FACE
a CYCLONE a CLOSED FACE a CHARCOAL TUBE a IMPINGERS, TWO IN SERIES
SIL1CAL GEL D FLORISIL TUBE CLOSED FACE
AUDIO DOSIMETER
SAMPLING MEDIA
0.8m MCEF, MILUPORE FILTER
Sfi PVC FILTER
a GLASS FIBER-SILVER MEM F1L1EF
ISO mg. CHARCOAL SODIUM BISULFITE 300 mg. SILICA GEL
o ISO mg. SKC FLORISIL TUBE GLASS FIBER FILTER
G 80dbi 8Sdbi a 90dbi
n DUPONT U R4000 FUKT
n DUPONT U P2500 PUMP
n DUPONT U P200A PUh*
qMSA U PUMP
1 DUPONT 0376
y DUPONT d3SI 1 DOSIMETER
r-y FUNCTIONING LJ NORMALLY
OUTSIDE TEhV
n NOT FUNCTIONING UJ NORMALLY
WIND DIRECTION
EXHAUST SYSTEMS/REMARKS
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOG
Q CLOUDY
HUMID
SHOWERS SNOW
RAIN PTL*. ri.fX.g3Y
c?mjL pPUi MP
noi* i AL NG
SAMPLE NO.
MILITARY TIME
TOTAL MINS
LPM/OC
VOLUME LITERS
ANALYSIS RESULT
AIRSORNE CONCENTRATION
DIO ExyUQYEE WEAR REgfRATORT
IF SOMETIMES WHENT
RESPIRATOR MAKE * MODEL
YES
Q NO
SOMETIMES
CNTRL NO DOS SERIAL
START
om9/-m l?3 \
DIO EMPLOYEE WEAR HEARING PROTECT*
'
(TIME!
STOP
4TOOTTAAL MIN mmtAaOoowvtMwikUwLi SWR CORR % fiffrrrpTW PA igyp
fpTW^
9^.4
'IFIFGSnOMMEETTlMIMBE*Sv WHEfnl
I
MAKE a MODEL
YES
Q NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016735
uerc3sn-:seq:. L
PLAMT NAME
W
9INDUSTRIAL HYGIENE MONITORING DATA SHEET
---
LW N ,
TAKEN DY
DATE Of TEST
employee name
V~~
JOB TITLE/environmental location
MANUFACTURl
CONTAMINANT
SAMPLING METHOD
FIBERGLASS
OPEN FACE
ASBESTOS
TOTAL DUST
closed face
SILICA DUST
CYCLONE
ASPHALT FUMES
closed face
VINYL CHLORIDE (MONOMER)
CHARCOAL TUBE
FORMALDEHYDE
a IMPINGERS. TWO IN SERIES .
PHENOL
a SILICAL GEL
a PCB
o FLORISIL TUBE
CLOSED FACE
Cr NOISE n
__ P'' AUDIO DOSIMETER
SAMPLING MEDIA
0.8(1 MCEF, MILLIFOKE FILTER
S(1 PVC FILTER
GLASS FIBER-SILVER MEM FILTEf ISO mg. CHARCOAL SODIUM BISULFITE 300 mg. SILICA GEL ISO mg. SRC FLORISIL TUBE
a GLASS FIBER FILTER
JZC80dt 8Sdh* U 90dbi
-
n ouFCNT u P4000 pu**
n dlpont u P2500 pump
J p200a pump
1 DUPONT D376
s DUPONT 0341
EXHAUST SYSTEMS/REMARKS
pi FUNCTIONING LJ NORMALLY
OUTSIDE TEMP
v--
CNTRL PUMP NO SERIAL NG
NOT FUNCTIONING
WIND DIRECTION
WEATHER CONDITIONS
WIND VELpCITY
SUNNY
FOG
CLOUDY HUMID SHOWERS SNOW
RAIN FTLY. CLOUDY
SAMPLE NO
MILITARY TIME
START
STOP
TOTAL MINS
MM m
LPM/CC
ML
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
2
DID 0*LOYCE WEAR RESPIRATOR?
IF SOMETIMES WHEN?
RESPIRATOR MAKE A MODEL
O YES
NO
SOMETIMES
CNTRL NO DOS SERIAL
START ITlMEj
STOP
m CTBH&TOTAL MIN N*oowTiMa _&HR CQRR
ggmnnm ass usybl
1i f-3o *3s %6.
3ls
DIO .OuWLOYEE WEAR HEARING PROTECT*
ir SOMETIMES WHOP
MAKE A MODEL
i VB
NO
SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016736
01-16-0056 12/81
CTD016737
certain laea.^i
INDUSTRIAL HYGIENE MONITORING DATA SHEET
LOG NO.
JQQ TITLE/ENVIRONMENTaL LOCATION
MANUFACTURING PRODUCT
CONTAMINANT
SAMPLING METHOD
FIBERGLASS ASBESTOS TOTAL DUST SILICA DUST a ASPHALT FUMES VINYL CHLORIDE (MONOMER) FORMALDEHYDE PHENOL a FCB
-tT8 NOISE
o OPEN FACE
CLOSED FACE a CYCLONE a CLOSED FACE CHARCOAL TUBE 1MPINGERS. TWO IN SERIES ' SIL1CAL GEL FLORISIL TUBE CLOSED FACE O'"' AUDIO DOSIMETER
EQUIPMENT
l-i DUPONT U P4000 PU***
r*1 DUPONT U P2S00 PUMP
r-i DUPONT LJ P200A PUMP
qMSA ^ PUMP
SAMPLING MCOIA
0.8|1 MCEF, MILLWORE FILTER
a Su PVC FILTER
GLASS EIDER-SILVER MEM FU.TEV ISO mg. CHARCOAL SODIUM BISULFITE 300 mg. SILICA GEL ISO mg. SKC FLORISIL TUDE a GLASS FIBER FILTER
52? 80dta 85dba 90dba
DUPONT 0376
I-1 OUPONT d381 LJ DOSIMETER
EXHAUST SYSTEMS/REMARKS
n FUNCTIONING LJ NORMALLY
pi NOT FUNCTIONING LJ NORMALLY
WEATHER CONDITIONS
outside temp
WIND DIRECTION
F
WIND VELOCITY
SUNNY roa
CLOUDY HUMID showers snow
CNTRL
PUMP
\ SAMPLE NO.
NO. SERIAL NO
///]
Jc
^7/ .j/rrh .
MILITARY TIME
START
STOP
P2~\
TOTAL MINS
LPM/CC
VOLUME LITERS
'
ANALYSIS RESULT
G RAIN
ptlv. cloudy
AIRBORNE CONCENTRATION
-,
it=30 jA:
Jpr
'i /2L&.________
YES
O NO
SOMETIMES
CNTRL NO QOS SERIAL
CELL
START
(TIME!
STOP
TOTAL MIN aooutwkult gHR CORR % eCoOwNVvgmWrTrT^-aD Pa* lLEVEL
DID EMPLOYEE WEAR HEARING PWUI EC1 >
YES
NO
SOMETIMES
IP SOMETIMES WHEN? COMMENTS/SKETCHES
MAKE & MODEL
!*$
01-16-0056 l?/8l
CTD016738
I. epto: rca. .LiPP HEhLTH- -..PtiV
r o eav: 330
tiB-lb.s?F:Pv'jt;e.fj ; >i
l'!_ ' F'LiPEMDEF . 3 ; .*1
CKf:ti ;
UJTOFF
3P t EL F t4FT
T'HOfllC ROUGE
iOMPLE rHTE
rotee
..11 t
mu',n urn
fit
oy jb
bn ce h-t Tie 4 -EE.'
ft ft . i.W
04.
i--?LEl
;:aTE UJ
U ER
TJTOL 10MPS CHANGE PM
PERIOD
TIME HIT
n: r.`
C nU
F.
HF:'-.
91 . 90
88 8b
92
91 91
94 94
p.P H
90
9
92 39
92 H! 91
33 94
92 94
90
. 93 92
92
95 mi
90
;.r,
CTD016739
TO 08
.
5 91
91
9c
9!
9!
90
90
89 93
92 91 92
94
92 94 94
92
91
90 94
91 93
y8 37
39 89.
93
b4 75
83
91 91 92 92 . 96 91
91
92
92
93 90 39 92 93 . 92 92 93
88
CTD016740
*$ 4
CTD016741
61
60
60
60
60 65
.IS
60
60
60 . . . 65 64
60
60 60 62
S3 6c! SI
. . . SO
34
S3
S3 30
. 30 30
33 30 30
4 . . 32 92 33
35 30 82 76 73
76
93 . . . 92
92 92 92 93 31 91 92
92 S3 . 70 .
31
90
91 92 90 68
36
34 63
.71
36 91
91 94
95 90 37
30 89 . . 90
92 92 92 92 92 93 92 91 . 91 . . . 34
94 90
93 95
93
---------------------------d2_____
f
I
CT0016742
ca *- w ro
CTD016743
COMMCNTS/SKTrCMaS
01-16-0056 12/61
CTD016744
CertairifeedB
INDUSTRIAL HYGIENE MONr^RING DATA SHEET
COMMENTMKXTCHES
01-16-0056 12/81
CTD016745
CertainTeedSH
INDUSTRIAL HYGIENE MONI' RING DATA SHEET
LOC NO. -SALWl TAKEN BY*___ ____241] OF TYST
\MlW>
kMPLOYIt NAME
^31 0 6lPARTMENT/UNC
J09 TITLE/CNVI RONMCMTlfL LOCATION OiffLSsU.
MWUF'ACTURJNG PRODUCT
OONTAMINANT FIBERGLASS
D SAMPLING METHOD OPEN FACE
ASBESTOS a TOTAL DOST SILICA DUST
CLOSED FACE CYCLONE
ASPHALT FUMES
CLOSED FACE
VINYL CHLORIDE (MONOMER)
CHARCOAL TUBE
FORMALDEHYDE PHENOL
IMPING ERS, TWO IN SERIES S1LICAL GEL
PCB
FLORIS1L TUBE QXCLOSED FACE
ZJ NOISE
'0 AUDIO DOSIMETER
a
EQUIPMENT
r, DUPONT UP4000 PUMP
rt DUPONT UP2500PUHV
pi DUPONT LJP200APU
n^ U PUMP
SAfcMJNG MEDIA 0.8(1 MCEF, MHUFORE FILTER
l/i PV(T FILTER
GLASS FIBER-SILVER MEM F1LTEI. ISO ms. CHARCOAL SODIUM BISULFITE 300 ms. SILICA GEL ISO ms. SIX FL0U9L TUBE GLASS FIBER FILTER
a'80db> gSdbs Q 90db
H DUPONT D376 ^ DOSIMETER
n DUPONT D38! `-'DOSIMETER
EXHAUST SYSTEMS/REMARKS
n FUNCTIONING n NOT FUNCTION!NO
LJ NORMALLY
LJ NORMALLY
OUTSIDE TEW*
WIND OIRECTION
1WEATHER CONDITIONS
WIND VELOCITY
c SUNNY CLOUDY HUMID
F
CNTRL PUMP NO.< SERIAL NC
SA*t NQl
MILITARY TIME START STOP
SH
TOTAL MINS
c3 roo LPM/CC
sHOwnts snow
VOLUME ANALYSIS
LITERS
ROULT
RAIN ftly. cloudy
AIRBORNE
CONCENTRATION
\
DIO D^LOYeE WEAR RE9VRATORT
O YES NO
SOMETIMES
CNTRL NO DOS SERIAL
0li-
CELL
START
DID EMPLOYEE WE/6l HEARING PROTECTM
YES d/ NO
SOMCTIMIS
IF SOMETIMES WHEN?
RE9IRATOR MAKE A MODEL
MASOUTMt UVI 8(TIME) STOP
TOTAL MIN
hr corr %
jhe
*IF SOMETIMES WHEN?
/6
/?-3
MAKE A MODEL
COMMENTSSKTrCHES
01-16-0056 12/81
CTD016746
01-16-0056 12/81
CTD016747
01-16-0056 12/81
CTD016748
01-16-0056 12/81
CTD016749
me ' ; i.l*: i 1
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ME POPt-PjE'!' '.Min
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IV. 40.33 11854?;
CITE
DATE
UGER
TQ'ftL COMP?. =
EXCHANGE PA E PEP!OB
460 1
5 DBi 1 MIN;
TIME HISTDRY
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90
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CTD016750
t
o4
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CTD016752
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. -4
Si 'it:. ?b
50 51
34
SI 31 U SO
s
?0 I so S4
CTD016753
pc X l'\
'? 1
8 *+ 4 84
84 :-:a 84 o4 84 84
CTD016754
c4
S'4 S4 ft j
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Ni.
CTD016755
CertainTeedSH
NAME
INDUSTRIAL HYGIENE MON*' 1RING DATA SHEET
LOC NO. S>
TAKEN OY
k.
EMPLOYEE NAME
..
JOB UTlS/ENVIRONMENTAL LOCATION
(hvjlu
\________ PtFARTMCNT/UNE-
^axaaul\, VKkvJi\.
MANUFACTURING PRODUCT
CONTAMINANT
SAMPLING METHOD
Q FIBERGLASS Q ASBESTOS____
TOTAL* DUST SILICA DUST
_ _ _ASPHA_LT_FUMES_______________
IQ _ _ytnyl~ chloride~(monomer
"g _ .formaldehyde___________________"
" P_HENOL~ ~_______"_3_________
** "pel**
NOISE
OPEN FACE
CLOSED FACE a CYCLONE
a___ CLOSED^ FACE.___ ' CHARCOAL TUBE
_ I8IJINGERS^ TWO JN _SERIES_ SILICAL GEL
a FLORISIL TUBE
a CLOSED FAC_E______
: AUDIO "DOSIMETER
EQUIPMENT
n DUPONT
u P4000 puw
t DUPONT jp2500 pump
n DUPONT u p200a puh*
Q MSA LJPUMP
SAMPLING MEDIA
0.8^ mcef, MILUFORE FILTER
5M PVC FILTER
GLASS FIBER-SILVER MEM FILTEI 150 mg. CHARCOAL ___ SODIUM _B]SULnTE_
3q0-mg_ SILICA GEL-
ISO mg. SKC FLORISIL TUBE
___ CLASS_FIBER_nLTER____
~ CLBabt~ Fsdba G 90dbi
r-i DUPONT D376 DOSIMETER
i DUPONT D38I DOSIMETER
EXHAUST SYSTEMS/REMARKS
n FUNCTIONING NORMALLY
OUTSIDE TEW
NOT FUNCTIONING
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
G SUNNY
FOG
G CLOUDY HUMID
G SHOWERS G SNOW
RAIN Q PTLY. CLOUDY
CNTOL PUMP NO. SERIAL NO
MILITARY TIME
TOTAL MINS
VOLUME LITERS
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DID EWLOYEE WEAR RESPIRATOR?
YES
G NO
SOMETIMES
CNTRL NO DOS SERIAL
CELL
START
oi6 1 mer \
nDmIO nEXm>tJnOvYrEeS uWiEeAsRa LHAEVAa bRiIuNRG hPiRnO' Ts'EiiCi 'T'*
YES
cy4o
SOMETIMES
IF SOMETIMES WHEN?
RESPIRATOR MAKE & MODEL
(T1MEI
STOP
TOTAL MIN moOUTiult 8hR CORP T. mvimm n.
\m\%\\i I
i
V rIFpSaOtM!.ETIMESHWtLiHvPELNM?'
> aub . . .pppt MAKE ft M9PSL
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016756
CertainTeedl
PUNT NAME
INDUSTRIAL HYGIENE MONr^RING DATA SHEET
1
LOC NO. SW._ TAKEN BY
DATE Of TOT
/ EMPIOYCE NAME
JOS T1T1JC/ENVIRONMENTAV^OCAT
AWTMEMT/UNE
lg_g
MANUFACTURING
CONTAMINANT
FIBERGLASS _ _ .ASBESTOS____ "d~ TOTAL dust
SILICA DUST _ asphalt_fumeS________________
~Q _ JVINYL. CHLORIDE (MONOMER^ " .formaldehyde________________
PHENOL__________________________ _G~ PCB
O
SAAVUNG MSTHOO
OPEN FACE
closed face _ -CYCLONE______
' closed face
___ CHARCOAL. TUBE_____________ ] ___ impingersT TWO JN JERJES~
D SILICAL GEL G FLORISIL TUBE closed_ face._____ O^AUDIO DOSIMETER
SAAVUNG MEDIA
0.8m MCEF. MHUPORE FILTER'
SM PVC FILTER
GLASS FIBER-SILVER MEM F1LTES
___ i5?.njt CHARCOAL _Q SODIUM BISULFITE.
~ jOO_m i'i-LCA_CE_L_
ISO mg. SKC FLORISIL TUBE
_GLASS .FIBER.nLTER________
dm, 0_85db
0db,
nDUPOT
up00 pu>
n DUPONT
u P2500 PUW
n DUPONT p200a puas
n dupont d376 LJ DODAIETER
n iiDUPONT 0381 ^ DOSIMETER
EXHAUST SYSTEMS;REMARKS
r-i FUNCTIONING NORMALLY
OUTSIDE TOP
NOT FUNCTIONING
WIND DIRECTION
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
POO
G CLOUDY D
HUMID
G
G RAIN Q PTLY. CLOUDY
CNCTIL PUAV NOSy j DUAL NC
SAAVLE NO
MILITARY TIME
TOTAL MINS
VOLUME
U'
ANALYSIS RESULT
AIRBORNE CONCENTRATION
DID EAVIjOYEE WEAR RESPIRATOR?
G YES
O-no
G SOMETIMES
DOS SERIAL
START
DID EMPLOYEEEE WEAR I^EARING PRoVcCTT___
YES
Q^fro
G SOMETIMES
IP SOMETIMES WHEN?
REOTRATOR MAKE & MODEL .
ITIME1
STOP
TOTAL MIN MMWTMyi 8hHrR CcOqRhRh 6%
unm.
IF SOMETIMES WHEN!
<33
fttftfg ft MOBIL
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016757
CertairifeedB
PI AWT NAME
Tiil&krVd
INDUSTRIAL HYGIENE MONI~->RING DATA SHEET
<
LOC NO.
SANy.-- TAKBW BY
DATE OF TEST
EMPLOYEE NAME
/Pfax^--------
JOS TITUE/ENVIRONMENTAL LOCATION
^1
XgyARTMENTT/ U NE____________________________ MANUFACTURING PRODUCT
aurtJ
CONTAMINANT
FIBERGLASS ____ ASBESJOS____ " total" dust
SILICA DUST a _ .ASPHALT_FJiME _______ : _ _vjNYiT CHLORIDEjmonomer IQ _ -FORMALDEHYDE________________ ~Q_ phenol ' "PCB
NOISE
SAKVUNG MCTHOO
OPEN FACE
CLOSED FACE
a_ _CYCLONE______ CLOSED FACE*
Q___ CHARCOAL^ TUBE_____________
a impingersT two in series
SILICAL_ GEL________ "florisil TUBE
qep&ETTfACE^____ ^AUDIO DOSImItER'
SAMPLING MEDIA
0.8*1 MCEF, MOUPORE FILTER
5M PVC FILTER
GLASS FTBER-SLVER MEM F1LTEI ISO mg. CHARCOAL
_Q SODIUM _BISULFJTE_ _ 300_m^ JILICa"gEJ._ ISO mg. SXC FLORISIL TUBE P GLASS _EJBER_FI lt_er________
*" 85dba G 90db
n DUPONT U R4000 MAP
n FUNCTIONING LJ NORMALLY
OUTSIDE TEH*
n DUPONT
UP2S00 pukv
, DUPONT jp200a punt
1 DUPONT d376 J DOSIMETER
EXHAUST SYSTEMS/REMARKS
r-. NOT FUNCTIONING LJ NORMALLY
WIND DIRECTION
WEATHER CONDITIONS
Wire VELOaTY
SUNNY
FOG
CLOUDY HUMID SHOWERS
i DUPONT 0381 1 DOSIMETER
RAIN PTLY. CLOUDY
CNTRlUCs PUI MP NOL. SEpiIAL NC
SAftTLE NO.
MILITARY TIME
TOTAL MINS
ANALYSIS RESULT
CONCENTRATION
DID D^LOYEE WE&A RESPIRATOR?
IF SOMETIMES WHEN?
REV1RATOR MAKE A MODEL
YES
SOMETIMES
CNTRL NO D--OS SERIAL
CELL
START
(TIME)
^-S--T--O---P _ TOTAL MIM WUWH
bfyiVritA ^-Yjs Lt'l`o Vfoo Y)
DID EKPljOYEE \
I HEARING PROTECT!1
IP SOMETIMES WHEN?
8hr ctrb ft eOWVCTTKD
B6.f SC
MAKE a mooei
YES
NO SOMETIMES
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016758
CertairifeedB
IwnilfiTRlfll HYGIENE MONI--'RIWG DATA SHEET
*7
LOC NO. JMWM-hL. TTAKWEN BYgJ2JATTgWOf 1 T-----------
TITLE/ENVIRONMENTAL
PPWTMEKT/UNC
3$
*
MANUFACTURING PROOUCT
CONTAMINANT
Q FIBERGLASS
ASBESJOS____
'total DUST
SILICA DUST
_Q _ --ASPHALT_FUMES________________ :! _VINYL_ H LORIDE~(MONOMER^ '__FORM ALDEHYDE____ '_'_____
'phenol__________________________
' pci
SAPVLING MCTHOO
OPEN FACE
CLOSED FACE _CYCLONE_____ CLOSED ~FACE' ___CRARCOAL__ TUBE____________ " ___IMPINGERS' TWO JN "s|wES~ ' SIL1CAL GEf FLOR1SIL TUBE
^CtC^SD-f^CE_______
AUDIO DOSIMETER
SAPTUNG MEDIA
0.8m MCEF, MUliFORE FILTER
SM PVC FILTER
GLASS FtBERdlLVER MEM FILTH ___ .CHARCOAL _Q__ SODIUM _BjSULFITE_ i _ loo'm$7 SILJCA_GEL_ ISO mj. SKC FLORBO. TUBE Q CLS|_FMER_FILTER_______
aOdbi" O BSdta" U 90db
n dupont U R4000
n FUNCTIONING 1-1 NORMALLY
OUTSIDE TUP
CNTRL NO
ST
IAL fC
! DUPONT 1 PJ500 PUPS'
n DUPONT U P200A PUPS'
DMA LJ PUPS'
. DUPONT D376 ` Doancin
1 DUPONT 0381
p NOT FUNCTIONING NORMALLY
WINS DIRECTION
EXHAUST SYSTHMSfflEMAHKB
WEATHER CONDITIONS
WIND VELOCITY
SUNNY
FOO
CLOUDY HUMID SHOWERS SNOW
RAIN FTLY. CLOUDY
SAA^LE NO.
MILITARY TIME
TOTAL MINS
ANALYSIS RISULT
AIRBORNE CONCENTRATION
DIO EKSMjOYEE WEAR RESPIRATOR?
YES
NO
SOMETIMES
DOS SERIAL
START
YES
AR HEARING PROTELIT NO SOMETIMES
IF SOMETIMES WHEN?
RESPIRATOR MAKE & MOOEL
tTIMP
STrOP
[TOTAL MlfftmAPOVT MmAiit 8hB. CQRR _% cohvpud bb* uvi
4z\ad/i\
\tr?> I
7
IF SOMETIMES WHEN?
MAKE A MOOEL
COMMENTS/SKETCHES
01-16-0056 12/81
CTD016759