Document ZBe5x21QJe3rnvvENQLgkG4OV
ABD00089008
Names Andrews Next test due:
TSI MODEL 8015 PORTACOUNT FIT-TESTING SOFTWARE
Version 2.01
S/N 927
VISTA POLYMERS
FIT TEST REPORT
Test date; Test time: Test subject last name: Test subject first name: ID numbers Operator name: Next fit test due: Test agent: Test device:
07-28-1994 12:00:54 pm
Andrews Dale 587602295 H.Pruitt
Ambient particles TSI MODEL 8010 PORTACOUNT
RESPIRATOR ID Size:
Model: Manufacturer: Approval number:
L Ultravue Facepiece MSA TC-19C-113
Additional notes: Additional notes:
TEST DATA
Ex .
Ambien t (Part/cc)
Pass/Fail level: 100
Test cycles....: 1
Mask
Fit Factor
(Part/cc)
Pass/Fai1
NB 6230 DB 6025 SS 5705 UD 5150 R 4920 NB 4605
0.170 0.460
781 0.500 0.380 0.210
36600 13100
7.3 10300 12900 21900
PASS
PASS
FAIL -- S-l.
PASS PASS PASS
Tt/& CfyM
OVERALL FIT FACTOR =
43.8
(Calculated per ANSI Z88.2-1980)
FAIL
Operator Test Subject
Date
Date 7~cX If ^