Document ZnjY7xndeQ1pNMNDjzjMZRjbJ
ABD00350176
N 001879
ABERDEEN CHEMICAL PLANT-DOSIMETRY RECORD
Mama L. . - .
_____________________________ Shift ^ ^ Date cW8^(o
Soc:iiaall Security No.
Instrument No.
HAZARD
(2 VCM
Lead Total Dust
QIC, --H im
. Job Code Q&_li 0^ c
Start___________________________ _______ Stop Time Q>C)Q AMp^PM( /5?A> AM| )t>U( )
Airflow.
8AVS8aSKSION
-PPM
' 1 --Miaograms/M*39
-Milligrams/M3
SamDleTime.
PEL:
--Miaogcams/M3
Analyst Analysis Date
j
/
ABD00350177
Hazard: VCM ( ) Lead ( ) Dust ( ).
I)
N2 001879
1. I came to work at--AM
( ),
FirewS^ch Work?
2.1 left work at
_____ AM ( ) PM
Yes ^'Np'tCircle One)
mo, .4____ Q. 3.1 did the regular work of a (enter Job Class)
4.1 used a respirator during the following jobs (check one)
P Oust
Non*
^-Maik
Alr-Llna Rasp.
Scott Air-Pak
3M Air Hat
5. The following unusual events may have caused me to be overexposed:
6. Other comments and informatiorvfwse reverse side of card)
Signature //
. ..
Please complete and return
iard