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CONOCO HEMICALS - ABERDEEN PVC PLANT DOSIMETRY CARO (A)
NSSAMPLE
0794 A
Huard: VCM (/I Name Department
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Date
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Analyst
Analysis Date:
Hazard VCM Noise Lead (Micrograms)i
/
PEL: 1 PPM
Over ( ) TOT:
Under ( ) PEL:
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115dBA Per M3
TWA Exposure ,, / PPM
% of PEL Per M3
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CONOCO CHEMICALS - ABERDEEN PVC PLANT DOSIMETRY
NSSAMPLE
0794 A
Hazard: VOW {)() Lead ( ) Noise ( ).----------------------------- ( ) Date
Time Clock (Lead Sampling Only) : IN:
AM( ) PMp^OUT:
) PM( )
List areas you sapnt most time in and estimate amount of time (nearest hour is sufficient) spent.
Time
Area
Time
List most likely causes of possible overexposure to the hazard.
1.
2.
3.
Check respiratory protection you used:
5* None^
( ) Dust Mask
) Air-line Respirator
Signature
Please complete and return to guard
( ) Scott Air-pak
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VAB.0001069755