Document bOYRXpQ75RYoq8G8G0xmyONKo

ABERDEEN CHEMICAL PLANT-DOSIMETRY RECORD N 001434 6LB \c aw***- ***/* ________ D Sdcial Security No.Job Code Start ____________________________________ Stop Instrument No. Time -------AM( ) ____AM(^)PM( ) Airflow--:____________ __________________ HAZARO VCM Lead Total Dust SAWnIS8?6'iT5.AJ1ION O --Micrograms/M -Milligrams/M^ Sample Time PEL: --Micrograms/M^ Analyst / Analysis Date / Hazard: VCM ( ) Lead ( ) Dust ( > I ) N 001434 1. I came to work atAM { ) 2. I left work at -------------------------- AM ( ) PM ( ) PM ( I Firewatch Work? Yes / No (Circle One) 3. I did the regular work of a (enter Job Class)________ 4. I used a respirator during the following jobs (check one) None Dust Mask Air-Un# Rasp. Scott Alr-Pak 3M Air Hat 5. The following unusual events may have caused me to be overexposed: 6. Other comments end information (Use reverse side of card) Signature. Please complete and return to Guard