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DOW CHEMICAL USA LOUISIANA DIVISION
ENVIRONMENTAL CONTROL
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DO A 110912 CONFIDENTIAL
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Monitoring for__f*------ Employee ID #------^l/A------------ --
Job Classification
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Type Sample: Personnel [Zf Area Excursion Other-
N2 08270
Date- S//7/SS
Other Chemicals Present:
Description of task performed during monitoring period including any unusual activities
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Time StartedTime 5topped-
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Beginning FI$W
Respirator used Yes
Ending Flow Rate tQQ
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Calibration Check Prior/o Monitoring? JE/ Yes No
Calibration: [] Bubblemeter
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Q Other N TE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
Type?Wind, Temp, and Humidity
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Employee ID # ^33--P3^?.. ___ _ Job Classification ..^
P j fi-ih )M <--_______________ Typo Sample: Q^Pertonnel Q Area Q Excursion Q Other_____
Sample |\]0 Q8269
Date. ^// 2/t8
Other Chemicals Present: Pi TU'/t _________
Description of task performed during monitoring period including any unusual activities
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Time Started /o<SLO
Tim Stopped. /o-.'fi Beginning Row Rote./Q(>0
Respirator used [/fYes No
Ending Flow Rate /oou CcJ/f\ fA, Calibration Check Prior to Monitoring? ^Yes No
Calibration: Q Bubblemoter
H'' Rotometer
Other_______
NOTE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
Type? c`On lIT
Wind, Temp, and Humidity 7C, 5$% Jlu fiu
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DO A 110914 CONFTDFNTTAL
Bifif cmvi&oaJ- ofeHA r/oa) 5 Monitoring 7-i PLoufig tYHihia) L )
Other Chemicals Present: fhtTrirL- Pf/L/LvC/ho*J
Person or Area Monitored___ ^0P3______ Employee ID #--______ tij/t Job Classification
Sample
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Typo Sample: [] Personnel Q^Area Q Excursion Ofher_
Date_
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Description of task performed during monitoring period including any unusual activities----------------------
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Time Started Time Stopped___` kP..
Beginning Flow Rote Ending Flow Rate /6cc/fluAS
Respirator used Q Yes
Calibration Check/Prior to Monitoring^ [] Yes Q No
Calibration: /Br Bubblemeter
0 Rotameter
Other
NOTE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
Type?. Wind, Temp, and Humidity
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Form filled in by.
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DO A 110915 CONFIDENTIAL
Monitoring lor
t^TAC, openin'- s Person or Area Monitored
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A f?L Employee ID #--------------Ai------------- Job ClassifleaHon,
Sample
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______ P f/2.(hi*J *>Type Sample: Q Personnel
Area Q Excursion Q Other.
Date.
Other Chemicals Present:
Description of task performed during monitoring period including any unusual activities-------- -
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Time Started____ /T.A Time Stopped. A-/S
Beginning How Rate. Ending How Rate. /0Q&Jm,A `
Respirator used O Yes ,
Calibration Check,Prior to Monitoring? 0 Yes [] No
Calibration: 0 Bubblemetor
Q Rotometer
Other
NOTE: Job description must be concise and complete.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
Type?____ A/A. Wind, Temp, and Humidity
DO A 110916 CONFIDENTIAL
Block.
Person or Area Monitored.
M nitoring lor f^A/Z/dsrf'cJ__ Employee ID #-----------------
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Sample N2 08783
J/Job Classification. a x
Typo Sample: [] Personnel O Area Excursion Q Other.
Date.
Other Chemicals Present:
Description of task performed during monitoring period including any unusual activities.
Time Started.
Time Stopped_____________________ _______________________________________________________________________ _
Beginning Row Rate______________ Respirator used Yes No
Type?----------------------------------
Ending Row Rate_________________
Wind, Temp, and Humidity
Calibration Check Prior to Monitoring? Q Yes No
Calibration: Q Bubblemeter
Rotameter
Other
N TE: J b description must bo concise and complete.
__________________ Form filled in by.
LOUISIANA DIVISION INDUSTRIAL HYGIENE
DO A 110917 CONFIDENTIAL