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CONOCO CHEMICALS - ABERDEEN PVC PLANT
DOSIMETRY CARD (A)
SAMPLE N
| IM HP Iff Mt**
0691k
Hazard: VCM (rf Lead ( ) Noise { )
Name
S.S
Department
Job Class
Instrument Np 3Q9^
Start Time <.'3?___ AM(X)
Noise Cell No.
Airflow
( ) Date
) ~n
*TStop AM( )PM(
Analyst:
Analysis Date:
Hazard VCM Noise
Lead (Micrograms)l
PEL: 1 PPM
Over ( )
Under ( )
TOT:
PEL
115dBA Per M3
<4-
TWA Exposure
0*1 PPM
% of PEL Per M3
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CONOCO CHEMICALS - ABERDEEN PVC PLANT DOSIMETRY DATA CARD (B)
SAMPLE N2
Hazard:' VCM li/f Lead ( ) Noise { ) Time Clock (Lead Sampling Only) : IN:__ !!l
( ) Date AM<^ PM( ) OUTi
AM(
0691
h
) PM
List areas you spent most time in and estimate amount of time (nearest hour is sufficient) spent.
ea
Time
Area
Time
List most likely causes of possible overexposure to the hazard
1.
2.
3.
Check respira protection you used:
( None
) Dust Mask
) Air-line Respirator
Signature
Please complete and return to guard
( ) Scott Air-pak
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