Attachment 4 Workstation 4.doc

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Professional Engineer for Dust Collector
Solicitation number
N4215822QA001
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Dust Collector Q A.docx DOCX document
Attachment 8 2021 Shop 57 IH Survey 49.pdf PDF
N4215822QA001.pdf PDF

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Text version

VENTILATION SURVEY FORM

COMMAND/SHOP INFO
INSTRUMENT DATA

COMMAND:________________________________

SHOP:_____________________________________

DATE:_____________________________________

LOCATION:________________________________

VENTILATION TYPE:________________________

PROBE TYPE:________________________________

TYPE USED:_________________________________

RANGE:_________________________________FPM

SERIAL NUMBER:____________________________

CALIBRATION DATE:_________________________

DIAGRAM OF SYSTEM AND VENTILATION DATA:

Baseline (Year: )

ACGIH Recommendations

Last Year’s Reading

Continuous Flow Indicator Present?
Y or N (If Yes – type: )

Reading: (Acceptable reading: )

Vent Used For

Vent Acceptable?
Y or N

Based on: ACGIH; Low samples at these flowrates;

Other:

COMMENTS: Manometer: Off _______ On________ Pre-Filter __________ HEPA Filter: __________

INDUSTRIAL HYGIENIST

65 ½”

Workstation #4

(FPM)

156” _______

132” _______

108” _______

84” _______

60” _______

36” _______

12” _______

RIGHT

(FPM)

156” _______

132” _______

108” _______

84” _______

60” _______

36” _______

12” _______

LEFT

170 ”

RIGHT 12” (in-line)

A=

Q=

LEFT 12” (in-line)

A=

Q=

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