RadNet FMHV Calibration Verification Report

OMB Control No. 2060-0015

Approval Expires XX/XX/XX

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY NATIONAL AIR AND RADIATION ENVIRONMENTAL LABORATORY 540 SOUTH MORRIS AVENUE MONTGOMERY, AL 36115-2601 PHONE: (334) 270-3400 FAX: (334) 270-3454

RADNET FMHV CALIBRATION VERIFICATION REPORT

D ATE: FMHV SERIAL #:

SAMPLER LOCATION (City, State):

SAMPLER LOCATION (CITY, STATE):

TABLE 1 Calibrated Instrument Inventory

CALIBRATED INSTRUMENT	CALIBRATION DATE	CALIBRATION DUE DATE
TEGAM Temperature Calibrator-Thermometer Serial #:
DRUCK Digital Pressure Indicator-Barometer Serial #:
DWYER Digital-Manometer Serial #:
ANDERSEN Reference Orifice Serial #:

TABLE 2 Temperature, Pressure and Flow Calibration Data *Difference = FMHV Value – Reference Value

PARAMETER	REFERENCE VALUE	FMHV VALUE	*DIFFERENCE	REQUIRED ACCURACY	WARNING (YES/NO)
Ambient T	deg C	deg C	deg C	±2 deg C
Abs P	mmHg	mmHg	mmHg	±10 mmHg
Delta P	mmHg	mmHg	mmHg	±0.2 mmHg
Flow	m3/hr	60.0 m3/hr	m3/hr	±5 %

COMMENTS:

T IME VERIFICATION COMPLETED: OPERATOR SIGNATURE:

The public reporting and recordkeeping burden for this collection of information is estimated to average 5 minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed [form or survey] to this address.

EPA Form 5900-25