5900-27 Radnet Air Particulate Report

RadNet (Renewal)

RadNet AIR PARTICULATE REPORT

RadNet - Air

OMB: 2060-0015

Document [doc]
Download: doc | pdf

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 AIR PARTICULATE REPORT


FOR USE BY NAREL PERSONNEL ONLY


S AMPLE ID: RAN - DATE RECEIVED:


C OMMENTS:



SAMPLE INFORMATION


1. STATION NUMBER: LOCATION: (city, state)


2. DATE OF COLLECTION:


3. STATION OPERATOR:


4. STATION OPRATORS TELEPHONE:


5. COMMENTS:




AIR SAMPLING DATA


6. SAMPLE START TIME (month/day/year): ________________________ (hr: min)___________:__________


7. SAMPLE STOP TIME (month/day/year): ____________________________________ (hr: min)___________:__________


8. DURATION (hr: min: sec): _______: ________: ________


9. AVG AIR FLOW (m3/hr): _______________


10. AIR VOLUME (m3) ____________________


FIELD ESTIMATE CALCULATION (Must wait 5 hours from time sample is collected to perform field estimate)


11. FIELD ESTIMATE DATE/TIME (month/day/year):____________________________ (hr: min)_______:_______


12. STANDARD ACTIVITY (pCi): ____________________


13. STANDARD GROSS CPM: ______________________ 16. SAMPLE GROSS CPM: ___________________


14. BACKGROUND CPM: __________________________ 17. BACKGROUND CPM: _____________________


15. STANDARD NET CPM: _________________________ 18. SAMPLE NET CPM: ______________________


19. GROSS BETA FIELD ESTIMATE CALCULATION


______________________×_____________________÷________________÷___________________=_______________________

Sample Net CPM Standard Activity (pCi) Air Volume (m3) Standard Net CPM Field Estimate (pCi/m3)




__________________________________

OPERATOR SIGNATURE DATE


C omments:


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 5900-27

File Typeapplication/msword
File TitleERAMS AIR PARTICULATE REPORT
AuthorPC Site Coordinator
Last Modified Bybronish
File Modified2007-03-14
File Created2004-06-16

© 2024 OMB.report | Privacy Policy