Other Non-Burden Instruments

ATTACHMENT S

Other Data Collection Instruments –

No Burden on Participants

ATTACHMENT S1

Field Observation Questions for Field Interviewer

FIELD OBSERVATION QUESTIONS FOR FIELD INTERVIEWER

OBSERVATION QUESTIONS FOR FIELD INTERVIEWER -SESSION 1

1. INTERVIEWER: COMMENT HERE ABOUT EASE OF ADMINISTERING QUESTIONNAIRES TO PARENT

2. INTERVIEWER: COMMENT HERE ABOUT CONCERNS PARENT OR CHILD RAISED ABOUT WEARING THE PEM.

OBS3. INTERVIEWER: HOW CONFIDENT ARE YOU IN THE MEMORY OF THIS RESPONDENT FOR OUR QUESTIONS ABOUT PREVIOUS HOMES AND [CHILD]’S ACTIVITIES? WOULD YOU SAY THAT YOU FEEL VERY CONFIDENT, SOMEWHAT CONFIDENT, SOMEWHAT UNCERTAIN, OR VERY UNCERTAIN?

OBSERVATION QUESTIONS FOR FIELD INTERVIEWER – SESSION 2

1. INTERVIEWER: CLOSE YOUR LAPTOP LID NOW. AFTER LEAVING THE HOME THEN REOPEN THE LAPTOP AND PRESS 1 TO CONTINUE BY ANSWERING TWO OBSERVATIONAL QUESTIONS.

2. INTERVIEWER: COMMENT HERE ABOUT EASE OF ADMINISTERING QUESTIONNAIRES TO PARENT

3. INTERVIEWER: COMMENT HERE ABOUT CONCERNS PARENT OR CHILD RAISED ABOUT WEARING THE PEM.

ATTACHMENT S2

Field Observation Questions for Registered Nurse

FIELD OBSERVATION QUESTIONS FOR REGISTERED NURSE – SESSION 2

1. NURSE: DID YOU CONDUCT THIS SESSION IN A MOBILE UNIT?

1 YES

2 NO

RN1a. WHERE WAS IT PARKED?

1. IN FRONT OF THE HOME

2. PARKING LOT

3 OTHER (SPECIFY: ___________________________

2. NURSE: COMMENT HERE ABOUT EASE OF ADMINISTERING QUESTIONNAIRES TO PARENT

3. NURSE: COMMENT HERE ABOUT ANY ISSUES RELATED TO THE CHILD EXAM

ATTACHMENT S3

Neighborhood Source Survey (GPS Unit)

NEIGHBORHOOD SOURCE SURVEY (GPS READING)

NSINTRO. Connect your GPS Receiver to your IPAQ.

The CHATS Neighborhood Source Survey should be completed after the session 1 visit and before you leave the participant’s neighborhood following the conclusion of the session 2 visit.

To complete the survey, you will drive around the neighborhood surrounding the participant’s residence looking for potential local “Sources” of particulate matter and toxic gases. Cover all streets within 0.5 mile of residence. Document all Sources of particulate matter and/or toxic cases you observe and record the GPS coordinates for each.

If you have questions, please refer to your Job Aids Booklet for a list of the Sources eligible for documentation in this survey and for instructions on how to locate these Sources.

Press next to continue

PROGRAMMER: PLEASE INCLUDE A NOTE SCREEN FOR THE FI TO BE ABLE TO USE AS A REFERENCE LISTING THE VIABLE SOURCES (THAT ARE INCLUDED IN THE DROP DOWN LIST BELOW)

NSINTROa. Have you found at least one Source to document in the Neighborhood Source Survey?

1. YES

2. NO

PROGRAMMER: IF NSINTROa=NO, PLEASE SKIP TO NSEND

NS1. [IF NSINTROa=YES] Please select from this drop down list the Sources that were found within a 0.5 mile radius of the respondent’s home.

Please enter each Source you observe. The screen that follows will instruct you to record the GPS waypoint for the Source.

For example, if you observe 3 construction projects within 0.5 miles of the residence, you should select “construction project” from the Source drop down list and record the unique GPS waypoint for each of the 3 construction project Sources

[PROGRAMMER: SOURCE DROPDOWN LIST TO INCLUDE:

• School

• Bakery

• Gas station

• Dirt road

• Major road or highway

• Cement plant

• Dry cleaner

• Landfill

• Industrial facility

• Bus station

• Railroad tracks

• Construction project

• Toll plaza/toll booth]

Press next to continue

NS1a. Enter a brief description of the selected Source, such as the name of the Source or the name of the street on which the Source is located (i.e. George’s Gas Station, Hornet st. bus station, etc.)

___________________ [ALLOW 25 CHARACTERS]

NS1b. To enter the GPS waypoint for the selected Source, press RECORD LOCATION after the HDOP color turns GREEN (from RED). This may take a few minutes.

PROGRAMMER: GPS WAYPOINT WILL BE DISPLAYED/RECORDED IN THE FOLLOWING FORMAT:

N _ _ ‘ _ _ . _ _ _ _° [ALLOW 8 NUMBERS], W _ _ _ ‘ _ _ . _ _ _ _° [ALLOW 8 NUMBERS]

NS1c. Are there any other sources within 0.5 miles of the residence that should be entered?

To see a list of the Sources you have already entered and to prevent entering a duplicate Source, select the Roster option from Menu.

1 YES

2 NO

PROGRAMMER: IF NS1c=YES, CREATE NEW LOOP WITH QUESTIONS NS1 THROUGH NS1c. PLEASE ALLOW UP TO 25 LOOPS FOR YES RESPONSES TO NS1B.

NSEND. [IF NS1c=NO OR NSINTROa=NO] You have completed the neighborhood source survey for this residence. Disconnect your GPS Receiver from your IPAQ.

ATTACHMENT S4

Medical Records Abstraction Form

MEDICAL RECORDS ABSTRACTION FORM

REVIEWER: DATA ELEMENTS TO BE COLLECTED ARE FOUND ON THE FOLLOWING PAGES.

a. Chart abstraction information: Abstractor’s initials:_____________________ Date (mm/dd/yyyy): ___/___/______
c. Patient Information: Medical ID: _________________ Child’s Name: Contact Name: Address: City: Zip: Home Phone: Cell Phone: Work Phone: E-Mail: Address changed: 1 Yes 2 No (Note: List in the comment section with date) Date of Birth (mm/dd/yyyy): ___/___/_____ Sex: 1 Male 2 Female Height at first visit: ____________(cm/inch) Weight at first visit:___________(lbs/kg) Race (Select all that apply): 1 White 2 Black or African American 3 Asian 4 Native Hawaiian or Other Pacific Islander 5 American Indian or Alaskan Native Hispanic Ethnicity: Hispanic Non-Hispanic
Insurance: 1 Medicaid 2 Private: 3 Uninsured 88 Other (specify)
d. Diagnosis
Visit type:		Diagnosis Type:
1. Physician/Clinic		A. Primary
2. ED Visit		B. Secondary
3. Hospitalization
Dates (mm/dd/yy) – Type of visit/Symptoms ICD-9-CM Example: 04/30/05 (1A)		Symptoms			ICD-9-CM
		1. Abdominal pain			789
		2. Abnormal chest sounds			786.7
		3. Acute atopic conjunctivitis			372.00, 372.05
		4. Acute nonsuppurative otitis media			381
		5. Acute respiratory infections			460-466
		a. Acute nasopharyngitis (common cold)			460
		b. Acute sinusitis			461.0-461.9
		c. Acute pharyngitis			462
		d. Acute tonsillitis			463
		e. Acute laryngitis and tracheitis			464.0-464.5
		f. Acute upper respiratory infections of multiple or unspecified sites			465. 465.9
		g. Acute bronchitis and bronchiolitis			466.0-466.19
		6. Allergic rhinitis			477
		7. Allergy, other than to medicinal agents			V15.0
		8. Allergy, unspecified			995.3
		9. Asthma (includes all extrinsic)			493
		10. Atopic dermatitis and related skin d/o			691.8
		11. Bronchitis not specified as acute 490 or chronic			490
		12. Chronic rhinitis, pharyngitis, and nasopharyngitis			472
		13. Chronic sinusitis			473
		14.14. Contact dermatitis and other eczema			692
		15. Cough			786.2
		16. Extrinsic allergic alveolitis			495.7
		17. Headache			784
		18. Hemoptysis (pulmonary hemorrhage)			786.3
		19. Nausea			787.0­, 787.02
		20. Pneumonia/influenza			480-487
		a. Viral pneumonia			480.0­, 480.9
		b. Pneumococcal pneumonia			481
		c. Other bacterial pneumonia			482.0­ 482.89
		d. Pneumonia due to other specified organism (Mycoplasma Chlamydia, other specified)			483.0-483.8
		e. Pneumonia in infectious disease classified elsewhere			484.1­484.8
		f. Bronchopneumonia organism unspecified			485
		g. Pneumonia organism unspecified			486
		h. Influenza			487.0­487.8
		21. Redness and discharge of eye			379.93
		22. Respiratory conditions due to chemical fumes and vapors (includes 506.1)			506
		23. Suppurative and unspecified otitis media			382
		24. Unspecified allergic alveolitis and pneumonitis			495.9
		25. Upper respiratory tract hypersensitivity reaction			478.8
		26. Urticaria			708
		27. Vomiting			078.82, 536.2, 578.0, 787.0, 787.01, 787.03
		28. Wheezing			786.07
e. Prescribed medications: (If ‘yes’, list ALL)
Name of Medication			Visit dates (mm/dd/yyyy) – Type of visit Example: 04/30/05 (1A)
			___/___/_____ (___)
			___/___/_____ (___)
			___/___/_____ (___)
			___/___/_____ (___)
f. Hospitalization
Dates (mm/dd/yyyy)	Location		Dates (mm/dd/yyyy)	Location
___/___/_____	__________________		___/___/_____	__________________
___/___/_____	__________________		___/___/_____	__________________
___/___/_____	__________________		___/___/_____	__________________
___/___/_____	__________________		___/___/_____	__________________
___/___/_____	__________________		___/___/_____	__________________
___/___/_____	__________________		___/___/_____	__________________
g. Co-morbidities: 1. Ever diagnosed with asthma: 1 Yes 2 No Age at onset:________________mos/years 2. Family Hx of asthma or atopy: 1 Yes 2 No 3. ETS: 1 Yes 2 No 4. Ever diagnosed with other chronic conditions: 1 Yes 2 No (If “Yes”, please specify): 5. Is the child immune-suppressed (lifetime): 1 Yes 2 No Specify: 6. Any congenital anomalies: 1 Yes 2 No Specify:
h. Diagnostics:
Serum IgE:
1. Serum IgE (total):__________date_______			2. Serum IgE (total):_____for_____date_______
3. Serum IgE (total):__________date_______			4. Serum IgE (total):_____for_____date_______
4. Serum IgE (total):__________date_______			6. Serum IgE (total):_____for_____date_______
7. Serum IgE (total):__________date_______			8. Serum IgE (total):_____for_____date_______
88.Other (specify)_______________________________________(date)_____________________
Skin test positive for (check ALL that apply): 1. Dust mites 2. Cat dander 3. Dog dander 4. Cockroach 5. Mouse 6. Mold 3. Outdoor (pollen, grass, etc.) 8. Not done 88. Other (specify): Carboxyhemoglobin levels: _______________(date) _______________ Lung function test (% of predicted): FEV1 ________ FVC_______ FEV1/FVC________ date ______ Carboxyhemoglobin levels: _______________(date) _______________ Lung function test (% of predicted): FEV1 ________ FVC_______ FEV1/FVC________ date ______ Other tests/dates: (Record highest levels)

ATTACHMENT S5

Environmental Assessment

(Central Site Equipment Deployment & Retrieval)

ENVIRONMENTAL ASSESSMENT (CENTRAL SITE EQUIPMENT DEPLOYMENT AND RETRIEVAL)

PROGRAMMER – DO NOT ALLOW DK/REF FOR THIS SCRIPT

--CENTRAL SITE BOX DEPLOYMENT--

CSPDINTRO1. PLEASE ENTER YOUR EMPLOYEE ID

EMPLOYEE ID NUMBER: ____________[ALLOW 6 CHARACTERS]

PROGRAMMER: CHECK THE ENTRY AGAINST THE INVENTORY OF VALID IDS. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE, INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT FIID TO PROCEED.

CSPDINTRO. [IF THE ID ENTERED IN CSPDINTRO1 = A VALID FIID FOUND IN THE INVENTORY] YOU WILL NOW DEPLOY THE CHATS ENVIRONMENTAL ASSESSMENT EQUIPMENT AT THIS CENTRAL SITE.

SCAN THE BARCODE ON THE CENTRAL SITE BOX CONTAINING THE MICROPEM, ALDEHYDE BADGE, AND VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

CENTRAL SITE BOX ID NUMBER: ____________[ALLOW 6 CHARACTERS – BX AND 4 NUMBERS]

NODK

NOREF

PROGRAMMER: CENTRAL SITE BOX ID SHOULD BE 6 CHARACTERS: BX####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED. RECORD THE DATE AND TIME WHEN THE FI PRESSES ENTER.

--CENTRAL SITE PLATFORM DEPLOYMENT –

CSPD1. (PUT ON NITRILE GLOVES)

HAVE READY THE EMPTY CENTRAL SITE PLATFORM CAGE WITH A SOLID, SLOPED ROOF

OPEN THE CENTRAL SITE BOX(ES) AND REMOVE SAMPLER TRAY

FOR CENTRAL SITE PLATFORM DEPLOYMENT, REMOVE FROM THE CENTRAL SITE BOX(ES) THE FOLLOWING ITEMS/SAMPLERS LABELED WITH A BLUE DOT ON THE CONTAINER:

1. CENTRAL SITE MICROPEM

2. CENTRAL SITE ALDEHYDE BADGE – YOU MAY HAVE MORE THAN 1

3. CENTRAL SITE VOC BADGE – YOU MAY HAVE MORE THAN 1

LEAVE SAMPLERS WITH BLACK DOTS IN THE BOX. IF INCLUDED IN THE BOX, THESE SAMPLERS WILL be used when YOU RETURN TOMORROW for retrieval OR AS REPLACEMENTS TODAY, IF NEEDED.

PRESS 1 TO CONTINUE

CENTRAL SITE MICROPEM DEPLOYMENT

CSPD2. [DISPLAY IF COLUMN URTOS IS NOT EMPTY, IF EMPTY SKIP TO CSPD6] PLACE CAP FROM YOUR SUPPLY BAG ONTO THE MICROPEM OPENING

TURN ON CENTRAL SITE MICROPEM LABELED WITH A BLUE DOT BY PRESSING BUTTON 1.

SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE CENTRAL SITE MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF YOU DO NOT HAVE THE CENTRAL SITE MICROPEM IN YOUR PARTICIPANT BOX, ENTER 000000

CENTRAL SITE MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER]

PROGRAMMER: CENTRAL SITE MICROPEM SERIAL ID SHOULD BE 10 CHARACTERS: UCC32#### AND 1 LETTER. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED. IF FI ENTERED 000000, PLEASE SKIP TO CSPD2b2

PROGRAMMER: IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE (WHICH IS A CENTRAL SITE MICROPEM UNIT FOUND IN COLUMN URTOS AS SET IN THE SYSTEM), GO TO CSPD2d. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT DOES NOT MATCH A CENTRAL SITE MICROPEM FOUND IN COLUMN URTOS), GO TO CSPD2a.

CSPD2a. ARE YOU SURE YOU SCANNED/KEYED THE SERIAL ID ON A CENTRAL SITE MICROPEM UNIT? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE MICROPEM.

1. YES, I AM SURE I SCANNED THE CENTRAL SITE MICROPEM UNIT

2. NO, I AM NOT SURE I SCANNED THE CENTRAL SITE MICROPEM UNIT

CSPD2b. [IF CSPD2a =YES] DO YOU WANT TO ADD THIS CENTRAL SITE MICROPEM UNIT TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1. YES

2. NO

PROGRAMMER IF CSPD2b =YES, SKIP TO CSPD2c

CSPD2b1. [IF CSPD2a=NO OR CSPD2b=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT CENTRAL SITE MICROPEM UNIT?

1 YES, I WANT TO SCAN THE CORRECT CENTRAL SITE MICROPEM UNIT

2 NO, I DO NOT HAVE THE CORRECT CENTRAL SITE MICROPEM

PROGRAMMER: IF CSPD2b1= 1, LOOP BACK TO CSPD2.

CSPD2b2. [IF CSPD2b1=2 OR IF CSPD2=000000] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT CENTRAL SITE MICROPEM

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD2b1=2, SKIP TO CSPD5

CSPD2c. [IF CSPD2b=YES] THIS CENTRAL SITE MICROPEM UNIT HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD2d. SCAN BARCODE ON THE CENTRAL SITE MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE CENTRAL SITE MICROPEM FILTER ID IS MISSING, ENTER 000000

CENTRAL SITE MICROPEM FILTER ID NUMBER: ____________[ALLOW 6 CHARACTERS – UP AND 4 NUMBERS]

PROGRAMMER: CENTRAL SITE MICROPEM FILTER ID SHOULD BE 6 CHARACTERS: UP####. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED. IF FI ENTERED 000000, PLEASE SKIP TO CSPD2f2

PROGRAMMER: IF SCANNED/KEYED BARCODE ON MICROPEM MATCHES EXPECTED BARCODE (WHICH IS A CENTRAL SITE MICROPEM FILTER ID FOUND IN COLUMN UP_OS AS SET IN THE SYSTEM), GO TO CSPD3. IF SCANNED BARCODE ON MICROPEM IS DIFFERENT FROM EXPECTED BARCODE (IT DOES NOT MATCH A CENTRAL SITE MICROPEM FILTER ID FOUND IN COLUMN UP_OS), GO TO CSPD2e.

CSPD2e. ARE YOU SURE YOU SCANNED/KEYED THE ID ON A CENTRAL SITE MICROPEM FILTER?

1. YES, I AM SURE I SCANNED THE CENTRAL SITE MICROPEM FILTER

2. NO, I AM NOT SURE I SCANNED THE CENTRAL SITE MICROPEM FILTER

CSPD2f. [IF CSPD2e=YES] DO YOU WANT TO ADD THIS CENTRAL SITE MICROPEM FILTER TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1. YES

2. NO

PROGRAMMER IF CSPD2f=YES, SKIP TO CSPD2g

CSPD2f1. [IF CSPD2e=NO OR CSPD2f=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT CENTRAL SITE MICROPEM FILTER?

1 YES, I WANT TO SCAN THE CORRECT CENTRAL SITE MICROPEM FILTER

2 NO, I DO NOT HAVE THE CORRECT CENTRAL SITE MICROPEM FILTER

PROGRAMMER: IF CSPD2f1= 1, LOOP BACK TO CSPD2d.

CSPD2f2. [IF CSPD2f1=2 OR IF CSPD2d=000000] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT CENTRAL SITE MICROPEM FILTER

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD2f1=2, SKIP TO CSPD3

CSPD2g. [IF CSPD2f=YES] THIS CENTRAL SITE MICROPEM FILTER HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD3. WHAT IS THE CONDITION OF THE CENTRAL SITE MICROPEM? SELECT ALL THAT APPLY

1 NO DAMAGE

2 PUMP DID NOT START/IS INAUDIBLE (NOT DEPLOYABLE)

3 LED IS NOT BLINKING (NOT DEPLOYABLE)

4 VISIBLE DAMAGE TO THE CASE

5 OTHER

CSPD3a. [IF CSPD3=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE MICROPEM

___________________ [ALLOW 100 CHARACTERS]

CSPD3b. [IF CSPD3=OTHER] CAN THE CENTRAL SITE MICROPEM STILL BE DEPLOYED?

1 YES

2 NO

CSPD3c. [IF CSPD3=2 OR 3 OR CSPD3b=NO] PLEASE REFER TO YOUR JOB AIDS BOOKLET FOR STEPS TO TAKE TO CORRECT THE MALFUNCTIONING MICROPEM. PLEASE COMPLETE THESE STEPS A MINIMUM OF 2 TIMES.

AFTER FOLLOWING THE STEPS IN THE JOB AIDS BOOKLET, IS THE MICROPEM NOW FUNCTIONING PROPERLY AND READY TO BE DEPLOYED?

1 YES

2 NO

CSPD3d. [IF CSPD3c=NO] DO NOT DEPLOY THE MICROPEM.

PLACE THE INOPERABLE CENTRAL SITE MICROPEM BACK IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

PROGRAMMER: IF CSPD3c=NO, AFTER PRESSING 1 TO CONTINUE, SKIP TO CSPD5

CSPD4. [IF CSPD3=1, 4, (OR 5 IF CSPD3b=YES) OR IF CSPD3c=YES] LEAVE THE CENTRAL SITE MICROPEM TURNED ON AND CAPPED FOR 1 MINUTE.

AFTER 1 MINUTE, REMOVE THE CAP AND PLACE BACK IN YOUR SUPPLY BAG

PLACE THE CENTRAL SITE MICROPEM (STILL POWERED ON) IN THE CENTER CAGE IN THE CENTRAL SITE PLATFORM CAGE.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPD5. HAS THE CENTRAL SITE MICROPEM BEEN SUCCESSFULLY DEPLOYED?

1 YES

2 NO

CSPD5a. [IF CSPD5=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE CENTRAL SITE MICROPEM

___________________ [ALLOW 100 CHARACTERS]

CENTRAL SITE ALDEHYDE BADGE DEPLOYMENT

CSPD6. [DISPLAY IF COLUMN AL_OD IS NOT EMPTY, IF EMPTY SKIP TO CSPD6a ] YOU SHOULD HAVE FOUND 2 ALDEHYDE BADGES IN YOUR CENTRAL SITE BOX.

THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO DEPLOY BOTH BADGES IN THE CENTRAL SITE PLATFORM CAGE. YOU WILL DEPLOY EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY

PRESS 1 TO CONTINUE

PROGRAMMER: IF COLUMN AL_OD IS NOT EMPTY, THIS INDICATES THE FI SHOULD DEPLOY 2 ALDEHYDE BADGES. PLEASE DUPLICATE THE STEPS FOR CSPD6a THROUGH CSPD8 AND ADD QUESTION CSPD9b IF DEPLOYING THE SECOND ALDEHYDE BADGE.

CSPD6a. [IF DEPLOYING THE FIRST ALDEHYDE BADGE DISPLAY IF COLUMN AL_OS IS NOT EMPTY, IF EMPTY SKIP TO CSPD10. IF DEPLOYING THE SECOND ALDEHYDE BADGE, DISPLAY IF COLUMN AL_OD IS NOT EMPTY, IF EMPTY SKIP TO CSPD10] TAKE THE CENTRAL SITE ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLUE DOT

PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE

SCAN BARCODE ON CENTRAL SITE ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF YOU DO NOT HAVE A CENTRAL SITE ALDEHYDE BADGE IN YOUR CENTRAL SITE BOX, ENTER 000000

CENTRAL SITE ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]

PROGRAMMER: CENTRAL SITE ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED. IF FI ENTERED 000000, PLEASE SKIP TO CSPD6c2

PROGRAMMER: IF SCANNED/KEYED BARCODE ON ALDEHYDE BADGE MATCHES EXPECTED BARCODE (WHICH IS A CENTRAL SITE ALDEHYDE BADGE LISTED IN AL_OS FOR THE FIRST BADGE OR AL_OD FOR THE SECOND BADGE), GO TO CSPD7. IF SCANNED BARCODE ON ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A CENTRAL SITE ALDEHYDE BADGE LISTED IN AL_OS FOR THE FIRST BADGE OR AL_OD FOR THE SECOND BADGE), GO TO CSPD6b.

CSPD6b. ARE YOU SURE YOU SCANNED/KEYED THE CENTRAL SITE (BLUE DOTTED) ALDEHYDE BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE ALDEHYDE BADGE.

[CHECK ID AGAINST ALDEHYDE IDS IN COLUMN AL_FB FOR THE CENTRAL SITE BOX ID SCANNED IN CSPDINTRO, IF A MATCH DISPLAY, “OUR RECORDS SHOW YOU HAVE SCANNED A FIELD BLANK ALDEHYDE BADGE LABELED WITH A BLACK DOT”]

1. YES, I AM SURE I SCANNED THE CENTRAL SITE NON-FIELD BLANK ALDEHYDE BADGE

2. NO, I AM NOT SURE I SCANNED THE CENTRAL SITE NON-FIELD BLANK ALDEHYDE BADGE

CSPD6c. [IF CSPD6b=YES] DO YOU WANT TO ADD THIS CENTRAL SITE ALDEHYDE BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1 YES

2 NO

PROGRAMMER: IF CSPD6c= YES, SKIP TO CSPD6d

CSPD6c1. [IF CSPD6b=NO OR CSPD6c=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT CENTRAL SITE ALDEHYDE BADGE?

1 YES, I WANT TO SCAN THE CORRECT CENTRAL SITE ALDEHYDE BADGE

2 NO, I DO NOT HAVE THE CORRECT CENTRAL SITE ALDEHYDE BADGE

PROGRAMMER: IF CSPD6c1= 1, LOOP BACK TO CSPD6a.

CSPD6c2. [IF CSPD6c1=2 OR IF CSPD6a=000000] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT CENTRAL SITE ALDEHYDE BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD6c1=2, SKIP TO CSPD7d

CSPD6d. [IF CSPD6c=YES] THIS CENTRAL SITE ALDEHYDE BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD7. WHAT IS THE CONDITION OF THE CENTRAL SITE ALDEHYDE BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 GREEN SLIDE OPEN ALREADY OR MISSING

3 CLIP BROKEN/NOT PRESENT

4 MINOR SCRATCH TO BADGE

5 MAJOR CRACK TO BADGE (NOT DEPLOYABLE)

6 OTHER

CSPD7a. [IF CSPD7=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPD7b. [IF CSPD7=OTHER] CAN THE CENTRAL SITE ALDEHYDE BADGE STILL BE DEPLOYED?

1 YES

2 NO

CSPD7c. [IF CSPD7=5 or CSPD7b=NO ] DO NOT DEPLOY THE CENTRAL SITE ALDEHYDE BADGE.

PLACE THE INOPERABLE CENTRAL SITE ALDEHYDE BACK IN ITS POUCH AND IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

CSPD7d. [IF CSPD7b=NO OR CSPD7=5 AND COLUMN AL_FB IS NOT EMPTY, IF AL_FB IS EMPTY, SKIP TO CSPD9] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK ALDEHYDE BADGE IN YOUR CENTRAL SITE BOX. DO YOU HAVE THIS BADGE?

1 YES

2 NO, THERE IS NO FIELD BLANK IN THE BOX

3 NO, I USED THE FIELD BLANK FOR THE CENTRAL SITE PLATFORM DEPLOYMENT

PROGRAMMER: IF CSPD7d=2 OR 3, SKIP TO CSPD9 IF DEPLOYING THE FIRST BADGE, SKIP TO CSPD9b IF DEPLOYING THE DUPLICATE BADGE

CSPD7e. [IF CSPD7d=YES] TAKE THE FIELD BLANK ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT.

PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE

SCAN BARCODE ON BLACK DOTTED FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

BLACK DOTTED FIELD BLANK ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]

PROGRAMMER: FIELD BLANK ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

PROGRAMMER: IF SCANNED/KEYED BARCODE ON ALDEHYDE BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK ALDEHYDE BADGE LISTED IN AL_FB), GO TO CSPD7i. IF SCANNED BARCODE ON ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK ALDEHYDE BADGE LISTED IN AL_FB), GO TO CSPD7f.

CSPD7f. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) ALDEHYDE BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE ALDEHYDE BADGE.

[CHECK ID AGAINST ALDEHYDE IDS IN COLUMN AL_OS FOR THE CENTRAL SITE BOX ID SCANNED IN CSPDINTRO, IF A MATCH DISPLAY, “OUR RECORDS SHOW YOU HAVE SCANNED AN CENTRAL SITE ALDEHYDE BADGE LABELED WITH A BLUE DOT”]

1. YES, I AM SURE I SCANNED THE FIELD BLANK ALDEHYDE BADGE

2. NO, I AM NOT SURE I SCANNED THE FIELD BLANK ALDEHYDE BADGE

CSPD7g. [IF CSPD7f=YES] DO YOU WANT TO ADD THIS FIELD BLANK ALDEHYDE BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1 YES

2 NO

PROGRAMMER IF CSPD7g= YES, SKIP TO CSPD7h

CSPD7g1. [IF CSPD7f=NO OR CSPD7g=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT FIELD BLANK ALDEHYDE BADGE?

1 YES, I WANT TO SCAN THE CORRECT FIELD BLANK ALDEHYDE BADGE

2 NO, I DO NOT HAVE THE CORRECT FIELD BLANK ALDEHYDE BADGE

PROGRAMMER: IF CSPD7g1= 1, LOOP BACK TO CSPD7e.

CSPD7g2. [IF CSPD7g1=2] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT FIELD BLANK ALDEHYDE BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD7g1=2, SKIP TO CSPD9 IF DEPLOYING THE FIRST BADGE, CSPD9b IF DEPLOYING THE SECOND BADGE

CSPD7h. [IF CSPD7g=YES] THIS FIELD BLANK ALDEHYDE BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD7i. WHAT IS THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 GREEN SLIDE OPEN ALREADY OR MISSING

3 CLIP BROKEN/NOT PRESENT

4 MINOR SCRATCH TO BADGE

5 MAJOR CRACK TO BADGE (NOT DEPLOYABLE)

6 OTHER

CSPD7j. [IF CSPD7i=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPD7k. [CSPD7i=OTHER] CAN THE FIELD BLANK ALDEHYDE BADGE STILL BE DEPLOYED?

1 YES

2 NO

CSPD7l. [IF CSPD7i=5 or CSPD7k=NO ] DO NOT DEPLOY THE FIELD BLANK ALDEHYDE BADGE.

PLACE THE INOPERABLE FIELD BLANK ALDEHYDE BADGE BACK IN ITS POUCH AND IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

PROGRAMMER: IF CSPD7i=5 OR CSPD7k=NO AND COLUMN AL_OD IS EMPTY SKIP TO CSPD9, IF NOT EMPTY SKIP TO CSPD9b

CSPD8. [IF CSPD7=1, 2, 3, 4 (OR 6 if CSPD7b=YES) OR CSPD7i=1, 2, 3, 4, (OR 6 IF CSPD7k=YES)] SLIDE THE GREEN COVER DOWN TO OPEN THE ALDEHYDE BADGE

CLIP THE BADGE TO THE LABELED LOCATION IN THE CENTRAL SITE PLATFORM CAGE

RESEAL THE ALDEHYDE POUCH AND PUT THE POUCH BACK INTO THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPD9. HAS THE ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?

1 YES

2 NO

CSPD9a. [IF CSPD9=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

PROGRAMMER: IF COLUMN AL_OD IS NOT EMPTY PLEASE DUPLICATE THE STEPS FOR CSPD6a-CSPD8 FOR DEPLOYING THE SECOND ALDEHYDE BADGE.

CSPD9b. [IF COLUMN AL_OD IS NOT EMPTY] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY DEPLOYED?

1 YES

2 NO

CSPD9c. [IF CSPD9b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE SECOND ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CENTRAL SITE VOC BADGE DEPLOYMENT

CSPD10. [DISPLAY IF COLUMN VC_OD IS NOT EMPTY, IF EMPTY SKIP TO CSPD10a] YOU SHOULD HAVE FOUND 2 VOC BADGES IN YOUR CENTRAL SITE BOX.

THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO DEPLOY BOTH BADGES IN THE CENTRAL SITE PLATFORM CAGE. YOU WILL DEPLOY EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY

PRESS 1 TO CONTINUE

PROGRAMMER: IF COLUMN VC_OD IS NOT EMPTY, THIS INDICATES THE FI SHOULD DEPLOY 2 VOC BADGES. PLEASE DUPLICATE THE STEPS FOR CSPD10a THROUGH CSPD12 AND ADD QUESTION CSPD13b FOR DEPLOYING THE SECOND VOC BADGE.

CSPD10a. [IF DEPLOYING THE FIRST VOC BADGE DISPLAY IF COLUMN VC_OS IS NOT EMPTY, IF EMPTY SKIP TO OP15. IF DEPLOYING THE SECOND VOC BADGE, DISPLAY IF COLUMN VC_OD IS NOT EMPTY, IF EMPTY SKIP TO OP15]TAKE THE CENTRAL SITE VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLUE DOT.

PLACE THE SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF THE BADGE

SCAN THE BARCODE ON CENTRAL SITE VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF YOU DO NOT HAVE A CENTRAL SITE VOC BADGE IN YOUR CENTRAL SITE BOX, ENTER 000000

CENTRAL SITE VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]

PROGRAMMER: CENTRAL SITE VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED. IF FI ENTERED 000000, PLEASE SKIP TO CSPD10c2

PROGRAMMER: IF SCANNED/KEYED BARCODE ON VOC BADGE MATCHES EXPECTED BARCODE (WHICH IS A CENTRAL SITE VOC BADGE LISTED IN VC_OS FOR THE FIRST BADGE OR VC_OD FOR THE SECOND BADGE), GO TO CSPD11. IF SCANNED BARCODE ON VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A CENTRAL SITE VOC BADGE LISTED IN VC_OS FOR THE FIRST BADGE OR VC_OD FOR THE SECOND BADGE), GO TO CSPD10b.

CSPD10b. ARE YOU SURE YOU SCANNED/KEYED THE CENTRAL SITE (BLUE DOTTED) VOC BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE VOC BADGE.

[CHECK ID AGAINST VOC IDS IN COLUMN VC_FB FOR THE CENTRAL SITE BOX ID SCANNED IN CSPDINTRO, IF A MATCH DISPLAY, “OUR RECORDS SHOW YOU HAVE SCANNED A FIELD BLANK VOC BADGE LABELED WITH A BLACK DOT”]

1. YES, I AM SURE I SCANNED THE CENTRAL SITE NON-FIELD BLANK VOC BADGE

2. NO, I AM NOT SURE I SCANNED THE CENTRAL SITE NON-FIELD BLANK VOC BADGE

CSPD10c. [IF CSPD10b=YES] DO YOU WANT TO ADD THIS CENTRAL SITE VOC BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1. YES

2. NO

PROGRAMMER: IF CSPD10c= YES, SKIP TO CSPD10d

CSPD10c1. [IF CSPD10b=NO OR CSPD10c=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT CENTRAL SITE VOC BADGE?

1 YES, I WANT TO SCAN THE CORRECT CENTRAL SITE VOC BADGE

2 NO, I DO NOT HAVE THE CORRECT CENTRAL SITE VOC BADGE

PROGRAMMER: IF CSPD10c1= 1, LOOP BACK TO CSPD10a.

CSPD10c2. [IF CSPD10c1=2 OR IF CSPD10a=000000] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT CENTRAL SITE VOC BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD10c1=2, SKIP TO CSPD12d

CSPD10d. [IF CSPD10c=YES] THIS CENTRAL SITE VOC BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD11. WHAT IS THE CONDITION OF THE CENTRAL SITE VOC BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 TORN MEMBRANE

3 CLIP BROKEN/NOT PRESENT

4 MINOR SCRATCH TO BADGE

5 MAJOR CRACK TO BADGE (NOT DEPLOYABLE)

6 OTHER

CSPD11a. [IF CSPD11=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPD11b. [IF CSPD11=OTHER] CAN THE CENTRAL SITE VOC BADGE STILL BE DEPLOYED?

1 YES

2 NO

CSPD11c. [IF CSPD11=5 OR CSPD11b=NO] DO NOT DEPLOY THE VOC BADGE.

PLACE THE INOPERABLE CENTRAL SITE VOC BADGE BACK IN ITS CAN AND IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

CSPD11d. [IF CSPD11b=NO OR CSPD11=5 AND COLUMN VC_FB IS NOT EMPTY] ] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK VOC BADGE IN YOUR CENTRAL SITE BOX. DO YOU HAVE THIS BADGE?

1. YES

2. NO, THERE IS NO FIELD BLANK IN BOX

3. NO, I USED THE FIELD BLANK FOR THE CENTRAL SITE PLATFORM DEPLOYMENT

PROGRAMMER: IF CSPD11d=2 OR 3, SKIP TO CSPD13 IF DEPLOYING THE FIRST BADGE, SKIP TO CSPD13b IF DEPLOYING THE DUPLICATE BADGE

CSPD11e. [IF CSPD11d=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT

PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE

SCAN BARCODE ON FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]

PROGRAMMER: FIELD BLANK VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

PROGRAMMER: IF SCANNED/KEYED BARCODE ON VOC BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK VOC BADGE LISTED IN VC_FB), GO TO CSPD11i. IF SCANNED BARCODE ON VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK VOC BADGE LISTED IN VC_FB), GO TO CSPD11f.

CSPD11f. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK (BLACK DOTTED) VOC BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE VOC BADGE.

[CHECK ID AGAINST VOC IDS IN COLUMN VC_OS FOR THE CENTRAL SITE BOX ID SCANNED IN CSPDINTRO, IF A MATCH DISPLAY, “OUR RECORDS SHOW YOU HAVE SCANNED A CENTRAL SITE VOC BADGE LABELED WITH A BLUE DOT”].

1. YES, I AM SURE I SCANNED THE FIELD BLANK VOC BADGE

2. NO, I AM NOT SURE I SCANNED THE FIELD BLANK VOC BADGE

CSPD11g. [IF CSPD11f=YES] DO YOU WANT TO ADD THIS FIELD BLANK VOC BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1 YES

2 NO

PROGRAMMER IF CSPD11g= YES, SKIP TO CSPD11h

CSPD12g1. [IF CSPD12f=NO OR CSPD12g=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT FIELD BLANK VOC BADGE?

1 YES, I WANT TO SCAN THE CORRECT FIELD BLANK VOC BADGE

2 NO, I DO NOT HAVE THE CORRECT FIELD BLANK VOC BADGE

PROGRAMMER: IF CSPD12g1= 1, LOOP BACK TO CSPD12e.

CSPD12g2. [IF CSPD12g1=2] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT FIELD BLANK VOC BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPD12g1=2, SKIP TO CSPD13 IF DEPLOYING THE FIRST BADGE, CSPD13b IF DEPLOYING THE SECOND BADGE

CSPD11h. [IF CSPD11g=YES] THIS FIELD BLANK VOC BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSPD11i. WHAT IS THE CONDITION OF THE FIELD BLANK VOC BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 TORN MEMBRANE

3 CLIP BROKEN/NOT PRESENT

4 MINOR SCRATCH TO BADGE

5 MAJOR CRACK TO BADGE (NOT DEPLOYABLE)

6 OTHER

CSPD11j. [IF CSPD11i=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPD11k. [IF CSPD11i=OTHER] CAN THE FIELD BLANK VOC BADGE STILL BE DEPLOYED?

1 YES

2 NO

CSPD11l. [IF CSPD11i=5 OR CSPD11k=NO] DO NOT DEPLOY THE FIELD BLANK VOC BADGE.

PLACE THE INOPERABLE FIELD BLANK VOC BADGE BACK IN ITS CAN AND IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

PROGRAMMER: IF CSPD11i=5 OR CSPD11k=NO AND COLUMN VC_OD IS EMPTY SKIP TO CSPD13, IF NOT EMPTY SKIP TO CSPD13b

CSPD12. [IF CSPD11=1, 2, 3, 4 (OR 6 IF CSPD11b=YES) OR CSPD11i=1, 2, 3, 4, (OR 6 IF CSPD11k=YES]

CLIP THE BADGE TO THE LABELED LOCATION IN THE CENTRAL SITE PLATFORM CAGE

PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPD13. HAS THE VOC BADGE BEEN SUCCESSFULLY DEPLOYED?

1 YES

2 NO

CSPD13a. [IF CSPD13=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

PROGRAMMER: IF COLUMN VC_OD IS NOT EMPTY PLEASE DUPLICATE THE STEPS FOR CSPD10-CSPD12 FOR DEPLOYING THE SECOND VOC BADGE.

CSPD13b. [IF COLUMN VC_OD IS NOT EMPTY] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY DEPLOYED?

1 YES

2 NO

CSPD13c. [IF CSPD13b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT DEPLOY THE SECOND VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPD14. [[IF CSPD5=NO AND CSPD9=NO AND CSPD9b=NO AND CSPD13=NO AND CSPD13b=NO] YOU WERE NOT ABLE TO SUCCESSFULLY DEPLOY THE MICROPEM, THE ALDEHYDE BADGE, AND THE VOC BADGE.

PRESS 1 TO CONTINUE

CSPD14a. [IF CSPD5=NO AND CSPD9=NO AND CSPD9b=NO AND CSPD13=NO AND CSPD13b=NO] DO YOU HAVE AN ADDITIONAL UNOPENED (REPLACEMENT) CENTRAL SITE BOX WITH YOU THAT CAN BE USED FOR DEPLOYMENT AT THE CENTRAL SITE?

1. YES, I HAVE ANOTHER CENTRAL SITE BOX TO RE-DEPLOY AT THIS CENTRAL SITE

2. NO, I DO NOT HAVE ANOTHER CENTRAL SITE BOX

CSPD14b. [IF CSPD14a=YES] THE STEPS THAT FOLLOW WILL INSTRUCT YOU ON DEPLOYING THIS NEW CENTRAL SITE BOX AT THE CENTRAL SITE.

PRESS 1 TO CONTINUE

PROGRAMMER: SKIP TO CSPDINTRO AND RE-ADMINISTER CENTRAL SITE DEPLOYMENT STEPS

CSPD14c. [IF CSPD14a=NO]. THE STEPS THAT FOLLOW WILL INSTRUCT YOU ON PLACING THE EMPTY CENTRAL SITE CAGE AT THE APPROVED LOCATION

WHEN YOU RETURN TOMORROW, YOU WILL USE A NEW UNOPENED (REPLACEMENT) CENTRAL SITE BOX) TO DEPLOY THE SAMPLERS. YOU WILL NOT RETRIEVE ANY SAMPLERS TOMORROW

PLEASE NOTIFY YOUR SUPERVISOR OF THIS ISSUE

PRESS 1 TO CONTINUE

CSPD15. CHECK ASSEMBLED CENTRAL SITE PLATFORM AGAINST PICTURE IN JOB AIDS BOOKLET TO ENSURE CORRECTLY ASSEMBLED

CLOSE THE LID AND SECURE THE CAGE USING THE COMBINATION LOCK FOUND IN YOUR TOOLKIT (COMBINATION IS 821)

PRESS 1 TO CONTINUE

CSPD16. PLACE THE CENTRAL SITE PLATFORM CAGE IN THE LOCATION PROVIDED FOR CHAT BY THE LOUISIANA DEPARTMENT OF ENVIRONMENTAL PROTECTION (LA DEP).

PRESS 1 TO CONTINUE

CSPD17. HAS THE CENTRAL SITE PLATFORM BEEN SUCCESSFULLY DEPLOYED AND PLACED AT THE SITE?

SELECT “NO” IF THERE ARE NO SAMPLERS CURRENTLY IN THE CENTRAL SITE CAGE.

1 YES

2 NO

CSPD17a. [IF CSPD17=NO] PLEASE DESCRIBE WHY YOU HAVE NOT SUCCESSFULLY DEPLOYED AND PLACED THE CENTRAL SITE PLATFORM

___________________ [ALLOW 100 CHARACTERS]

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPDREND. PLEASE ENTER A ROC ABOUT TODAY’S CENTRAL SITE PLATFORM RETRIEVAL AND DEPLOYMENT ACTIVITIES

PRESS 1 TO ENTER

--END OF CENTRAL SITE PLATFORM DEPLOYMENT--

PROGRAMMER: EXIT USER OUT OF DEPLOYMENT SCRIPT

--CENTRAL SITE BOX RETRIEVAL--

CSPRINTRO1. PLEASE ENTER YOUR EMPLOYEE ID

EMPLOYEE ID NUMBER: ____________[ALLOW 6 CHARACTERS]

PROGRAMMER: CHECK THE ENTRY AGAINST THE INVENTORY OF VALID IDS. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE, INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT FIID TO PROCEED.

CSPRINTRO. [IF THE ID ENTERED IN CSPRINTRO1 = A VALID FIID FOUND IN THE INVENTORY] YOU WILL NOW RETRIEVE THE CHATS ENVIRONMENTAL ASSESSMENT EQUIPMENT DEPLOYED AT THIS CENTRAL SITE ON THE PREVIOUS DAY.

SCAN THE BARCODE ON THE CENTRAL SITE BOX USED TO DEPLOY THE MICROPEM, ALDEHYDE BADGE, AND VOC BADGE ON THE PREVIOUS DAY. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, OR THE ORIGINAL DEPLOYMENT BOX IS UNUSABLE, ENTER 000000

CENTRAL SITE BOX ID NUMBER: ____________[ALLOW 6 CHARACTERS – BX AND 4 NUMBERS OR 000000]

NODK

NOREF

PROGRAMMER: CENTRAL SITE BOX ID SHOULD BE 6 CHARACTERS: BX#### OR 000000. RECORD THE DATE AND TIME WHEN THE FI PRESSES ENTER. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED.

IF SCANNED/KEYED BARCODE MATCHES EXPECTED BARCODE (WHICH IS ID ENTERED IN CSPDINTRO), GO TO CSFBINTRO. IF SCANNED BARCODE IS DIFFERENT FROM EXPECTED BARCODE (IT DOES NOT MATCH ID ENTERED IN CSPDINTRO OR IT EQUALS 000000), GO TO CSPRINTROa.

CSPRINTROa. OUR RECORDS INDICATE THIS IS NOT THE SAME CENTRAL SITE BOX USED FOR DEPLOYMENT ON THE PREVIOUS DAY. IF YOU USE AN INCORRECT BOX FOR RETRIEVAL, THE CORRECT QUESTIONS MAY NOT DISPLAY FOR THIS CASE.

IF THE CORRECT CENTRAL SITE BOX IS IN A DIFFERENT LOCATION (SUCH AS YOUR HOME), PLEASE PERFORM A BREAK-OFF ON THIS SCREEN AND RETRIEVE THE CORRECT BOX.

DO YOU WANT TO TRY TO SCAN THE CORRECT CENTRAL SITE BOX?

1 YES, I WANT TO SCAN THE CORRECT CENTRAL SITE BOX

2 NO, THIS IS THE CORRECT CENTRAL SITE BOX. THE BARCODE HAS BEEN DAMAGED

3 NO, THE CORRECT CENTRAL SITE BOX IS NOT USABLE (SELECT ONLY IF THE CORRECT BOX HAS BEEN LOST, DAMAGED BEYOND REPAIR, OR IS OTHERWISE UNUSABLE)

PROGRAMMER: IF CSPRINTROa= 1, LOOP BACK TO CSPRINTRO. IF CSPRINTROa=2, SKIP TO CSFBIINTRO.

CSPRINTROb. [IF CSPRINTROa=3] PLEASE DESCRIBE THE REASON WHY THE CORRECT CENTRAL SITE BOX IS NOT USABLE. YOU WILL CONTINUE WITH THE RETRIEVAL STEPS. A NEW BOX WILL BE SENT TO YOU FOR SHIPPING THE ITEMS/SAMPLERS TO RTI.

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSPRINTROb=3, SKIP TO CSPR1

--CENTRAL SITE FIELD BLANK COLLECTION --

CSFBINTRO. [IF COLUMN AL_FB IS NOT EMPTY OR COLUMN VC_FB IS NOT EMPTY FOR THE CENTRAL SITE BOX SCANNED IN CSPRINTRO, IF BOTH COLUMNS ARE EMPTY SKIP TO CSPR1] FIELD BLANKS SHOULD HAVE BEEN INCLUDED IN THIS CENTRAL SITE BOX. THE NEXT SCREENS WILL GUIDE YOU THROUGH THE FIELD BLANK COLLECTION PROCESS

(PUT ON NITRILE GLOVES)

REMOVE FROM THE CENTRAL SITE BOX THE FOLLOWING FIELD BLANK CONTAINERS LABELED WITH A BLACK DOT:

1 FIELD BLANK ALDEHYDE BADGE POUCH

2 FIELD BLANK VOC BADGE CAN

PRESS 1 TO CONTINUE

--CENTRAL SITE FIELD BLANK ALDEHYDE BADGE—

CSFBINTROa. [DISPLAY IF COLUMN AL_FB IS NOT EMPTY, IF EMPTY SKIP TO CSFB5INTRO] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK ALDEHYDE BADGE IN YOUR CENTRAL SITE BOX. DO YOU HAVE THIS SAMPLER?

1 YES

2 NO, THERE IS NO BLACK DOTTED FIELD BLANK ALDEHYDE POUCH IN THE BOX

3 THE BLACK DOTTED FIELD BLANK ALDEHYDE POUCH IS EMPTY

PROGRAMMER: IF CSFBINTROa=2 OR 3, SKIP TO CSFB4

CSFB1. [IF CSFBINTROa=YES] TAKE THE FIELD BLANK ALDEHYDE (AL) BADGE OUT OF THE POUCH LABELED WITH A BLACK DOT

PEEL SECOND BARCODE LABEL FROM OUTSIDE OF POUCH AND PLACE ON BACK OF BADGE

SCAN BARCODE ON FIELD BLANK ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

FIELD BLANK ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS]

PRESS 1 TO CONTINUE

PROGRAMMER: FIELD BLANK ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

PROGRAMMER: IF SCANNED/KEYED BARCODE ON ALDEHYDE BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK ALDEHYDE BADGE LISTED IN AL_FB), GO TO CSFB2. IF SCANNED BARCODE ON ALDEHYDE BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK ALDEHYDE BADGE LISTED IN AL_FB), GO TO CSFB1a.

CSFB1a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK ALDEHYDE BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE ALDEHYDE BADGE.

1. YES, I AM SURE I SCANNED THE FIELD BLANK ALDEHYDE BADGE

2. NO, I AM NOT SURE I SCANNED THE FIELD BLANK ALDEHYDE BADGE

CSFB1b. [IF CSFB1a=YES] DO YOU WANT TO ADD THIS FIELD BLANK ALDEHYDE BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1 YES

2 NO

PROGRAMMER: IF CSFB1b=YES, SKIP TO CSFB1c

CSFB1b1. [IF CSFB1a=NO OR CSFB1b=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT FIELD BLANK ALDEHYDE BADGE?

1 YES, I WANT TO SCAN THE CORRECT FIELD BLANK ALDEHYDE BADGE

2 NO, I DO NOT HAVE THE CORRECT FIELD BLANK ALDEHYDE BADGE

PROGRAMMER: IF CSFB1b1= 1, LOOP BACK TO CSFB1.

CSFB1b2. [IF CSFB1b1=2] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT FIELD BLANK ALDEHYDE BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSFB1b1=2, SKIP TO CSFB4

CSFB1c. [IF CSFB1b=YES] THIS FIELD BLANK ALDEHYDE BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSFB2. WHAT IS THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE? SELECT ALL THAT APPLY.

1. NO DAMAGE

2. POUCH WAS ALREADY OPEN

3. GREEN SLIDE OPEN ALREADY OR MISSING

4. CLIP BROKEN/NOT PRESENT

5. MINOR SCRATCH TO BADGE

6. MAJOR CRACK TO BADGE

7. OTHER

CSFB2a. [IF CSFB2=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CSFB2b. SLIDE THE GREEN COVER DOWN TO OPEN THE BADGE AND THEN QUICKLY SLIDE IT UP TO CLOSE THE BADGE

PRESS 1 TO CONTINUE

CSFB3. PLACE THE BADGE BACK IN THE POUCH LABELED WITH A BLACK DOT, RESEAL THE POUCH AND PUT THE POUCH BACK INTO THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER: RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSFB4. HAS THE FIELD BLANK ALDEHYDE BADGE BEEN SUCCESSFULLY COLLECTED?

1 YES

2 NO

CSFB4a. [IF CSFB4=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE FIELD BLANK ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

--CENTRAL SITE FIELD BLANK VOC BADGE--

CSFB5INTRO. [DISPLAY IF COLUMN VC_FB IS NOT EMPTY, IF EMPTY SKIP TO CSPR1] YOU SHOULD HAVE A BLACK DOTTED FIELD BLANK VOC BADGE IN YOUR CENTRAL SITE BOX. DO YOU HAVE THIS SAMPLER?

1 YES

2 NO, THERE IS NO BLACK DOTTED FIELD BLANK VOC CAN IN THE BOX

3 THE BLACK DOTTED FIELD BLANK VOC CAN IS EMPTY

PROGRAMMER: IF CSFB5INTRO=2 OR 3, SKIP TO CSFB8

CSFB5. [IF CSFB5INTRO=YES] TAKE THE FIELD BLANK VOC (VC) BADGE OUT OF THE CAN LABELED WITH A BLACK DOT

PEEL SECOND BARCODE LABEL FROM THE CAN LID ONTO THE BACK OF BADGE

SCAN BARCODE ON THE FIELD BLANK VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

FIELD BLANK VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS]

PRESS 1 TO CONTINUE

PROGRAMMER: FIELD BLANK VOC BADGE ID SHOULD BE 6 CHARACTERS: VC####. CHECK THE ENTERED ID AGAINST VALID IDS IN THE SAMPLER INVENTORY. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

PROGRAMMER: IF SCANNED/KEYED BARCODE ON VOC BADGE MATCHES EXPECTED BARCODE (WHICH IS A FIELD BLANK VOC BADGE LISTED IN VC_FB), GO TO CSFB6. IF SCANNED BARCODE ON VOC BADGE IS DIFFERENT FROM EXPECTED BARCODE (IT IS NOT A FIELD BLANK VOC BADGE LISTED IN VC_FB), GO TO CSFB5a.

CSFB5a. ARE YOU SURE YOU SCANNED/KEYED THE FIELD BLANK VOC BADGE? PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THE VOC BADGE.

1. YES, I AM SURE I SCANNED THE FIELD BLANK VOC BADGE

2. NO, I AM NOT SURE I SCANNED THE FIELD BLANK VOC BADGE

CSFB5b. [IF CSFB5a=YES] DO YOU WANT TO ADD THIS FIELD BLANK VOC BADGE TO YOUR CENTRAL SITE BOX? A REPORT WILL BE SENT TO CHATS SUPERVISORS INFORMING THEM OF THE ADDITION.

1 YES

2 NO

PROGRAMMER: IF CSFB5b=YES, SKIP TO CSFB5c

CSFB5b1. [IF CSFB5a=NO OR CSFB5b=NO] DO YOU WANT TO TRY TO SCAN THE CORRECT FIELD BLANK VOC BADGE?

1 YES, I WANT TO SCAN THE CORRECT FIELD BLANK VOC BADGE

2 NO, I DO NOT HAVE THE CORRECT FIELD BLANK VOC BADGE

PROGRAMMER: IF CSFB5b1= 1, LOOP BACK TO CSFB5.

CSFB5b2. [IF CSFB5b1=2] PLEASE DESCRIBE THE REASON WHY YOU DO NOT HAVE THE CORRECT FIELD BLANK VOC BADGE

_________ ALLOW 100 CHARACTERS

PROGRAMMER: IF CSFB5b1=2, SKIP TO CSFB8

CSFB5c. [IF CSFB5b=YES] THIS FIELD BLANK VOC BADGE HAS BEEN ADDED TO THE CENTRAL SITE BOX ASSIGNED TO THIS CASE.

PRESS 1 TO CONTINUE

CSFB6. WHAT IS THE CONDITION OF THE FIELD BLANK VOC BADGE? SELECT ALL THAT APPLY.

1. NO DAMAGE

2. CAN WAS ALREADY OPEN

3. TORN MEMBRANE

4. CLIP BROKEN/NOT PRESENT

5. MINOR SCRATCH TO BADGE

6. MAJOR CRACK TO BADGE (NOT DEPLOYABLE)

7. OTHER

CSFB6a. [IF CSFB6=OTHER] PLEASE DESCRIBE THE CONDITION OF THE FIELD BLANK VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSFB7. PLACE THE FIELD BLANK VOC BADGE BACK IN THE CAN LABELED WITH A BLACK DOT.

PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSFB8. HAS THE FIELD BLANK VOC BADGE BEEN SUCCESSFULLY COLLECTED?

1. YES

2. NO

CSFB8a. [IF CSFB8=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT COMPLETE COLLECTION FOR THE FIELD BLANK VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

- CENTRAL SITE PLATFORM RETRIEVAL –

CSPR1. (PUT ON NITRILE GLOVES)

CSPR2. FOR CENTRAL SITE PLATFORM RETRIEVAL AND PACKAGING, REMOVE FROM THE CENTRAL SITE BOX THE FOLLOWING EMPTY CONTAINERS LABELED WITH A BLUE DOT:

1. CENTRAL SITE ALDEHYDE BADGE POUCH

2. CENTRAL SITE VOC BADGE CAN

IF THE CONTAINER IS NOT EMPTY, CHECK TO SEE IF YOU HAVE ANY EMPTY BLACK DOTTED FIELD BLANK CONTAINERS. YOU MAY HAVE USED A FIELD BLANK DURING THE PREVIOUS DAY’S DEPLOYMENT IF THE CENTRAL SITE BADGES WERE DAMAGED.

PRESS 1 TO CONTINUE

--CENTRAL SITE MICROPEM RETRIEVAL--

CSPR3. IS THE CENTRAL SITE MICROPEM IN THE CENTRAL SITE CAGE, OR IS IT MISSING? IF IN THE CENTRAL SITE CAGE, REMOVE THE MICROPEM FROM THE CAGE.

PLEASE SEE YOUR JOB AIDS BOOKLET FOR A PICTURE OF THE MICROPEM

1 YES, THE MICROPEM IS IN THE CENTRAL SITE CAGE

2 NO, THE MICROPEM IS MISSING

PROGRAMMER: IF CSPR3=2, SKIP TO QUESTION CSPR7

CSPR4. SCAN SERIAL ID BARCODE ON THE BOTTOM OF THE MICROPEM. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, ENTER 000000

CENTRAL SITE MICROPEM SERIAL ID NUMBER: ____________[ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER OR 6 CHARACTERS – UP AND 4 NUMBERS OR 000000]

PROGRAMMER: CENTRAL SITE MICROPEM SERIAL ID SHOULD BE 10 CHARACTERS: UCC32#### AND 1 LETTER OR 6 CHARACTERS – UP AND 4 NUMBERS OR 000000. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED.

CSPR4a. SCAN BARCODE ON THE CENTRAL SITE MICROPEM FILTER. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, ENTER 000000

CENTRAL SITE MICROPEM FILTER ID NUMBER: ____________[ALLOW 6 CHARACTERS – UP AND 4 NUMBERS OR ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER OR 000000]

PROGRAMMER: CENTRAL SITE MICROPEM FILTER ID SHOULD BE 6 CHARACTERS: UP#### OR ALLOW 10 CHARACTERS – UCC32, 4 NUMBERS, AND 1 LETTER OR 000000. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED.

CSPR5. WHAT IS THE CONDITION OF THE CENTRAL SITE MICROPEM? SELECT ALL THAT APPLY

1 MICROPEM STILL OPERATING

2 LIGHT ON MICROPEM IS NOT BLINKING

3 CANNOT HEAR HUMMING SOUND COMING FROM MICROPEM

4 CRACKS TO THE MICROPEM CASE

5 OTHER

CSPR5a. [IF CSPR5=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE MICROPEM

___________________ [ALLOW 100 CHARACTERS]

CSPR5b. [IF CSPR5=1] PUT THE CAP ON THE MICROPEM FOR 1 MINUTE. AFTER 1 MINUTE, TURN OFF MICROPEM

PRESS 1 TO CONTINUE

CSPR6. PLACE THE CENTRAL SITE MICROPEM BACK IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPR7. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE CENTRAL SITE MICROPEM?

1 YES

2 NO

CSPR7a. [IF CSPR7=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE CENTRAL SITE MICROPEM

___________________ [ALLOW 100 CHARACTERS]

--CENTRAL SITE ALDEHYDE BADGE RETRIEVAL--

CSPR8INTRO. [DISPLAY IF COLUMN AL_OD IS NOT EMPTY FOR THE CENTRAL SITE BOX SCANNED IN CSPRINTRO, IF EMPTY SKIP TO CSPR8] YOU WILL ATTEMPT TO RETRIEVE 2 ALDEHYDE BADGES FROM THE CENTRAL SITE CAGE.

THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.

PRESS 1 TO CONTINUE

CSPR8. IS THE CENTRAL SITE ALDEHYDE (AL) BADGE IN THE CENTRAL SITE CAGE, OR IS IT MISSING? IF IN THE CENTRAL SITE CAGE, REMOVE THE ALDEHYDE BADGE FROM THE CAGE.

PLEASE SEE YOUR JOB AIDS BOOKLET FOR A PICTURE OF THE ALDEHYDE BADGE

[IF AL_OD IS EMPTY, DISPLAY OPTIONS 1 AND 2, IF AL_OD IS NOT EMPTY DISPLAY OPTIONS 3, 4, AND 5]

1. THE ALDEHYDE BADGE IS IN THE CENTRAL SITE CAGE

2. THE ALDEHYDE BADGE IS MISSING

3. THE 2 ALDEHYDE BADGES ARE IN THE CENTRAL SITE CAGE

4. THE 2 ALDEHYDE BADGES ARE MISSING

5. ONE OF THE 2 EXPECTED ALDEHYDE BADGES IS MISSING

PROGRAMMER: IF CSPR8=2 OR 4, SKIP TO QUESTION CSPR12

PROGRAMMER: IF CSPR8=3 PLEASE DUPLICATE THE STEPS FOR CSPR9 THROUGH CSPR12 AND ADD QUESTION CSPR12b FOR RETRIEVING THE SECOND ALDEHYDE BADGE.

CSPR9. [IF CSPR8=1 OR 3 OR 5] SCAN BARCODE ON CENTRAL SITE ALDEHYDE BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, ENTER 000000

CENTRAL SITE ALDEHYDE BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - AL AND 4 NUMBERS OR 000000]

PRESS 1 TO CONTINUE

PROGRAMMER: CENTRAL SITE ALDEHYDE BADGE ID SHOULD BE 6 CHARACTERS: AL#### OR 000000. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

CSPR10. WHAT IS THE CONDITION OF THE CENTRAL SITE ALDEHYDE BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 GREEN SLIDE CLOSED (UP) ALREADY

3 GREEN SLIDE MISSING

4 CLIP BROKEN/NOT PRESENT

5 MINOR SCRATCH TO BADGE

6 MAJOR CRACK TO BADGE

7 OTHER

CSPR10a. [IF CSPR10=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPR10b. [IF CSPR10=1, 4, 5, 6, OR 7] SLIDE THE GREEN COVER UP TO CLOSE THE CENTRAL SITE ALDEHYDE BADGE

PRESS 1 TO CONTINUE

CSPR11. PLACE THE CENTRAL SITE ALDEHYDE BADGE BACK IN ITS POUCH

RESEAL THE POUCH AND PLACE THE POUCH BACK IN THE CENTRAL SITE BOX

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPR12. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE CENTRAL SITE ALDEHYDE BADGE?

1 YES

2 NO

CSPR12a. [IF CSPR12=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE CENTRAL SITE ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPR12b. [IF CSPR8=3] HAS THE SECOND ALDEHYDE BADGE BEEN SUCCESSFULLY RETRIEVED?

1 YES

2 NO

CSPR12c. [IF CSPR12b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND ALDEHYDE BADGE

___________________ [ALLOW 100 CHARACTERS]

--CENTRAL SITE VOC BADGE RETRIEVAL--

CSPR13INTRO. [DISPLAY IF COLUMN VC_OD IS NOT EMPTY FOR THE CENTRAL SITE BOX SCANNED IN CSPRINTRO, IF EMPTY SKIP TO CSPR13] YOU WILL RETRIEVE 2 VOC BADGES FROM THE CENTRAL SITE CAGE.

THE INSTRUCTIONS THAT FOLLOW WILL TELL YOU HOW TO RETRIEVE AND PACKAGE BOTH BADGES. YOU WILL RETRIEVE EACH BADGE SEPARATELY. FOLLOW THE NEXT STEPS CAREFULLY.

PRESS 1 TO CONTINUE

CSPR13. IS THE CENTRAL SITE VOC (VC) BADGE IN THE CENTRAL SITE CAGE, OR IS IT MISSING? IF IN THE CENTRAL SITE CAGE, REMOVE THE VOC BADGE FROM THE CAGE.

PLEASE SEE YOUR JOB AIDS BOOKLET FOR A PICTURE OF THE VOC BADGE

[IF VC_OD IS EMPTY, DISPLAY OPTIONS 1 AND 2, IF VC_OD IS NOT EMPTY DISPLAY OPTIONS 3, 4, AND 5]

1. THE VOC BADGE IS IN THE CENTRAL SITE CAGE

2. THE VOC BADGE IS MISSING

3. THE 2 VOC BADGES ARE IN THE CENTRAL SITE CAGE

4. THE 2 VOC BADGES ARE MISSING

5. ONE OF THE 2 EXPECTED VOC BADGES IS MISSING

PROGRAMMER: IF CSPR13=2 OR 4, SKIP TO QUESTION CSPR17

PROGRAMMER: IF CSPR13=3 PLEASE DUPLICATE THE STEPS FOR CSPR14 THROUGH CSPR17 AND ADD QUESTION CSPR17b FOR RETRIEVING THE SECOND VOC BADGE.

CSPR14. [IF CSPR13=1 OR 3 OR 5] SCAN THE BARCODE ON CENTRAL SITE VOC BADGE. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, ENTER 000000

CENTRAL SITE VOC BADGE ID NUMBER: ____________[ALLOW 6 CHARACTERS - VC AND 4 NUMBERS OR 000000]

PRESS 1 TO CONTINUE

PROGRAMMER: CENTRAL SITE VOC BADGE ID SHOULD BE 6 CHARACTERS: VC#### OR 000000. IF NOT A VALID ID, PLEASE HAVE A POP-UP BOX APPEAR WHEN THE FI PRESSES ENTER TO CONTINUE INDICATING THE FI HAS ENTERED AN INVALID ID AND SHOULD ENTER A CORRECT ID TO PROCEED

CSPR15. WHAT IS THE CONDITION OF THE CENTRAL SITE VOC BADGE? SELECT ALL THAT APPLY.

1 NO DAMAGE

2 TORN MEMBRANE

3 CLIP BROKEN/NOT PRESENT

4 MINOR SCRATCH TO BADGE

5 MAJOR CRACK TO BADGE

6 OTHER

CSPR15a. [IF CSPR15=OTHER] PLEASE DESCRIBE THE CONDITION OF THE CENTRAL SITE VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPR16. PLACE THE CENTRAL SITE VOC BADGE BACK IN ITS CAN.

PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE

CSPR17. HAVE YOU SUCCESSFULLY RETRIEVED AND PACKAGED THE CENTRAL SITE VOC BADGE?

1 YES

2 NO

CSPR17a. [IF CSPR17=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY RETRIEVE AND PACKAGE THE CENTRAL SITE VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPR17b. [IF CSPR13=3] HAS THE SECOND VOC BADGE BEEN SUCCESSFULLY RETRIEVED?

1 YES

2 NO

CSPR17c. [IF CSPR17b=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT RETRIEVE THE SECOND VOC BADGE

___________________ [ALLOW 100 CHARACTERS]

CSPR18. DID YOU RETRIEVE ALL SAMPLERS IN THE CENTRAL SITE CAGE AND IS THE CAGE CURRENTLY EMPTY?

1 YES

2 NO

CSPR18a. [IF CSPR18=NO] WHAT TYPE OF SAMPLER(S) IS REMAINING IN THE CENTRAL SITE CAGE?

PLEASE REVIEW YOUR JOB AIDS BOOKLET TO SEE A PICTURE OF THESE SAMPLERS

1. CENTRAL SITE MICROPEM

2. CENTRAL SITE ALDEHYDE BADGE

3. CENTRAL SITE VOC BADGE

CSPR18b. [IF CSPR18=NO] SCAN THE BARCODE ON [FILL FROMCSPR17c1]. IF THE BARCODE DOES NOT SCAN, KEY THE ID.

IF THE BARCODE HAS BEEN DAMAGED AND YOU ARE UNABLE TO SCAN OR KEY THE ID, ENTER 000000

[FILL FROM CSPR17c1]ID NUMBER: ____________[ALLOW 6 CHARACTERS]

PRESS 1 TO CONTINUE

CSPR18c. [IF CSPR18=NO] PLACE THE [FILL FROM CSPR18a] BACK IN ITS CONTAINER.

[DISPLAY IF CSPR18a=1] PUT THE CAP ON THE CENTRAL SITE MICROPEM FOR 1 MINUTE. AFTER 1 MINUTE, TURN OFF MICROPEM. PLACE THE CENTRAL SITE MICROPEM BACK IN THE CENTRAL SITE BOX

[DISPLAY IF CSPR18a=2] SLIDE THE GREEN COVER UP TO CLOSE THE CENTRAL SITE ALDEHYDE BADGE. PLACE THE CENTRAL SITE ALDEHYDE BADGE BACK IN ITS POUCH. RESEAL THE POUCH AND PLACE THE POUCH BACK IN THE CENTRAL SITE BOX

[DISPLAY IF CSPR18a=3]PLACE WHITE LID BACK ON THE CAN, MAKE SURE THE 3 CLEAR LIDS ARE STILL IN THE CAN, AND PUT THE CAN BACK IN THE CENTRAL SITE BOX.

PRESS 1 TO CONTINUE

PROGRAMMER RECORD TIME AND DATE STAMP WHEN USER PRESSES 1 TO CONTINUE. LOOP BACK TO CSPR18 UNTIL FI ENTERS YES.

--FINAL CENTRAL SITE RETRIEVAL QUESTIONS FOR RESPONDENTS--

CSPR19. TO THE BEST OF YOUR KNOWLEDGE, WAS THE CENTRAL SITE CAGE AND/OR THE DEVICES ATTACHED TO THE CAGE TAMPERED WITH OR DAMAGED IN ANY WAY?

1 YES

2 NO

CSPR19a. [IF CSPR19=YES] PLEASE DESCRIBE HOW THE CENTRAL SITE CAGE AND/OR THE DEVICES ATTACHED TO THE CAGE WERE TAMPERED WITH OR DAMAGED.

___________________ [ALLOW 100 CHARACTERS]

CSPR19b. TO THE BEST OF YOUR KNOWLEDGE HAS THE CENTRAL SITE CAGE BEEN MOVED TO DIFFERENT LOCATIONS AT THE SITE?

1 YES

2 NO

CPSR19c. [IF CSPR19b=YES] PLEASE DESCRIBE WHERE THE CAGE WAS MOVED TO.

___________________ [ALLOW 100 CHARACTERS]

--PREPARING CENTRAL SITE RETRIEVAL PACKAGE FOR FEDEX--

CSPR20. YOU WILL NOW PREPARE YOUR PACKED CENTRAL SITE RETRIEVAL CENTRAL SITE BOX(ES) FOR FEDEX SHIPMENT.

HOW MANY CENTRAL SITE BOXES WERE USED TO RETRIEVE ENVIRONMENTAL DEVICE/SAMPLERS FROM THIS SITE?

1 1 BOX

2 2 BOXES

CSPR20ICE. BEFORE SHIPPING YOUR CENTRAL SITE BOX(ES) TO RTI, PLEASE NOTE YOU SHOULD HAVE AN ICE PACK IN ALL BOXES THAT CONTAIN ALDEHYDE BADGE(S).

IF YOU DO NOT CURRENTLY HAVE AN ICEPACK IN THE BOX CONTAINING THE ALDEHYDE BADGE, DO NOT SEAL OR SHIP THE BOX UNTIL YOU HAVE INSERTED THE ICE PACK.

CSPR20a. SEE YOUR JOB AIDS BOOKLET FOR INSTRUCTIONS ON HOW TO PREPARE THE BOX(ES) FOR FEDEX SHIPMENT.

SCAN THE FEDEX TRACKING NUMBER ON THE COMPLETED FEDEX LABEL FOR BOX #1. IF THE BARCODE DOES NOT SCAN, KEY THE FEDEX TRACKING NUMBER.

BOX #1 FEDEX TRACKING NUMBER: ____________[ ALLOW 12 DIGIT NUMBER or F4]

IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU AT THE SITE ENTER F4 FOR REFUSED. YOU WILL NEED TO PROVIDE THE FEDEX LABEL TRACKING NUMBER TO YOUR SUPERVISOR WHEN YOU RETURN HOME.

CSPR20b. [IF CSPR20=2]. SCAN THE FEDEX TRACKING NUMBER ON THE COMPLETED FEDEX LABEL FOR BOX #2. IF THE BARCODE DOES NOT SCAN, KEY THE FEDEX TRACKING NUMBER.

BOX #2 FEDEX TRACKING NUMBER: ____________[ ALLOW 12 DIGIT NUMBER or F4]

IF YOU DO NOT HAVE A FEDEX LABEL WITH YOU AT THE SITE ENTER F4 FOR REFUSED. YOU WILL NEED TO PROVIDE THE FEDEX LABEL TRACKING NUMBER TO YOUR SUPERVISOR WHEN YOU RETURN HOME.

CSPR20c. HAVE YOU SUCCESSFULLY PREPARED YOUR CENTRAL SITE RETRIEVAL CENTRAL SITE BOX(ES) FOR FEDEX SHIPMENT?

1 YES

2 NO

CSPR20d. [IF CSPR20c=NO] PLEASE DESCRIBE THE REASON WHY YOU DID NOT SUCCESSFULLY PREPARE THE CENTRAL SITE BOX(ES) FOR FEDEX SHIPMENT

___________________ [ALLOW 100 CHARACTERS]

CSPR21. PLEASE ENTER A ROC ABOUT TODAY’S CENTRAL SITE PLATFORM RETRIEVAL AND DEPLOYMENT ACTIVITIES

--END OF CENTRAL SITE PLATFORM RETRIEVAL--

PROGRAMMER: EXIT USER OUT OF RETRIEVAL SCRIPT

Other Data Collection Instruments –

No Burden on Participants S-1