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Exposure Measurement

ICR 201708-0923-001 · OMB 0923-0058 · Object 76476601.

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Record metadata
File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	Exposure Measurement
Author	Zartarian, Valerie
Last Modified By	Writer
File Modified	2017-05-04
File Created	2026-10-10
Conversion State	complete

Extracted Text

Attachment 4f.  Exposure Measurement Form




Field Air Samples
(mark collection locations on field chart)

Sample Type
Field Location A
Sample Collected
Field Location B
Sample Collected
Background Location
Sample Collected
VOC Sample
Yes          No
Yes          No
Yes          No
SVOC Sample
Yes          No
Yes          No
Yes          No
Particle Sample
Yes          No
Yes          No
Yes          No



Field Wipe Samples
(mark collection locations on field chart)

Sample Type
Field Location A
Sample Collected
Field Location B
Sample Collected
Field Location C
Sample Collected
SVOC Sample A
Yes          No
Yes          No
Yes          No
SVOC Sample B
Yes          No
Yes          No
Yes          No
Metals Sample
Yes          No
Yes          No
Yes          No




Field Dust Samples
(mark collection locations on field chart)

Sample Type
Field Location A
Sample Collected
Field Location B
Sample Collected
Field Location C
Sample Collected
SVOC Sample
Yes          No
Yes          No
Yes          No
Metals Sample
Yes          No
Yes          No
Yes          No
Particles Sample
Yes          No
Yes          No
Yes          No








Sample Collection Locations


NOTE:  Use one form for each participant if multiple participants are part of a sampling event

Personal Air Sample – VOCs

Sample Type

Sample Collected
Personal
Yes          No

Dermal Dosimeter Samples - SVOCs

Sample Type
                        Sample Collected
Location 1 – Hand
Yes          No
Location 2 – Arm 
Yes          No
Location 3 - Leg
Yes          No

Dermal Dosimeter Samples - Metals

Sample Type
                                     Sample Collected
Location 1 – Hand 
Yes          No
Location 2 – Arm
Yes          No
Location 3 - Leg
Yes          No


Urine Samples 

Sample Type

Sample Collected
Pre-Activity
Yes          No
Post-Activity
Yes          No

Blood Samples 

Sample Type

Tube 1 Collected

Tube 2 Collected
Pre-Activity
Yes          No
Yes          No
Post-Activity
Yes          No
Yes          No