Form 0920-0109 Determination of Capacity (CCER)

[NIOSH] Information Collection Provisions in 42 CFR Part 84 - Tests and Requirements for Certification and Approval of Respiratory Protective Devices

Atch_14_Capacity Test.xlsx

Att 14 Capacity Test

OMB: 0920-0109

Document [xlsx]
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Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSD Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0109).
DETERMINATION OF CAPACITY (CCER)




PROCEDURE NO. TEB-CCER-STP-0612










Date

Manufacturer

TN

Model

Serial #

Manufacturing Date



Phenol:

Leak Rate

Capacity

Subject Height

Subject Weight Initial



Subject Weight Final



Unit Weight Initial

Unit Weight Final

Starting O2

End O2












Speed



Grade









Test Duration



Technician(s)









Comments








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