Form ETB-1214 Rev 1 FPW ETB-1214 Rev 1 FPW Determination of Performance Form

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Overview

OMB Form #
Avg. Inhaled CO2 and O2

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Sheet 1: OMB Form #

Form Approved

OMB No. 0920-0109

Exp. Date xx/xx/20xx

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).

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Sheet 2: Avg. Inhaled CO2 and O2

		Determination of Performance Form
	TEB-CCER-STP-0613
	Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen
Time	Maximum Inhaled CO2%	Minute Average CO2%	Running Range Average CO2%	Minimum Inhaled O2%	Minute Average O2%	Running Range Average O2%
Minute	Limit= ≤ 4%	Limit = 4%	Limit = ≤ 1.5% at test end	Limit = ≥ 15%	Limit = 15%	Limit = > 19.5% at test end
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	Determination of Performance Form
	TEB-CCER-STP-0613
	Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen
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	Determination of Performance Form
	TEB-CCER-STP-0613
	Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen
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	TEB-CCER-STP-0613
	Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen
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