Form 0920-0109 Special Test - Model Transfer- Combination, Open-Circuit

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

Atch_23_Stressors.xlsx

Att 25 Test 147

OMB: 0920-0109

Document [xlsx]
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Overview

OMB Form #
Avg. Inhaled CO2 and O2


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).

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

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Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen







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Determination of Performance Form

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Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen







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Data Sheet for Average Inhaled Carbon Dioxide and Average Inhaled Oxygen







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