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2.0 HEALTH AND SAFETY ACTIVITIES <br /> a. Was air monitoring performed? Yes No <br /> b. What type of air monitoring was conducted? Personal Area <br /> c. What instrument was used? <br /> d. Was medical monitoring conducted? Yes No <br /> e. What changes were made due to air monitoring results? <br /> 3.0 NAMES OF PERSONNEL ON SITE <br /> Name Company <br /> 4.0 PLEASE ATTACH THE FOLLOWING INFORMATION <br /> Air Monitoring Data Sheet <br /> Medical Monitoring Records <br /> Compliance Agreements <br /> FORM COMPLETED BY: <br /> Signature Dane <br /> Print Name <br />