Major Noise Source(s):
Engineering Controls (Describe if applicable):
Hours in Work Shift
(PEL) Permissible exposure limit:
Sample length (minutes):
Sample result (TWA):
SUBMIT a copy or original of this Document to Human Resources for inclusion in the employee file:
NOTIFICATION of EMPLOYEE = or > 85dBa?
IF YES, Then Notify Employee using this document, as part of the Hearing Conservation Program, or similar communication to meet notification intent.
W.C. Spratt, Inc. shall notify each employee exposed at or above an 8 hour time-weighted average (TWA) of 85 decibels of the results of the monitoring."