Respirator Evaluation Questionnaire - Part B, Questions 18-19

The final questions of the questionnaire involve toxic substance exposure.

18. Provide the following information, if you know it, for each toxic substance that you'll be exposed to when you're using your respirator(s):
    • Name of the first toxic substance:
      • Estimated maximum exposure level per shift:
      • Duration of exposure per shift:
    • Name of the second toxic substance:
      • Estimated maximum exposure level per shift:
      • Duration of exposure per shift:
    • Name of the third toxic substance:
      • Estimated maximum exposure level per shift:
      • Duration of exposure per shift:
    • The name of any other toxic substances that you'll be exposed to while using your respirator.
19. Describe any special responsibilities you'll have while using your respirator(s) that may affect the safety and well-being of others (for example, rescue, security).

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