PM2.

5 FRM Sample Report

Site Identification: Mira Loma

Field Operator:

_______________________________

Sampler Type: BGI PQ200VSCC, Sampler Serial No: ______

Date & Time of Visit:

_______________________________

Post-Sampling Information
Record sampler and site conditions below. Sample data is available from the * Review Last Run Data and Conditions screen.

Collected Filter ID: ____________

Filter Condition: Normal

Other _______________________________________

Elapsed Time (ET): ____________

Total Volume (TV): ____________(m3)

Sampler Status (Circle): P Q F T M

Start Date & Time: __________________ Stop Date & Time: __________________
Flowrate - Q (VLpm): ____________

AVG Flowrate: ____________ (Lpm)

CV: ____________%

Ambient Temp (A) ____________C

Filter Temp (F) ____________C

Tmin:

____________ (C)

Tavg:

____________ (C)

BPmin:

____________ (mmHg)

BPavg:

____________ (mmHg)

Current Conditions
BP ____________mmHg
Run Conditions
Tmax:

____________ (C)

BPmax: ____________ (mmHg)

Current Site
Conditions:

No Unusual Conditions
Wind, Blown Sand or Dust

Rain or Snow
Other _________________________________________________________

Has sampler data file been downloaded to a PC? Yes No (Details: ____________________________________________)
Notes: __________________________________________________________________________________________________

FRM Service Informartion

Confirm performed tasks, and record all data. Work shall be performed as per the Field Test Schedule.

Visually inspect the sampler o-rings, filter holder housing, electrical connections, and the internal water trap. Empty and clean the
water collection jar as needed. Note any abnormalities: _________________________________________________________
External Leak
Check Performed?

YES / NO

Results:

PASS / FAIL

Final __________(cmH2O)

(Daily)

Internal Leak
Check Performed?

YES / NO

Results:

PASS / FAIL

YES / NO

Results:

(1/5 Samples)

Verified Ambient
Temperature?

YES / NO

Results:

(1/5 Samples)

Verified Sampler
Flowrate?

YES / NO

Results:

(1/5 Samples)

Verified Sampler
Clock?

YES / NO

Results:

(1/5 Samples)

Field Blank
Installed:

Initial__________(cmH2O)
Final __________(cmH2O)

(1/5 Samples)

Verified Barometric
Pressure?

Initial__________(cmH2O)

YES / NO

Filter ID:

Sampler Reading:

__________mmHg

Standard Reading:

__________mmHg

Sampler Reading:

__________C (A)

Standard Reading:

__________C (A)

Sampler Reading:

__________Lpm

Standard Reading:

__________Lpm

Sampler Reading:

__________

Standard Reading:

__________

_______________

(1/10 Samples)

Acceptance Criteria
+/- 10mmHg
Acceptance Criteria
+/- 2.0 C
Acceptance Criteria
+/-2% (16.3/17.0 lpm)
Acceptance Criteria
+/-1.0 minute
If acceptance criteria are not
met, or a leak check fails,
advise a field test contact
ASAP.

Sample Run Setup Information

Record the following information regarding the subsequent sample run. Use the * Run Sampler w/ User Defined Start/Stop screen to schedule the event.

Installed Filter ID: __________

Start Date & Time: __________________ Stop Date & Time: __________________

Signature: _________________________