UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
NATIONAL AIR AND RADIATION ENVIRONMENTAL LABORATORY
540 SOUTH MORRIS AVENUE
MONTGOMERY, AL  36115-2601
PHONE:  (334) 270-3400	FAX:  (334) 270-3454	

AIR PARTICULATE SAMPLE REPORT

THIS SECTION FOR USE BY NAREL PERSONNEL ONLY

SAMPLE ID:  RAN - ____________________		DATE RECEIVED: ______________________

COMMENTS: 																											_____
SAMPLE INFORMATION
STATION NUMBER:  _______	LOCATION:  ___________________________________________
DATE/TIME OF COLLECTION (Coordinated Universal Time): _______________________________
NAME OF STATION OPERATOR:  ____________________________________________________
STATION OPERATOR’S TELEPHONE NUMBER:  _______________________________________
COMMENTS:  ____________________________________________________________________
________________________________________________________________________________
AIR SAMPLING DATA

SAMPLE START DATE/TIME (Coordinated Universal Time):  _______________________________
SAMPLE STOP DATE/TIME (Coordinated Universal Time):  ________________________________
TOTAL SAMPLE TIME (hours):  ______________    SAMPLE VOLUME (m3):  __________________	
AVERAGE SAMPLE FLOW RATE (m3/hour):  ___________________________________________
FIELD ACTIVITY CALCULATION
MEASUREMENT DATE/TIME (Coordinated Universal Time):  ______________________________								            GROSS ALPHA/BETA CPM:  ____________
								            BACKGROUND CPM:  -____________
							                   NET ALPHA/BETA CPM:  ____________
ALPHA CPM  _________________				               ALPHA CPM:  -____________
					    				         NET BETA CPM:  _____________
ALPHA EFFICIENCY: X                (pCi/cpm)                   BETA EFFICIENCY: X _________ (pCi/cpm)
	
ALPHA ACTIVITY:                    pCi					BETA ACTIVITY: _________ pCi
SAMPLE VOLUME:  ∕__________ m3				     SAMPLE VOLUME:  ∕__________ m3
α CONCENTRATION __________ pCi/m3		        β CONCENTRATION __________ pCi/m3
β ∕ α RATIO: __________