BOS 4301 Industial Hygiene

February 4, 2013

Mr. Bob Johnson ACME Printing Corporation, Inc.

100 Main Street

Happy Valley, Washington 70001

SUBJECT: ANNUAL AIR SAMPLING SURVEY

Dear Mr. Johnson:

The subject report is attached and discusses the results of the air sampling survey I conducted on December 13th at the ACME Printing Corporation facility in Happy Valley, WS. The purpose of the survey was to evaluate personal exposures to select components of commonly used chemicals associated with the ACME printing process. An additional sample was collected to assess ambient concentrations of ozone. A discussion of relevant exposure limits is included.

If there are any comments or questions, call me at (720) 123-4567.

Thank you.

Signature Here

Sam “IH” Sampler Industrial Hygienist

1234 1st Street

Gilbert, WS 70002

(720) 123-4567