Standard Report

Quantitative

Qualitative

A. Employer / CompanyRAM Enterprises
B. Employee First NameIon
Last NameVoigt
Date10/18/2024
Employee No:2541
Employee Job Title / Description

PMD

C: Location / Address1225 west main street
Elko, NV 89801
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D. Conditions which could affect your respirator fit:
  • None
Squeezes Sensitivity10
E. Fit Check Test (select one of each):E. Fit Check Test (select one of each):
Positive Pressure
  • Pass
Negative Pressure
  • Pass
Respirator TypePAPR
Manufacturer3M
Model NumberVersiflow
SizeSmall N95
F: Fit Testing
  • Qualitative
Isoamyl AcetatePass
SweetPass
BitterPass
Irritant SmokePass
Select OneEmployee acknowledgment of test results and that there were NO ADVERSE REACTIONS to the fit test solutions at the time of the testing:(Required)
Comments

None

Choose fit test solution to test:Bitrex
G. REACTIONS to Fit Testing Solution:No
Complaints or IssuesNo
Fit test: Pass/FailPass
Type Full NameIon Voigt
Please check
  • I have received a copy of the medical approval letter form the PLHCP:
First and Last Name of Worker:Ion Voigt
Employee Signature
Date:Date: March 17, 2026
Retest Date10/18/2025
Test Conducted By:Dahiana Pimentel
Signature:
Date:Date: March 17, 2026
Disclaimer:The above respirator fit test was performed on and by the persons listed. The results indicate the performance of the listed respiratory protective device, as fitted on the employee named on this record under controlled conditions. Fit testing as performed measures the ability of the respiratory protective device to provide protection to the individual tested. The Test Conductor express or imply no guarantee that this or an identical respiratory protective device will provide adequate protection under conditions other than those present when this test was performed. Improper use, maintenance, or application of this or any other respiratory protective device will reduce or eliminate protection.