New Jersey Department of HealthPEOSH Unit FIT-TEST RECORD Responder has been medically cleared to wear a respirator prior to fit-testing. Name of EMS AgencyName of EMS ResponderDate of Fit-TestType of Fit-Test Qualitative Quantitative Bitrex Saccharin List device used:Respirator Model:NIOSHSize:PASS/FAIL:Fit Factor:Brand #:Approval #:Name of Person Conducting TestTitle Δ
