Respiratory Protection Table of Contents
Record Keeping
All records will be kept in the St. Olaf personnel office.
Compliance Checklist
Person Projected Actual
Responsible Completion Completion
Date Date
1.Identify
Program
Administrator.
Place his/her
name in the
Compliance
Manual. __________________ / _______________ / _______________
2.Program
Administrator
reads Standard
and Plan filling
in all blanks. __________________ / _______________ / _______________
3.Program
Administrator
duplicates forms
in Facilities
Application
Section. __________________ / _______________ / _______________
4.Determine the
areas that need
to be surveyed
for air
contaminants. __________________ / _______________ / _______________
5.Assign people to
do the surveying.
They will
complete columns
1-3 of the Air
Contaminant
Inventory and
Evaluation form
for any air
contaminants. __________________ / _______________ / _______________
6.Obtain MSDS's for
all air
contaminants
identified on the
inventory. __________________ / _______________ / _______________
7.Have the
contaminant
evaluated for
respirator use. __________________ / _______________ / _______________
8.The
Contaminant
Inventory and
Evaluation form
will be
completed. __________________ / _______________ / _______________
9.Purchase various
sizes of the
required
respirators. __________________ / _______________ / _______________
10.Schedule
Respirator
Protection and
Training&Fit
Testing. __________________ / _______________ / _______________
11.Conduct Training.
__________________ / _______________ / _______________
12.Insert docu-
mentation in the
manual. __________________ / _______________ / _______________
13.Send medical
questionnaires to
a physician for
evaluation. __________________ / _______________ / _______________
14.Review Medical
forms evaluated
by Physician to
ensure employee's
ability to use a
respirator. __________________ / _______________ / _______________
15.Arranges Physical
Exam for any employee
recommended for
exam if employer
is going to
require
respiratory
protection. __________________ / _______________ / _______________
16.Route Respiratory
Protection
Written Program
to all individuals
on sign off sheet
for their
signature. __________________ / _______________ / _______________
17.Evaluate program
yearly. __________________ / _______________ / _______________
18.Reschedule
training as
needed. __________________ / _______________ / _______________
19.Contact the
coordinator
of Environmental
Health and Safety
whenever exposures
are expected to
change, new exposures
are anticipated, or
complaints are
received. _________________ / _______________ / _______________
20.St. Olaf will
contact the
coordinator of
Environmental Health
and Safety whenever
changes in personnel,
equipment, processes,
etc., or program
inadequacies make
updating necessary.________________ / _______________ / _______________
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