1. LETTER OF APPOINTMENT- AFI 91-202 Virtual SEG 54 #2 (1/8)

1.1. Is the Primary USR appointed in writing by the Unit Commander? (SEG 54 #2)

2. PURCHASE REQUEST 91-202 Virtual SEG 54 #6 (2/8)

2.1. Has the commander ensured requests for equipment, products, and services using purchase orders and/or GPC are reviewed for potential safety and health impact? (SEG 54 #6)

3. Unit CC Perspective Letter 91-202 Virtual SEG 54 #8 (3/8)

3.1. Is the current Unit Commander’s Safety Perspective Letter available? (SEG 54 #8) 91-202 para

4. Supervisor Information

4.1. Does the supervisor use risk management techniques to analyze the work environment and job tasks for hazards. Is JSA part of the process? Virtual SEG 55 #2 (4/8) AFI 91-202
Looking for all RM/JSA processes.

4.2. Has the work center supervisor developed a Job Safety Training Outline that is work center/ environment specific? SEG 55 #4 (5/8) 91-202

4.2.1. Does the Supervisor review and update the JST guide annually?

4.3. Has the supervisor ensured any hazards identified by an AF Form 1118 are added to the JST Guide and employees are trained on the interim control measures and documented IAW Attachment 5, Section 5.4? Virtual SEG 55 #7 (6/8)

4.4.. Have (as required) supervisors attended Supervisor Safety Training? Virtual SEG 55 #10 (7/8) 91-202,

4.5. Has the Supervisor conducted and documented spot inspections? Virtual SEG 55 #11 (8/8), 91-202


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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.