Information
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2017 Command Support Programs Version 22.0
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Document No.
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Company
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Conducted on
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Prepared by
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Location
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Personnel
A-Army hearing Program
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1.00 Has the unit commander of noise exposed personnel appointed a Hearing Program Officer (HPO) / NCO to manage the Army hearing program?<br>
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2.00 Was this sub area surveyed when the program manager was appointed?<br>
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3.00 Has an Army Hearing Program SOP been published detailing procedures<br>to accomplish hearing program requirements?
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4.00 Has a noise survey been conducted of all suspected noise-hazard areas and equipment, and are identified noise hazard areas posted with warning signs? <br>
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5.00 Are annual hearing tests (audiograms) performed on all soldiers and personnel who work in noise hazard environments and those who are occupationally exposed to impulse noise at 140dPB (or greater)?<br>
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6.00 Are hearing protection devices in use in the organization when required?<br>
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7.00 Do ALL noise exposed personnel receive hearing conservation health education annually?<br>
Signatures
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Program Manager
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Evaluator
B-Fire Prevention
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1.00 Has an individual been appointed to manage the fire prevention program?<br>
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2.00 Was this sub area surveyed when the program manager was appointed?<br>
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3.00 Has the unit established written procedures for the fire prevention program to include any procedures established to obtain fire prevention program support from other sources? <br>
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4.00 (WEIGHTED 2 POINTS) Are building fire risk management surveys<br>completed, documented, and records maintained (DA Form 5381 or<br>equivalent)?<br>
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5.00 (WEIGHTED 3 POINTS) Are fire extinguishers accessible, maintained in a fully charged and operable condition to include monthly & annual inspection, 6 year maintenance, & hydrostatic test, and kept in designated<br>places not obscured from view?
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6.00 Are appropriate type and number of fire extinguishers available on the flight line? <br>
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7.00 Are safe aisles and passageways properly marked and is the width adequate for exits?<br>Are extension or flexible cords being utilized as a substitute for permanent fixed wiring?<br>Are grounding points properly inspected, tested, and marked? <br>
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8.00 Is paint and flammable or combustible liquids stored in approved containers or cabinets?
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9.00 Is fire prevention training and fire extinguisher training conducted at least<br>annually?
Signatures
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Program Manager
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Evaluator
C-Hazards Communication
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1.00 Has an individual been appointed to manage the hazards communication<br>program?
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2.00 Was this sub area surveyed when the program manager was appointed?
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3.00 Has a written hazard communication program (SOP) been implemented?
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4.00 Is hazard communication training conducted and documented?
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5.00 (WEIGHTED 2 POINTS) Are all hazardous materials present in the organization listed on the Hazardous Material list to identify required SDSs’ to have on hand?
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6.00 (WEIGHTED 2 POINTS) Are all required Safety Data Sheets current (i.e.prepared by the manufacturer of the actual items that are currently on your hazardous materials list and in your hazardous materials lockers) and<br>located so the employees have access to them at all times?
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7.00 Are hazardous material labeling procedures for portable containers of hazardous material in use in the organization covered in the SOP?
Signatures
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Program Manager
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Evaluator
D-Waste Management
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1.00 Has an individual been appointed and trained to manage the waste<br>management program?
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2.00 Was this sub area surveyed when the program manager was appointed?
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3.00 Have written procedures been established in the unit SOP for the collection, management, and disposal of hazardous waste material to include operator level tasks?
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4.00 Are appropriate records maintained for hazardous waste disposal?
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5.00 Has a site specific spill prevention plan been developed and posted at oil<br>and hazardous material storage facilities?
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6.00 Is secondary containment provided for the hazardous waste collection<br>area?
Signatures
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Program Manager
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Evaluator
E-Fod Prevention
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1.00 Has an individual (who is neither the ASO/ASNCO nor the Maintenance Officer) been appointed to manage the FOD program?
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2.00 Was this sub area surveyed when the program manager was appointed?<br>
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3.00 Is a FOD prevention program established in writing and include all the required items?
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4.00 Are FOD inspections conducted as a minimum monthly by the FOD<br>prevention officer or NCO?
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5.00 Is FOD prevention a topic of discussion at all monthly/quarterly aviation safety training meetings?<br>
Signatures
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Program Manager
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Evaluator
F-Drivers Training and Education
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1.00 Has an individual been appointed to manage the drivers training and licensing program?
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2.00 Was this sub area surveyed when the program manager was appointed?
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3.00 Are procedures established in the SOP for the following areas: selection, training, and licensing of vehicle and equipment operators in the unit?; driver endurance schedules?; safety precautions for vehicles transporting hazardous material such as flammables and munitions? ; convoy and off-road operations?
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4.00 Does the unit conducting a drivers’ training and or education program have<br>written authority from the appropriate commander?
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5.00 Are flight line/ramp drivers properly trained and are procedures established in the SOP and the driver’s training program for vehicle operations in the vicinity of parked or running aircraft?
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6.00 Does the unit drivers’ training program include sustainment training?
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7.00 Is a DA Form 348 and DA Form 348–1 (if necessary) maintained correctly<br>on every person in the unit who operates a vehicle or equipment owned or<br>leased by the U.S. Army?
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8.00 Is the permit ledger maintained with required information and is the OF<br>346, or equivalent (5984), properly issued and controlled?
Signatures
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Program Manager
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Evaluator
G-Personal Protective Equipment
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1.00 Has an individual been appointed to manage the PCE program?
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2.00 Was this sub area surveyed when the program manager was appointed?
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3.00 Are step by step procedures published in the organization to describe how<br>the personnel protective equipment program is implemented?
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4.00 (WEIGHTED 2 POINTS) Has a job hazard assessment (Survey) been completed to determine if, and what hazards are present, or are likely to be present, which necessitate the use of personal protective equipment<br>(PPE)?
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5.00 Has the employer determined the exact PPE (to include the specific types and size) necessary to protect the affected employee from the hazards identified in the hazard assessment?
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6.00 Has the employer developed and implemented a training and certification program for employees required to use PPE identified in the workplace assessment?
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7.00 (Weighted 2 Points) Has a respiratory protection program beenestablished where required?<br>
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8.00 Is adequate respiratory protection equipment available?
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9.00 Have employees using respirators been fit tested and have completed<br>OSHA Respirator Medical Evaluations?
Signatures
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Program Manager
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Evaluator