Title Page
-
Organization Name
-
Date of Inspection
-
Prepared by
Inventory of Chemicals and Other Hazardous Materials
-
Inventory Manager
-
Location of Inventory
-
Inventory List (Attach a file or include the list below)
Safety Data Sheets (SDS)
-
Location of SDSs
-
Access Instructions
-
SDS Coordinator
-
Procedure for Obtaining New SDSs
-
Frequency of Verifying the Accuracy SDS
Chemical Labels and Warning Signs
-
Responsible Person
-
Have all containers of chemicals and other hazardous substances been labeled with manufacturer information and hazard warnings?
-
Are all labels and warning signs in English?
-
How often should these labels be checked if they have fallen off or become unreadable?
Training Programs
-
Training Content
-
Training Frequency
- Upon Hire
- Monthly
- Quarterly
- Bi-Annually
- Annually
- When new chemicals and other substances are introduced
-
Training Records Maintained By
-
Training Location
Written Hazard Communication Program
-
Attach a copy of the file or detail your Hazard Communication program.
Sign-off
-
Plan Approved by
-
Designation
