Industrial Hygiene Qualitative Survey & Audit - Aggregates

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 - Respirable Crystalline Silica (RCS)

1.1 - General

• What is the predominant geological formation (limestone, granite, sand & gravel)?

  Limestone

  Granite

  S & G

• Percent silica (SiO2) in material (estimated or confirmed through bulk sampling)?

• Overview of production activities (type of plant, annual tonnage, etc...) that will impact risk of employee exposure to RCS:

• Number of employees potentially exposed to RCS (regardless of control measures implemented)?

• Add media

  Media

1.2 - Plant & Process Sources

1.3 - Work Task Sources

• Yes

  No

  N/A

1.4 - Mobile Equipment & Haul Roads

• Yes

  No

  N/A

1.5 - Control Measures

• Yes

  No

  N/A

• Add media

  Media

2.0 - Noise & Hearing Conservation

2.1 - Noise Sources

• Has a site noise level survey been conducted to determine noise sources and areas > 85 dB?

  Yes

  No

  N/A

• Has full shift noise dosimetry been conducted for employees anticipated to be exposed at or above 85 dB?

  Yes

  No

  N/A

• What are the primary noise sources at the site?

2.2 - Noise control methods

• Is signage posted to identify noise sources/areas that are > 85 dB?

  Yes

  No

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

2.3 - Hearing Conservation Program

• Are all employees potentially exposed > 85 dB included in hearing conservation program?

  Yes

  No

  N/A

• Are all employees included in HCP offered an annual audiogram? Is this documented?

  Yes

  No

  N/A

• Have all potential hearing threshold shifts been followed up on to determine persistence and report ability?

  Yes

  No

  N/A

• Have employees with confirmed STS been advised of this in writing, provided/retrained on HP, and been advised of operators plan to control noise exposure?

  Yes

  No

  N/A

• Add media

  Media

3.0 - Other IH issues (welding fume, vibration, ergonomics, confined space, etc...)

• Add media

  Media

• Add signature

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4.0 - IH Risk Assessment Tool

• GEOLOGY: What is the anticipated silica content within the geological formation that is being mined?

  Yes

  No

  N/A

• EXPOSED POPULATION: What number of employees are potentially exposed to RCS and/or noise?

  Yes

  No

  N/A

• PLANT OPERATIONS: What is the size and scope of the operation?

  Yes

  No

  N/A

• QUALITATIVE ASSESSMENT: What is the status of exposure control measures in place?

  Yes

  No

  N/A

• EXPOSURE HISTORY: Have historical over exposures to RCS been identified?

  Yes

  No

  N/A

• Overall risk rating?

  Yes

  No

  N/A

5.0 - Comments & Observations

• Yes

  No

  N/A

• Ryan J. Langton, CIH, CSP

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