Industrial Hygiene Qualitative Survey & Audit - Cement Distribution

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Description of Site Operations

• Number of employees, typical daily shipping volume, frequency of rail/barge unloading, etc...

• How do bulk cement and other cementitious materials typically arrive at the facility?

  Rail

  Ship/barge

  Truck

  Combination

• Does the site blend or bag cement for downstream use?

  Yes

  No

  N/A

• Does the site utilize flat storage for the loading of bulk cement, slag, or fly ash?

  Yes

  No

  N/A

• Insert rough sketch of site layout here:

  Drawing

• Add media

  Media

Air Contaminants and Chemical Hazards

• What are the primary housekeeping practices at the site (dry sweeping, compressed air blow down, vacuum, other)?

  Yes

  No

  N/A

• Are environmental controls (bag houses) maintained?

  Yes

  No

  N/A

• Is respiratory protection available at the site?

  Yes

  No

  N/A

• Is there any visible dust generated through site activities?

  Yes

  No

  N/A

• If so, what type of respiratory protection is provided for employee use?

  Yes

  No

  N/A

• Have employees who wear respirators (or dust masks) on a voluntary basis been provided a copy of OSHA appendix D as specified in 1910.134?

  Yes

  No

  N/A

• Are MSDS available for all chemicals defined as hazardous under OSHA 1910.1200?

  Yes

  No

  N/A

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  Media

Noise and Physical Hazards

• What are the primary noise sources at the site? (trucks, compressors, etc...)

• What are the secondary noise sources at the site? (silo vibrators, rail car unloaders, etc...)

• Is hearing protection available at the site?

  Yes

  No

  N/A

• Is hearing protection worn by employees working in high noise areas (>85 dBA)?

  Yes

  No

  N/A

• What type and noise reduction rating (NRR)?

• Is a copy of the OSHA noise standard posted at the site as specified by 1910.95(l)(1)

  Yes

  No

  N/A

• Have any standard threshold shifts been identified through audiometric testing or hearing loss claims been made through workers compensation system?

  Yes

  No

  N/A

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  Media

Other Associated Hazards

• Diesel exhaust, carbon monoxide, etc...

• Have any allergic contact dermatitis (cement burn) cases been reported?

  Yes

  No

  N/A

• Add media

  Media

Group Standard - Respirable Crystalline Silica and Total Dust

• Has a qualitative and quantitative risk assessment been conducted in accordance with the Group H&S risk management standard to determine exposure potential for every job classification and task?

  Yes

  No

  N/A

• Has a site specific RCS and TD-PNOR management and control program been established?

  Yes

  No

  N/A

• Has a health surveillance program consistent with the Group's HASOP been established for employees exposed to RCS and TD-PNOR?

  Yes

  No

  N/A

Group Standard - Workplace Noise

• Has a site noise survey been conducted?

  Yes

  No

  N/A

• Has a noise map been developed for the site?

  Yes

  No

  N/A

• Has noise dosimetry been conducted for employees anticipated to be exposed above 85 dBA?

  Yes

  No

  N/A

• Has the hierarchy of controls (HOC) been applied in cases where TWA noise exposures exceed 85 dB?

  Yes

  No

  N/A

• Have high noise areas (>85 dBA) been posted with appropriate signage?

  Yes

  No

  N/A

• Have employees exposed to noise > 85dBA received baseline and annual audiometric testing?

  Yes

  No

  N/A

Other Group Standards - Ergonomics, Whole Body Vibration, Hand-Arm Vibration

• Any ergonomic or other risks identified during survey? ( bagging or other repetitive manual tasks, etc...)

• Have any musculoskeletal injury/illness claims been reported to Health Bridge that are could be attributable to repetitive motion or other ergonomic risk factors?

  Yes

  No

  N/A

Summary and Perception of Overall IH Risk

• Summary of Observations

• What is the perception of the overall risk for the site?

  High

  Medium

  Low

• Any significant other safety deficiency or compliance concerns noted during survey?

• Any good practices or other positive feedback for the site in the area of H&S?

• Signature of H&S Professional Who Lead Survey/Audit

  Sign