Lead Paint Removal

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• The correct paint removal method being used? Wet, Dry, Chomical?

  Yes

  No

  N/A

• Yes

  No

  N/A

Control of exposure

• Containment measures been implemented? Drop sheets / encapsulation?

  Yes

  No

  N/A

• Exclusion zone with signage and info tagged in place?

  Yes

  No

  N/A

• Contaminated water not allowed to drain over area or sewer?

  Yes

  No

  N/A

• Lead process area kept clean?

  Yes

  No

  N/A

• No eating, drinking, smoking, chewing gum in lead process area

  Compliant

  Non-Compliant

  N/A

• Uncontaminated area where the workers can <br>take breaks available?

  Yes

  No

  N/A

• Workers aware to wash hands, forearms and face before eating, drinking or smoking?<br>

  Yes

  No

  N/A

• PPE - Overalls, disposable booties and head covering provided?

  Yes

  No

  N/A

• PPE - Respirators provided are fit tested?

  Yes

  No

  N/A

• PPE - Eye protection adequate for removal method?

  Yes

  No

  N/A

• PPE - Contaminated PPE not removed from lead process area?<br>

  Yes

  No

  N/A

• PPE - Disposable PPE disposed at end of the job?

  Yes

  No

  N/A

Chemical stripping – other requirements

• SDS obtained - Copy kept where readily accessible by worker?

  Yes

  No

  N/A

• Hazardous chemicals register - Register readily accessible by workers?

  Yes

  No

  N/A

• Containers correctly labelled?

  Yes

  No

  N/A

• Yes

  No

  N/A

Information and Training?

• Information, training and instruction given on use, wearing, storage and maintenance of PPE?

  Yes

  No

  N/A

• Information about the health risks and toxic effects associated with exposure to lead given to workers?

  Yes

  No

  N/A

• Yes

  No

  N/A

Health monitoring for lead risk work

• Health monitoring conducted for each worker doing lead risk work? Before / up to one Month after?

  Yes

  No

  N/A

• Health monitoring conducted by a registered medical practitioner?

  Yes

  No

  N/A

Removal from lead risk work

• Are workers immediately removed from lead risk work when Worker’s blood lead levels exceed the removal level?

  Yes

  No

  N/A

Return to lead risk work

• Workers do not return to work until blood lead levels are below return to work levels?

  Yes

  No

  N/A