MTW Health CCMP

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

Participant Information 1

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 2

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 3

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 4

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 5

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 6

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 7

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 8

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 9

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 10

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 11

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 12

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 13

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 14

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

Participant Information 15

• Enter the person's name

• Is the person a contractor?

• Enter contracting company name

• What SEG does the person work in?

  Select Mining Operator Boilermaker Dozer Truck CHPP Maintenance Field Mtce/RAM

  • Mining Operator
  • Boilermaker
  • Dozer
  • Truck
  • CHPP
  • Maintenance
  • Field Mtce/RAM

• Airborne Dust and Fume questions apply to the following high risk SEGs only:
  - Boilermaker

• Only Employees and Cat 1 Contractors will have fit testing information with the Occ Health Nurse

Dust - Boilermaker

• Have airborne hazards been identified in the Take5/JHA and have controls been implemented to reduce exposure to dust or welding fume?

  Yes

  No

• Controls may include:
  Windows up, roads/drill or shot pattern watered, dust suppression sprays in use, adequate distance from dust generating equipment (eg loading unit), use of wet cleaning methods or vacuum, clean surfaces, local exhaust ventilation or fans in use during welding, use of respirators, cabin door and window seals intact, cabin pressurisation.

• Has the participant been scheduled for a fit test and have they attended and passed?

  Yes

  No

  N/A

• See the site Occ Health Nurse for attendance records.
  The fit test must be conducted for the respirator that the individual uses.

• Is the person in adherence with the facial hair policy for site?

  Yes

  No

  N/A

Dust - Boilermaker

• Have airborne hazards been identified in the Take5/JHA and have controls been implemented to reduce exposure to dust or welding fume?

  Yes

  No

• Controls may include:
  Windows up, roads/drill or shot pattern watered, dust suppression sprays in use, adequate distance from dust generating equipment (eg loading unit), use of wet cleaning methods or vacuum, clean surfaces, local exhaust ventilation or fans in use during welding, use of respirators, cabin door and window seals intact, cabin pressurisation.

• Has the participant been scheduled for a fit test and have they attended and passed?

  Yes

  No

  N/A

• See the site Occ Health Nurse for attendance records.
  The fit test must be conducted for the respirator that the individual uses.

• Is the person in adherence with the facial hair policy for site?

  Yes

  No

  N/A

Dust - Boilermaker

• Have airborne hazards been identified in the Take5/JHA and have controls been implemented to reduce exposure to dust or welding fume?

  Yes

  No

• Controls may include:
  Windows up, roads/drill or shot pattern watered, dust suppression sprays in use, adequate distance from dust generating equipment (eg loading unit), use of wet cleaning methods or vacuum, clean surfaces, local exhaust ventilation or fans in use during welding, use of respirators, cabin door and window seals intact, cabin pressurisation.

• Has the participant been scheduled for a fit test and have they attended and passed?

  Yes

  No

  N/A

• See the site Occ Health Nurse for attendance records.
  The fit test must be conducted for the respirator that the individual uses.

• Is the person in adherence with the facial hair policy for site?

  Yes

  No

  N/A

• Hearing protection question applies to all personnel interviewed.

Hearing Protection - Mining Operator (excl Dozer & Truck)

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Mining Operator (excl Dozer & Truck)

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Boilermaker

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• When they are air arc gouging do they wear double hearing protection? Class 5 plugs + Muffs?

  Yes

  No

  N/A

Hearing Protection - Boilermaker

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• When they are air arc gouging do they wear double hearing protection? Class 5 plugs + Muffs?

  Yes

  No

  N/A

Hearing Protection - Boilermaker

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• When they are air arc gouging do they wear double hearing protection? Class 5 plugs + Muffs?

  Yes

  No

  N/A

Hearing Protection - Dozer

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Dozer

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Truck

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Truck

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - CHPP

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - CHPP

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

Hearing Protection - Maintenance

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• Does the individual use class 5 hearing protection for high noise tasks? Eg rattle gun, grinder?

  Yes

  No

  N/A

Hearing Protection - Maintenance

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• Does the individual use class 5 hearing protection for high noise tasks? Eg rattle gun, grinder?

  Yes

  No

  N/A

Hearing Protection - Field Maintenance/RAM

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• Does the individual use class 5 hearing protection for high noise tasks? Eg rattle gun, grinder?

  Yes

  No

  N/A

Hearing Protection - Field Maintenance/RAM

• 

• What hearing protection is the individual wearing or do they normally wear?

  Select EAR Classic (4) Pro-Soft (4) Pro-Soft Corded (4) Bilsom (4) Blue Rapta (5) Blue Rapta Corded (5) X-Fit Corded (5) Skull Screws (5) Spark Plugs (5) Spark Plugs Corded (5) 3M Peltor H7B Neck Band Muffs (5) 3M Pelto H7P3G Helmet Attach Muffs (5) 3M Pelts H7A Head Band Muffs (5) 3M Peltor H6B Slim Line Muffs (4) Welding Neckband Muffs (4) Class 3 Other None

  • EAR Classic (4)
  • Pro-Soft (4)
  • Pro-Soft Corded (4)
  • Bilsom (4)
  • Blue Rapta (5)
  • Blue Rapta Corded (5)
  • X-Fit Corded (5)
  • Skull Screws (5)
  • Spark Plugs (5)
  • Spark Plugs Corded (5)
  • 3M Peltor H7B Neck Band Muffs (5)
  • 3M Pelto H7P3G Helmet Attach Muffs (5)
  • 3M Pelts H7A Head Band Muffs (5)
  • 3M Peltor H6B Slim Line Muffs (4)
  • Welding Neckband Muffs (4)
  • Class 3
  • Other
  • None

• Correct type of hearing protection for SEG

• Incorrect hearing protection for SEG - provide education for correct plugs/muffs

• Is this correct type of hearing protection?

  Yes

  No

• Does the individual use class 5 hearing protection for high noise tasks? Eg rattle gun, grinder?

  Yes

  No

  N/A

• Vibration CCMP applies to dozers and trucks only:
  - dozer ripping
  - truck loading

Vibration - Dozer

• What is the equipment number?

• Do operators demonstrate correct seating set up and adjustment?

  Yes

  No

  N/A

• Using IP18 n SAP, has the seat been changed out within the last 52 weeks as per schedule (CAT or ISRI seat)?

  Yes

  No

  N/A

• Using IW39 in SAP, has there been a Maintenance Order created in relation to *vibration* or *rough*. Has the Maintenance Order been completed/closed?

  Created and closed

  Created/not closed

  N/A

• Has the operator adhered to the 2 hour limit for dozer ripping?<br>Are there enough breaks in the work for recovery during tasks with a risk of high vibration?<br>Has job rotation been implemented for tasks with risk of high vibration exposure?

  Yes

  No

  N/A

Vibration - Dozer

• What is the equipment number?

• Do operators demonstrate correct seating set up and adjustment?

  Yes

  No

  N/A

• Using IP18 n SAP, has the seat been changed out within the last 52 weeks as per schedule (CAT or ISRI seat)?

  Yes

  No

  N/A

• Using IW39 in SAP, has there been a Maintenance Order created in relation to *vibration* or *rough*. Has the Maintenance Order been completed/closed?

  Created and closed

  Created/not closed

  N/A

• Has the operator adhered to the 2 hour limit for dozer ripping?<br>Are there enough breaks in the work for recovery during tasks with a risk of high vibration?<br>Has job rotation been implemented for tasks with risk of high vibration exposure?

  Yes

  No

  N/A

Vibration - Truck

• What is the equipment number?

• Do operators demonstrate correct seating set up and adjustment?

  Yes

  No

  N/A

• Using IP18 n SAP, has the seat been changed out within the last 52 weeks as per schedule (CAT or ISRI seat)?

  Yes

  No

  N/A

• Using IW39 in SAP, has there been a Maintenance Order created in relation to *vibration* or *rough*. Has the Maintenance Order been completed/closed?

  Created and closed

  Created/not closed

  N/A

Vibration - Truck

• What is the equipment number?

• Do operators demonstrate correct seating set up and adjustment?

  Yes

  No

  N/A

• Using IP18 n SAP, has the seat been changed out within the last 52 weeks as per schedule (CAT or ISRI seat)?

  Yes

  No

  N/A

• Using IW39 in SAP, has there been a Maintenance Order created in relation to *vibration* or *rough*. Has the Maintenance Order been completed/closed?

  Created and closed

  Created/not closed

  N/A