OCCUPATIONAL HEALTH WORK-PLACE VISIT CHECKLIST

• Squadron:

  Select

• Workplace Name:

• Conducted On:

  Date

• Shop Point of Contact:

• Duty Phone:

• Office Symbol:

• # Full Time Personnel:

• # Drill Status Personnel:

• # State Employees:

Hazardous Noise

• 1. Hazardous Noise: Do personnel work in loud areas or with loud equipment?

  Yes

  No

MEASUREMENTS

• Is the shop on the Hearing Conservation Program?

  Yes

  No

• Is a copy of 29 CFR 1910.95 in its entirety posted in a visible location in the workplace? (AFI 48-127, para 2.12.15)

  Yes

  No

• Has noise dosimetry or an equivalent calculation been accomplished? (AFI 48-127, Para A2.5.4)

  Yes

  No

• a. Is noise dosimetry current? (within 5 years)

  Yes

  No

• Have any processes changed since last noise dosimetry?

  No

  Yes

  N/A

• Has all hazardous noise producing equipment been surveyed with a sound level meter? (AFI 48-127, para A2.5.3)

  Yes

  No

  N/A
Add Process Specific Information

• Process Name

• Noise Source

• dBA

• dBC

• Duration

• Distance to 85 dB (ft)

• Labeled

  Yes

  No

• HPD Type (detail in PPE section)

  Ear Plugs

  Ear Muffs

  Both

• Have hazard distances of all hazardous noise equipment been determined & 85 dBA lines established?

  Yes

  No

  N/A

• Has BE notified the shop supervisor on noise survey results?

  Yes

  No

SIGNS & PLACARDS

• Has all hazardous noise producing equipment been labeled if possible? (AFI 48-127, para A2.5.3)

  Yes

  No

• Is any part of the shop area classified as a hazardous noise area?

  Yes

  No

• Do placards read "Caution: Hazardous Noise Area, Hearing Protection Required"?

  Yes

  No

• Are all entrances and borders properly posted? (AFI 48-127, para 2.12.3)

  Yes

  No

PPE & TRAINING

• Are earmuff cups clean, soft/pliable and free of rips and tears? (AFI 48-127, para A4.7.4)

  Yes

  No

  N/A

• Are pre-formed earplugs clean, discarded if they become brittle or torn, or if routine cleaning cannot remove debris? (AFI 48-127, para A4.6.1.1)

  Yes

  No

  N/A

• Are formable earplugs (e.g. foam) clean, replaced after five uses or when they no longer form an airtight seal? (AFI 48-127, para A4.6.1.2)

  Yes

  No

  N/A

• Are all hearing PPE used in the shop listed on BE Certified PPE list?

  Yes

  No
Add Hearing PPE

• PPE Type

  Ear Plug

  Ear Muff

• Brand & Model Number

• NRR

• ** Are there any special surveillance items required for this section?

  Select Noise Dosimetry Noise Source Survey

  • Noise Dosimetry
  • Noise Source Survey

• 1.a. Do you want to complete the Occupational Noise Workplace Maturity Audit?

  Yes

  No

Occupational Noise (WMA 1.3)

Roles & Responsibilities

• Does the workplace supervisor ensure personnel comply with all AF Hearing Conservation Program, DOD, and OSHA requirements?

  Yes

  No

  N/A

• Does the supervisor notify each worker exposed at or above an 8-hour TWA of 85 dBA of the results of noise monitoring performed by BE?

  Yes

  No

  N/A

• When workplace conditions change that potentially impact exposure to hazardous noise, did the supervisor notify BE within 3 calendar days for a follow-up noise survey and assure no hazardous noise producing equipment was used beyond a 30-day implementation period unless assessed by BE and required controls were in place?

  Yes

  No

  N/A

• Does the Workplace Supervisor contact BE, PH, and the Occupational Medicine consultant before purchasing custom molded earplugs for the unit?

  Yes

  No

  N/A

• Do workers report to the supervisor or medical personnel conditions that place themselves or others at risk for accidents/incidents because of communication difficulty or the inability to hear warning signals?

  Yes

  No

  N/A

Control of Hazards

• Is hazardous noise equipment (as identified by BE) labeled appropriately and is hearing protection readily available?

  Yes

  No

  N/A

• Are hazardous noise areas (as identified by BE) marked with signs and is hearing protection readily available along pathways leading to noise areas?

  Yes

  No

  N/A

• Did the workplace supervisor use BE-recommended engineering controls as a primary means to eliminate exposure to hazardous noise?

  Yes

  No

  N/A

• Does new equipment being considered for purchase have the lowest sound emission levels that are technologically and economically possible and compatible with performance and environmental requirements?

  Yes

  No

  N/A

Training and Information

• Do workers notify the supervisor when HPDs need to be replaced?

  Yes

  No

  N/A

• Is initial and annual workplace-specific hazard communication training (includes ototoxic chemicals when present) conducted and documented in ARCNet?

  Yes

  No

  N/A

• Is a copy of 29 CFR 1910.95 available to employees?

  Yes

  No

  N/A

Thermal Stress

• 2. Thermal Stress: Are personnel exposed to extreme temperatures?

  Yes

  No

• Does the shop get informed of the effective temperature from their command structure?

  Yes

  No

• Are weather appropriate PPE available? (i.e., cold weather gear, ice vests, etc.)?

  Yes

  No

  N/A

• Are workers provided water during work in hot environments? (AFI 91-203, para 14.5.11 & 14.5.12)

  Yes

  No

• Are heat stress guidelines available for workers?

  Yes

  No

• Is a cool break area available to personnel when working in hot environments?

  Yes

  No

• Is a warm break area available to personnel when working in cold environments?

  Yes

  No

• Are workers allowed to take breaks, as needed when working in extreme temperatures? (91- 203, Para 14.5.11)

  Yes

  No

• Is training specifically for heat/cold stress (to include signs and symptoms) documented? (check in ARCNet) (AFI 48-151, para 2.18.5)

  Yes

  No

• ** Are there any special surveillance items required for this section?

Ergonomic Stress

• 3. Ergonomic Stress: Do personnel perform repetitive movements or maintain static/awkward positions?

  Yes

  No

• List primary ergonomic stresses and hazards:

• Are there complaints of wrist, shoulder, back problems?

  Yes

  No

• Complete DOEHRS Ergonomic Checklist

• Are there any trends of members with work-related musculoskeletal disorders in this or similar jobs?

  Yes

  No

• Complete DOEHRS Ergonomic Checklist

Do any tasks or processes include any of the following:

• a. Performance of the same motion or motion pattern every 10 seconds for more than 10% of the workday or total of 2 hours/day?

  Yes

  No

• b. A fixed or awkward work posture (e.g., overhead work, twisted or bent back, bent wrist, kneeling, stooping, and squatting) for more than a total of 2 hours/day?

  Yes

  No

• c. Exposure to localized or whole body vibration (e.g., the use of vibrating or impact tools or equipment) for more than a total of 2 hours/day?

  Yes

  No

• d. Forceful hand exertions for more than a total of 2 hours/day?

  Yes

  No

• e. Unassisted frequent or forceful manual handling for more than a total of 2 hours/day? (i.e. lifting or moving)

  Yes

  No

• Do personnel use back support belts as a form of PPE? (DAFMAN 91-203, para 14.3.9)

  Yes

  No

  N/A

• Recommend discontinuing use as the AF does not categorize as PPE. Supervisory approval and specific training is required.

• ** Are there any special surveillance items required for this section?

  Yes

  No

• Contact PH and Flight Medicine to schedule ergonomic assessments

Welding/Soldering/Cutting/Brazing

• 4. Welding/Soldering/Cutting/Brazing: Does the shop perform welding, soldering, cutting, or brazing?

  Yes

  No

• Are DAFMAN 91-203 Chapter 20 and 29 CFR 1910.252 available in the shop?

  Yes

  No

• What types of welding are done?

  Select ARC MIG TIG Other

  • ARC
  • MIG
  • TIG
  • Other

• If other, specify:

• What rods and materials are used in these welding processes?

• Are these rods approved through ESOH-MIS and are they labeled appropriately?

  Yes

  No

  N/A

• What rods and materials are used in these welding processes?

• Are these rods approved through ESOH-MIS and are they labeled appropriately?

  Yes

  No

  N/A

• What rods and materials are used in these welding processes?

• Are these rods approved through ESOH-MIS and are they labeled appropriately?

  Yes

  No

  N/A

• What rods and materials are used in these welding processes?

• Are these rods approved through ESOH-MIS and are they labeled appropriately?

  Yes

  No

  N/A

• Does shop perform welding, soldering, or brazing duties inside a confined space?

  No

  Yes

  N/A

• Are procedures established to contact Bioenvironmental prior to cutting, grinding or welding operations involving magnesium-thorium and other potentially radioactive materials? (DAFMAN 91-203 para 20.5.2.6)

  Yes

  No

  N/A

• Is local exhaust ventilation available when indoor welding, soldering, cutting or brazing on any surface (painted or unpainted) that contains zinc, lead, beryllium, cadmium, mercury, or hexavalent chromium? (DAFMAN 91-203 para 25.11.2.2.1)

  Yes

  No

  N/A

• Has air sampling been performed to determine if exposures to personnel are below the Occupational Exposure Limits for all types of metals and fluxes that could create an airborne exposure hazard?

  Yes

  No

  N/A

PPE/TRAINING

• Are only approved respirator equipment used when working in atmospheres containing hazardous concentrations of airborne contaminants?(DAFMAN 91-203, Para 27.2.7)

  Yes

  No

  N/A

• Are welders receiving blood borne pathogens training? (Due to the likelihood of giving CPR if a welder touches a live electrode)

  Yes

  No

  N/A

• ** Are there any special surveillance items required for this section?

Lasers

• 5. Lasers: Do personnel use or work around lasers? (e.g. etching, cutting, scribing, pointers, range finders – not including laser printers)

  Yes

  No

• Is the laser inventory up to date with any new items? (AFI 48-139, para 2.17.11)

  Yes

  No

• Have any lasers been classified as Class 3R, 3A, 3B, or 4?

  Yes

  No

• Has an evaluation of hazards been conducted by BE and documented on an AF Form 2760 or equivalent and does the shop have copies? (AFI 48-139, Para 3.3.1)

  Yes

  No

• For Class 3B and 4 lasers, are protective housing, interlocks, beam stop, activation warning systems and procedural controls in use?

  Yes

  No

  N/A

• For Class 3B and 4 lasers, is laser eye protection available to personnel working with systems that are not enclosed? (AFI 48-139, para 3.3.1 & 3.4)

  Yes

  No

  N/A

• For Class 3B and 4 lasers, are laser hazard warning signs and labels used to control access to laser hazard areas? (AFI 48-139, para 2.25.2)

  Yes

  No

  N/A

• For Class 3B and 4 lasers, does shop have a laser safety training plan/operational instruction? (AFI 48- 139, para 3.2.1)

  Yes

  No

  N/A

• Is training plan/OI approved by BE?

  Yes

  No

• Is a Unit Laser Safety Officer/shop LSO appointed in writing for organizations with 3B or 4 lasers? (AFI 48-139, para 3.1.4)

  Yes

  No

  N/A

• Has BE trained the Unit Laser Safety Officer (AFI 48-139, Para 3.2)?

  Yes

  No

• Date Training Completed

  Date

• Has Unit Laser Safety Officer trained shop personnel initially and annually? (AFI 48-139, para 3.2)

  Yes

  No

• Is all training documented in ARCNet? (AFI 48-139, para 2.24.13)

  Yes

  No

• Is awareness training provided for shops with 1M, 2M, and 3R lasers annually and documented in ARCNet? (AFI 48-139, para 2.24.10)

  Yes

  No

  N/A

• Are personnel using combat laser systems, such as MILES and HAVIS Shield, being briefed annually on the hazards and correct use of the lasers?

  Yes

  No

  N/A

Administrative Controls

• Are control measures such as cordons, ropes, cones, and/or signs recommended by BE available?

  Yes

  No

  N/A

• Are laser warning signs posted at entrance where exposure might exceed the FDA limit?

  Yes

  No

  N/A

• Are visitors briefed prior to entering laser hazard area to ensure no exposure will occur?

  Yes

  No

  N/A

• Are all potential laser overexposures reported as soon as possible?

  Yes

  No

PPE Controls

• Is PPE provided for and used by all personnel within NHZ of laser when engineering controls are not feasible?

  Yes

  No

  N/A

• Is required protective eyewear marked with frequency and OD?

  Yes

  No

  N/A

• ** Are there any special surveillance items required for this section?

  Laser Hazard Survey

• 5.a. Do you want to complete the Laser Workplace Maturity Audit?

  Yes

  No

Lasers (WMA 1.2)

General Requirements

• Does the Unit have a qualified Unit Laser Safety Officer (ULSO) appointed by the Unit Commander?

  Yes

  No

  N/A

• Did the ULSO develop and manage the unit laser and optical radiation safety program?

  Yes

  No

  N/A

• Did the ULSO and workplace supervisor review the hazard evaluations for laser systems and optical radiation sources in the workcenter and develop standard operating procedures?

  Yes

  No

  N/A

Control Measures

• Has the ULSO and workplace supervisor verified the Class 3 and 4 laser system's manufacturer controls are in place prior to operation?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and personnel are instructed on care/hygiene of their PPE?

  Yes

  No

  N/A

• Are warning signs posted in areas operating Class 3R, 3B, and 4 laser systems?

  Yes

  No

  N/A

• Are standard operating procedures for Class 3B and 4 lasers maintained in the workcenter and reviewed by the ULSO and ILSO?

  Yes

  No

  N/A

Accident/Incident

• Do shop personnel immediately report to the workplace supervisor and the ULSO any suspected laser or optical radiation incident, accident, or overexposure?

  Yes

  No

  N/A

• Does the workplace supervisor ensure that medical treatment is sought immediately after a suspected laser accident, incident, or overexposure?

  Yes

  No

  N/A

Training and Information

• Are all operators of Class 1M, 2M, 3R, 3B, and 4 FDA-Compliant Lasers, military-specific lasers, or optical radiation sources trained upon initial assignment to a workcenter and annually thereafter?

  Yes

  No

  N/A

• Has the workplace supervisor provided training to personnel who are not allowed to work around lasers when they are operational?

  Yes

  No

  N/A

EMF/RF Radiation

• 6. EMF/RF Radiation: Do personnel work with or near RF radiation sources (i.e. RADAR, ECM, COM/NAV- not including cell phones or personal radios)?

  Yes

  No

• Is the Electro-Magnetic-Frequency (EMF) inventory up to date? (AFI 48-109, para 4.2.1)

  Yes

  No

• Inventory must contain emitter nomenclature, description, quantity, frequency range, upper tier and lower tier, MPEs and hazard distance

• Does supervisor have a copy of reports with hazard potential & far field calculations performed by BE for each EMF? (AFI 48-109, Para 4.2.5)

  Yes

  No

Engineering Controls

• Are moderate risk safety interlocks operable on ground accessible systems? (AFI 48-109, para 2.14.3)

  Yes

  No

  N/A

• Do moderate risk ground accessible systems have dummy loads or hats? (AFI 48-109, para 2.14.3)

  Yes

  No

  N/A

• Are there other engineering control measures in place?

Administrative Controls

• Has an EMF Safety Awareness Training Plan been established where PEL has the potential to be exceeded? (AFI 48-109, para 4.4)

  Yes

  No

  N/A

Does the EMF Safety Awareness Training Plan include:

• a. Location of potentially hazardous emitters?

  Yes

  No

• b. Areas that could exceed radiation levels?

  Yes

  No

• c. Potential effects resulting from overexposure?

  Yes

  No

• d. Actions taken in the event of overexposure?

  Yes

  No

• Has supervisor trained shop personnel initially and annually and documented in ARCNet? (AFI 48-109, para 4.4.2)

  Yes

  No

• Have procedures been established to report suspected over exposures to supervisors and BE? (AFI 48-109, para 4.6.1)

  Yes

  No

• In the instance of a suspected overexposure, personnel report to BE within 72 hours.

• Are control measures (cordons, ropes, signs, etc.) recommended by BE available?

  Yes

  No

  N/A

• Are signs available for high risk ground accessible systems? (AFI 48-109, para 2.14.3)

  Yes

  No

  N/A

• Are rope barriers available for high risk ground accessible systems? (AFI 48-109, para 2.14.3)

  Yes

  No

  N/A

• Are warning signs required and posted on entrances to controlled environments (areas that may exceed and equipment that exceeds)? (AFI 48-109, para 4.3.2.1)

  Yes

  No

  N/A

• Do warning signs follow the right format? (29 CFR 1910.97 (a) (3) (iii) (Fig G-11)) (see below)

  Yes

  No

• Add media

  Media

• Are warning signs required and posted in uncontrolled environments e.g. flight line? (areas that may exceed and equipment that exceeds) (AFI 48-109, para 4.3.2.1)

  Yes

  No

  N/A

• Do warning signs follow the right format? (29 CFR 1910.97 (a) (3) (iii) (Fig G-11)) (see below)

  Yes

  No

• Add media

  Media

• Are warning devices used in addition to signs in “High Level Areas” where the PEL can be exceeded? (i.e., flashing light, audible signs, barriers, interlocks)

  Yes

  No

  N/A

• Do devices such as EMF sensors, detectors, alarms, area monitors and personal warning devices have written approval from HQ AF/SG (AFI 48-109, para. 3.2.2)

  Yes

  No

  N/A

• Are there other administrative control measures in place?

• ** Are there any special surveillance items required for this section?

  EMF Hazard Survey

• 6.a. Do you want to complete the EMF Workplace Maturity Audit?

  Yes

  No

EMF (WMA 1.1)

General Requirements

• Did the workplace supervisor contact BE when there was a suspected RF overexposure?

  Yes

  No

  N/A

• Did the workplace supervisor request an EMF hazard assessment when physical or operational changes occurred in the section or when a new EMF system was installed?

  Yes

  No

  N/A

Control of Hazards

• Are warning signs posted at all approaches to RF-emitting devices?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly?

  Yes

  No

  N/A

• Has the AF provided and assure the use of appropriate personal protective clothing?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor implemented EMF training: 1) initial assignment, annually, and when a workplace change results in new or increased exposure; 2) maintained copies of the training materials; and 3) documented training in ARCNet?

  Yes

  No

  N/A

• Does the workplace use the USAFSAM/OE Hazard Communication training template and include EMF hazards?

  Yes

  No

  N/A

Ionizing Radiation

• 7. Ionizing Radiation (Permitted Sources, Generally Licensed Devices, X-ray Emitters): Do personnel work with/near ionizing radiation sources/equipment?

  Yes

  No

• Are personnel monitored on the OSL/TLD program? (AFMAN 48-125, Para. 4.1.2)

  Yes

  No

• Does the shop have X-ray producing equipment (e.g. Dental, Medical Radiology, NDI, SFS, EOD, AMC Passenger Terminal, etc.)?

  Yes

  No

• Has BE evaluated radiation exposure for each x-ray unit?

  Yes

  No

• Does the shop have generally licensed devices (e.g. APD-2000, SABRE 2000, SABRE 4000, Vapor Tracer2, IONSCAN 400B, etc.)

  Yes

  No

• Does the shop have radiation sources permitted by AF Radioisotope Committee (e.g. NITON XRF, CAD/CAM/ACADA, LANTIRN pod, Sniper pod, RAPIDSCAN, etc.)?

  Yes

  No

• Does the shop use or work with any Radium-226 containing old dials or regulators?

  Yes

  No

• Does the shop use or work with depleted uranium?

  Yes

  No

• Does the shop use or work with any Thorium-232 containing aircraft parts?

  Yes

  No

• Are procedures established to report suspected over exposures to supervisors and BE? (AFI 48- 148, para 3.5.3 and 5.2.6)

  Yes

  No

• Are procedures established to notify BE of the changes in practices or procedures involving<br>radiation sources? (AFI 48-148, para 2.23.7)

  Yes

  No

• Do you have written procedures to contact BE at 580-8703 prior to packaging and shipping radioactive materials? (AFI 40-201, para A2.3.4)

  Yes

  No

• ** Are there any special surveillance items required for this section?

  Yes

  No

• Contact IRSO to schedule & conduct a program review for this workcenter.

• 7.a. Do you want to complete the Ionizing Radiation Workplace Maturity Audit?

  Yes

  No

Ionizing Radiation (WMA 1.2)

General Requirements

• Does the IRSO maintain RAM inventories as required to include permitted RAM, GLDs, radioluminescent exit signs, exempt quantities, and special nuclear material?

  Yes

  No

  N/A

• Are posting requirements met for RAM permits?

  Yes

  No

  N/A

• Is there a written Radiation Safety program that is implemented by supervisors and followed by workers?

  Yes

  No

  N/A

• Is the unit radiation protection program reviewed annually by the URSO/PRSO?

  Yes

  No

  N/A

• Do Organization or Unit Commanders designate, in writing, a Unit RSO (URSO) when in possession of RAM, 91(b), and/or radiation sources? And do Organization or Unit Commanders designate, in writing, a Permit Radiation Safety Officer (PRSO) when required?

  Yes

  No

  N/A

• Are cumulative absorbed doses to an embryo/fetus or nursing child greater than 50 mSv (5 rem) dose equivalent reported by the medical/dental clinics, and is documentation of dose maintained for 50 years?

  Yes

  No

  N/A

• Do declared pregnant workers notify Public Health?

  Yes

  No

  N/A

Control Measures

• Does each container which is used to transport, store or use a quantity of radioactive material that (1) exceeds the limits in 10 CFR Part 20, Appendix C; or for natural uranium or thorium, exceeds 10 times the Appendix C quantity, displays "CAUTION RADIOACTIVE MATERIALS" or "DANGER, RADIOACTIVE MATERIAL(S)" label?

  Yes

  No

  N/A

• Are restricted, radiation, high radiation, very high radiation areas and radioactive material use/storage areas posted with appropriate signs, labels, and signals unless otherwise exempted?

  Yes

  No

  N/A

• Is the IRSO notified of any changes to RAM or radiation sources, use, storage, facilities, or controls?

  Yes

  No

  N/A

• When a surface cannot be decontaminated to the applicable levels listed in: 1) DODM 3145.03, section 7.2; Table 2; 2) the specific permit; or 3) AFMRA/SG3PB approved clearance levels (case by case), is the area controlled and labeled as contaminated?

  Yes

  No

  N/A

Dosimetry

• Do radiation workers provide the URSO and/or IRSO information on past and current work relevant to radiation exposure, as well as off-duty or moonlighting dosimetry data?

  Yes

  No

  N/A

• Are dosimeters worn, handled and secured properly?

  Yes

  No

  N/A

• Are assessments completed for assigned administrative doses due to loss, stolen, destroyed, or inadvertently exposed personnel dosimeters?

  Yes

  No

  N/A

Training

• Are personnel on the installation who handle the disposition, transport, or shipment of RAM properly trained?

  Yes

  No

  N/A

• Are workers properly trained on radiation risks and methods to minimize exposure and ALARA?

  Yes

  No

  N/A

• Is a written training plan developed and reviewed as necessary to reflect changes in workplaces practices?

  Yes

  No

  N/A

Accident/Incident

• When a potential overexposure occurs, is IRSO notified immediately?

  Yes

  No

  N/A

• For potential occupational overexposures, is the employee removed from all duties involving potential radiation exposure until the investigation is complete?

  Yes

  No

  N/A

Biological Hazards

• 8. Biological Hazards: Can personnel be exposed to body fluids, human or animal feces because of their work-related duties? (29 CFR 1910.1030)

  Yes

  No

• Is there a reasonably anticipated risk for exposure to human fluids or sewage?

  No

  Yes

  N/A

• Has BE fully evaluated workers' biological exposures?

  Yes

  No

• Have personnel received blood borne pathogen training? (29 CFR 1910.130 (g)(2))

  Yes

  No

• Is the training documented in ARCNET?

  Yes

  No

• Is any PPE used for bloodblood pathogens?

  Yes

  No

• Type/Details

• Is PPE clean and serviceable?

  Yes

  No

Chemical Hazards

• 9. Chemical Hazards: Do shop personnel use chemicals in their work-related duties?

  Yes

  No

Chemical Inventory & ESOH-MIS

• Are all shop chemicals listed and approved in ESOH-MIS?

  Yes

  No

• Have potential exposures to chemicals not on the shop’s ESOH-MIS Chemical Inventory been identified and assessed? (ex: Fire Fighter Responding to Hazardous Materials Incident)

  Yes

  No

Air Sampling

• Does the supervisor notify BE prior to conducting operations that require air sampling?

  Yes

  No

Training & Administrative Controls

• Is consumption and storage of food and beverages in industrial areas prohibited?

  Yes

  No

• Do emergency plans cover spills, leaks or other potential releases?

  Yes

  No

Chemical Storage Lockers

• Is the chemical storage locker clean?

  Yes

  No

  N/A

• Are there signs of gross contamination of chemicals, or are any caps missing?

  No

  Yes

  N/A

• Is anything stored on top of the chemical locker?

  No

  Yes

  N/A

• Is a spill kit available?

  Yes

  No

  N/A

OSHA Expanded Standards Workplace Maturity Audits

• OSHA Expanded Standards

  Select Asbestos Benzene Beryllium Cadmium Formaldehyde Hexavalent Chromium Lead Methylene Chloride Silica

  • Asbestos
  • Benzene
  • Beryllium
  • Cadmium
  • Formaldehyde
  • Hexavalent Chromium
  • Lead
  • Methylene Chloride
  • Silica

Asbestos (WMA 1.1)

Regulated Areas

• Has the workplace established Regulated Area(s) wherever airborne concentrations of asbestos are in excess of the 8-hour TWA-PEL and/or 30-minute excursion limit?

  Yes

  No

  N/A

• Are warning signs posted at all approaches to regulated areas so that an employee may read the signs and take precautions before entering the area?

  Yes

  No

  N/A

• Are workers in regulated areas provided adequate protective clothing and respirators?

  Yes

  No

  N/A

• Are workers prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics in the regulated area(s)?

  Yes

  No

  N/A

Methods of Compliance

• Does the work center have an established asbestos written program to reduce employee exposure to or below the 8-hr TWA-PEL and to or below the 30-minute excursion limit?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls were implemented and functioning correctly (i.e., ventilation); workplace practices are in place (i.e., wet methods); and PPE is available and used correctly?

  Yes

  No

  N/A

• Is employee rotation prohibited as a method of compliance?

  Yes

  No

  N/A

Control of Hazards

• Has the workcenter supervisor provided protective clothing and respiratory protection at no cost to the employee?

  Yes

  No

  N/A

• Are procedures in place to have contaminated protective clothing and equipment removed from the change room for authorized laundering, maintenance, or disposal at an approved facility for processing asbestos-contaminated items?

  Yes

  No

  N/A

Housekeeping and Hygiene

• Where airborne exposures to asbestos are above the 8-hour TWA-PEL and/or excursion limit, does the work center ensure that all protective clothing and equipment are removed in a change room and stored in properly sealed and labeled containers?

  Yes

  No

  N/A

• Are workers directed to shower at the end of the work shift when asbestos exposures are above the 8-hr TWA PEL and/or excursion limit?

  Yes

  No

  N/A

• Does the workcenter provide lunchroom facilities for employees where exposures to asbestos are greater than the 8-hr TWA-PEL and/or excursion limit?

  Yes

  No

  N/A

• Are all workplace surfaces maintained as free as practicable of ACM waste and debris and accompanying dust/fibers while using appropriate cleaning methods?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor implemented asbestos training when potential exposures are above the 8-hr TWA-PEL and/or excursion limit: 1) initial assignment and annually; 2) maintained copies of the training material, and 3) documented training on employee’s AF Form 55 or equivalent?

  Yes

  No

  N/A

• Did the workplace supervisor utilize the USAFSAM/OE Hazard Communication training template and include asbestos hazards?

  Yes

  No

  N/A

• Are copies of the OSHA Standard 29 CFR 1910.1001 and asbestos training materials readily available to workplace personnel?

  Yes

  No

  N/A

• Has the workplace supervisor been provided the locations of ACM and PACM in the facility?

  Yes

  No

  N/A

Benzene (WMA 1.1)

Regulated Areas

• Has the workplace established a regulated area wherever exposure to airborne concentrations of benzene can reasonably be expected to exceed the OELs and boundaries clearly marked?

  Yes

  No

  N/A

• Are regulated area boundaries established and are warning signs posted effectively to alert employees that only authorized personnel are allowed into the area?

  Yes

  No

  N/A

• Are personnel prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics in regulated areas?

  Yes

  No

  N/A

• Are workers in regulated areas provided adequate protective clothing and respirators?

  Yes

  No

  N/A

Methods of Compliance

• Has the workplace established and implemented a written compliance program to reduce employee exposures to or below the OEL?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and personnel are instructed on care/hygiene of their PPE?

  Yes

  No

  N/A

Control of Hazards

• Do workplace personnel wear appropriate facepiece with filters or cartridges approved for benzene?

  Yes

  No

  N/A

• During escape or emergency operations, are self-contained breathing apparatus (SCBA) or full face respirators with cartridges or canisters approved for benzene provided to workers?

  Yes

  No

  N/A

• Has the workplace supervisor provided at no cost to the employee protective work clothing and equipment?

  Yes

  No

  N/A

Training and Information

• Did the workplace use the USAFSAM/OE developed training template for Hazard Communication and included benzene hazards?

  Yes

  No

  N/A

• For workplaces with any potential benzene exposure, has the workplace supervisor: 1) implemented benzene training for initial assignment, when exposures are above the action level, and annually; 2) maintained copies of the training material; and 3) documented training on employee's AF Form 55 or equivalent?

  Yes

  No

  N/A

Beryllium (WMA 1.1)

Regulated Areas

• Has the workplace established a regulated area wherever employees are, or can reasonably be expected to be, exposed to airborne beryllium at levels above the TWA-TLV or OSHA STEL and boundaries are clearly marked?

  Yes

  No

  N/A

• Are workplace personnel prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics in regulated areas?

  Yes

  No

  N/A

• Are warning signs posted at all approaches to regulated areas so that an employee may read the signs and take necessary protective steps before entering the area?

  Yes

  No

  N/A

Methods of Compliance

• Are beryllium work areas established where materials that contain at least 0.1% beryllium by weight are used during operations listed in Appendix A of 29 CFR 1910.1024 or where materials that contain at least 0.1% beryllium by weight are used in operations where employees are, or can reasonably be expected to be, exposed to airborne beryllium at or above the action level (50% of the TLV-TWA)?

  Yes

  No

  N/A

• Does the workcenter prohibit employee rotation as a method of compliance?

  Yes

  No

  N/A

• Where workplace personnel are exposed to beryllium above the TLV-TWA or OSHA STEL, has the Air Force implemented engineering controls and workplace practices to reduce exposures?

  Yes

  No

  N/A

• Has the workplace established, implemented, and maintain a written exposure control plan?

  Yes

  No

  N/A

Personal Protective Equipment

• Has the workplace supervisor provided at no cost to the employee appropriate protective clothing and equipment?

  Yes

  No

  N/A

• Does the work center ensure each worker removes all beryllium-contaminated personal protective clothing and equipment at the end of the work shift; at the completion of tasks involving beryllium; or when personal protective clothing or equipment becomes visibly contaminated with beryllium IAW the written exposure control plan?

  Yes

  No

  N/A

• Are procedures in place to prevent personnel from removing beryllium-contaminated protective clothing or equipment from the workplace, except for authorized laundering, cleaning, maintenance, or disposal at an appropriate location or facility?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and instructed personnel on care and hygiene of their PPE?

  Yes

  No

  N/A

Housekeeping and Hygiene

• Does the workplace have a housekeeping plan that covers the topics outlined in 29 CFR 1910.1024, paragraph (j), and is approved by the BE?

  Yes

  No

  N/A

• Are change rooms used by workers and equipped with separate lockers for street clothes and for protective clothing and equipment?

  Yes

  No

  N/A

• Where beryllium airborne exposure exceed, or can reasonably be expected to exceed the TLV-TWA or OSHA STEL, are showers provided and workers required to use the facilities at the end of the work shift or work activity?

  Yes

  No

  N/A

• Does the workplace supervisor ensure workers do not enter the lunchroom or break areas unless beryllium dust is removed from protective clothing?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor implemented beryllium training: 1) initial assignment, annually, and when a workplace change results in new or increased airborne exposure; 2) maintained copies of the training material; and 3) documented training on employee's AF Form 55 or equivalent?

  Yes

  No

  N/A

• Does the workplace use the USAFSAM/OE Hazard Communication training template and includes Beryllium hazards?

  Yes

  No

  N/A

• Is 29 CFR 1910.1024 readily available without cost to workplace personnel?

  Yes

  No

  N/A

Cadmium (WMA 1.4)

Regulated Areas

• Has the workplace established a regulated area, with boundaries clearly demarcated, wherever exposure to airborne concentrations of cadmium can reasonably be expected to exceed the PEL?

  Yes

  No

  N/A

• Are warning signs posted at the entrances to regulated areas and have verbiage required by the standard?

  Yes

  No

  N/A

• Are workplace personnel prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics in regulated areas?

  Yes

  No

  N/A

• Are workers in regulated areas provided adequate protective clothing and respirators

  Yes

  No

  N/A

Methods of Compliance

• Does the workcenter prohibit employee rotation as a method of compliance?

  Yes

  No

  N/A

• Has the workplace established and implemented a written cadmium compliance program to reduce exposures to or below the PEL?

  Yes

  No

  N/A

• Has the workplace established and implemented a written plan for emergency situations involving substantial releases of airborne cadmium?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and personnel are instructed on the care/hygiene of their PPE?

  Yes

  No

  N/A

• Are procedures developed and implemented to minimize personal exposure to cadmium when performing ventilation system maintenance and filter changing operations?

  Yes

  No

  N/A

Personal Protective Equipment

• Has the workplace supervisor provided at no cost to the employee, and assured that the employee uses appropriate protective work clothing and equipment?

  Yes

  No

  N/A

• Does the work center ensure each worker remove all cadmium-contaminated personal protective clothing and equipment at the end of the workshift or at the completion of their tasks involving cadmium in the change rooms provided for that purpose?

  Yes

  No

  N/A

• Are procedures established and enforced to prohibit the removal of cadmium dust from worker clothing and equipment by compressed air for blowing; shaking, or any other means which disperses dust into the air?

  Yes

  No

  N/A

• Are procedures in place to prevent personnel from removing cadmium-contaminated protective clothing or equipment from the workplace, except for authorized laundering, cleaning, maintenance or disposal at an appropriate location or facility?

  Yes

  No

  N/A

Housekeeping and Hygiene

• Where the airborne exposure to cadmium is above the 8-hr TWA PEL, are change rooms used by workers and equipped with separate lockers for street clothes and for protective clothing and equipment?

  Yes

  No

  N/A

• Where the airborne exposure to cadmium is above the 8-hr TWA PEL, does the workcenter have handwashing facilities and showers available to employees?

  Yes

  No

  N/A

• Does the workplace supervisor ensure that workers do not enter the lunchroom facilities unless surface cadmium is removed from protective clothing?

  Yes

  No

  N/A

• Does the workplace have a housekeeping plan that covers the topics outlined in 29 CFR 1910.1027, paragraph (k), and is it approved by BE and assessed by the unit's Quality Assurance program for compliance?

  Yes

  No

  N/A

Training and Information

• Does the workplace use the USAFSAM/OE Hazard Communication developed training template for Hazard Communication and include cadmium hazards?

  Yes

  No

  N/A

• For workplaces with any potential cadmium exposure, has the workplace supervisor implemented cadmium training upon initial assignment and annually, maintained copies of the training material, and documented on employee's AF Form 55 or equivalent?

  Yes

  No

  N/A

• Is 29 CFR 1910.1027 and training materials readily available without cost to workplace personnel?

  Yes

  No

  N/A

Formaldehyde (WMA 1.1)

Regulated Areas

• Has the workplace established a regulated area wherever exposure to airborne concentrations of formaldehyde can be expected to exceed the ACGIH TLV-TWA or ACGIH 15-minute short-term exposure limit (STEL)?

  Yes

  No

  N/A

• Are warning signs posted at all approaches to regulated areas so that an employee may read the signs and take precautions before entering the area?

  Yes

  No

  N/A

• Are workers in regulated areas provided adequate protective clothing and respirators?

  Yes

  No

  N/A

Methods of Compliance

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and personnel are instructed on care/hygiene of their PPE?

  Yes

  No

  N/A

• Has the workplace established and implemented a written emergency plan for situations involving releases of formaldehyde?

  Yes

  No

  N/A

Control of Hazards

• Where air purifying respirators are required, do workplace personnel wear appropriate facepiece with filters or cartridges approved for formaldehyde?

  Yes

  No

  N/A

• During escape or emergency operations, are self-contained breathing apparatus (SCBA) or full face respirators with formaldehyde cartridges or canisters provided to workers?

  Yes

  No

  N/A

• Has protective clothing and equipment been selected based on the form of formaldehyde in the work center to prevent skin or eye irritation or sensitizing?

  Yes

  No

  N/A

• Does the workcenter place formaldehyde-contaminated protective clothing and equipment in closed containers and in a secured ventilated storage area prior to laundering, cleaning, or disposal?

  Yes

  No

  N/A

• Are warning signs posted at the entry to the storage area for formaldehyde-contaminated protective clothing, equipment, waste, and debris; and are containers properly labeled?

  Yes

  No

  N/A

• Does the work center ensure each worker removes all formaldehyde-contaminated personal protective clothing and equipment at the end of the work shift; at the completion of tasks involving formaldehyde; or when personal protective clothing or equipment becomes visibly contaminated with formaldehyde?

  Yes

  No

  N/A

• Are quick drench emergency showers available for immediate use in locations where solutions containing 1% or greater of formaldehyde have potential splash hazard or skin contact?

  Yes

  No

  N/A

• Are emergency eyewash stations available for immediate use in locations where solutions containing 0.1% or greater of formaldehyde have potential splash hazard or eye contact?

  Yes

  No

  N/A

Housekeeping and Hygiene

• Are change rooms equipped with separate lockers for protective clothing/equipment and for street clothes?

  Yes

  No

  N/A

• Are equipment leaks or spillage in work areas contained, cleaned up, and decontaminated immediately by workers in protective clothing with the waste and debris properly disposed in sealed and labeled containers?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor implemented formaldehyde training: 1) formaldehyde hazard training for initial assignment, annually, and when a workplace change results in new or increased airborne exposure; 2) maintained copies of the training material; and 3) documented training on employee’s AF Form 55 or equivalent?

  Yes

  No

  N/A

• Does the workplace use the USAFSAM/OE developed training template for Hazard Communication and include formaldehyde hazards?

  Yes

  No

  N/A

• Is a copy of 29 CFR 1910.1048 Formaldehyde, and training materials readily available without cost to workplace personnel?

  Yes

  No

  N/A

Hexavalent Chromium (WMA 1.4)

Regulated Areas

• Has the workplace established a regulated area with boundaries clearly demarcated, wherever exposure to airborne concentrations of Chromium (VI) can reasonably be expected to exceed the PEL?

  Yes

  No

  N/A

• Is access to the regulated area controlled and granted to authorized personnel?

  Yes

  No

  N/A

• Are workplace personnel prohibited from eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics in regulated areas?

  Yes

  No

  N/A

Methods of Compliance

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and personnel are instructed on the care/hygiene of their PPE?

  Yes

  No

  N/A

• Where painting of aircraft or large aircraft parts is performed, are engineering and work practice controls implemented to reduce and maintain employee exposure to Chromium (VI) to or below 25 µgm/m3?

  Yes

  No

  N/A

• Is employee rotation prohibited as a method of compliance?

  Yes

  No

  N/A

Personal Protective Equipment

• Has the workplace supervisor provided at no cost to the employee and assured that the employee uses appropriate protective work clothing and equipment?

  Yes

  No

  N/A

• Does the workplace supervisor ensure each worker removes all Chromium (VI) contaminated personal protective clothing and equipment at the end of the workshift or at the completion of their tasks involving Chromium (VI) in the change rooms provided for that purpose?

  Yes

  No

  N/A

• Are procedures in place to prevent workplace personnel from taking Chromium (VI) contaminated protective clothing or equipment from the workplace, except for authorized laundering, cleaning, maintaining, or disposing at an appropriate location or facility?

  Yes

  No

  N/A

• Are procedures established and enforced to prohibit the removal of Chromium (VI) dust from worker clothing and equipment by blowing, shaking, using compressed air, or any other means which disperses dust into the air?

  Yes

  No

  N/A

Housekeeping and Hygiene

• Where airborne exposure to Chromium (VI) is above the 8-hr TWA PEL, are change rooms used by workers and equipped with separate lockers for street clothes and for protective clothing and equipment?

  Yes

  No

  N/A

• Does the workplace supervisor ensure workers who have skin contact with Chromium (VI) wash their hands and faces at the end of the workshift and prior to eating, drinking, smoking, chewing gum or tobacco, applying cosmetics, or using the toilet?

  Yes

  No

  N/A

• Does the workplace supervisor ensure workers do not enter the lunchroom facilities unless Chromium (VI) dust is removed from protective clothing?

  Yes

  No

  N/A

• Does the workplace have a published housekeeping plan that covers the topics outlined in 29 CFR 1910.1026, paragraph (j) and is approved by BE and assessed by the unit's Quality Assurance program for compliance?

  Yes

  No

  N/A

Training and Information

• Does the workplace use the USAFSAM/OE Hazard Communication training template for HAZCOM and include Chromium (VI) hazards?

  Yes

  No

  N/A

• Has the workplace supervisor implemented Chromium (VI) training initially and annually, ensured employees demonstrate knowledge of Chromium (VI) hazards, maintained copies of the training material, and documented the training on the employee's AF Form 55 or equivalent?

  Yes

  No

  N/A

• Is 29 CFR 1910.1026 and training materials readily available without cost to workplace personnel?

  Yes

  No

  N/A

Lead (WMA 1.3)

Methods of Compliance

• Has the workplace established and implemented a written lead compliance program to reduce exposures to or below the PEL?

  Yes

  No

  N/A

• Are administrative controls used as a means of reducing employees TWA exposure to lead?

  Yes

  No

  N/A

• Are lead hazard warning signs posted in each work area where the PEL is exceeded?

  Yes

  No

  N/A

Personal Protective Equipment

• Has the workplace supervisor provided appropriate personal protective work clothing and equipment at no cost to the employee?

  Yes

  No

  N/A

• Are procedures in place to prevent workplace personnel from removing lead-contaminated protective clothing or equipment from the workplace, except for authorized laundering and transported in containers that prevent the spread of contamination?

  Yes

  No

  N/A

• Does the workplace supervisor ensure each worker removes all lead contaminated personal protective clothing and equipment at the end of the workshift or at the completion of their tasks involving lead in the change rooms provided for that purpose?

  Yes

  No

  N/A

• Are procedures established and enforced to prohibit the removal of lead dust from worker clothing and equipment by blowing, shaking, using compressed air, or any other means which disperses dust into the air?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and instructed personnel on care/hygiene of their PPE?

  Yes

  No

  N/A

• Does the workplace use recirculated air from the exhaust ventilation system?

  Yes

  No

  N/A

Hygiene Areas and Practices

• Does the workplace have a BE-approved housekeeping plan and was it assessed by the unit's Quality Assurance program for compliance?

  Yes

  No

  N/A

• In areas where workers are exposed to lead above the PEL, are food, beverages, tobacco products, and cosmetics prohibited?

  Yes

  No

  N/A

• Are clean change rooms provided with separate lockers for protective work clothing and equipment and for street clothes?

  Yes

  No

  N/A

• Are shower facilities provided in the work center?

  Yes

  No

  N/A

• Does the workplace supervisor ensure workers do not enter the lunchroom facilities unless lead dust is removed from protective clothing?

  Yes

  No

  N/A

Training and Information

• For workplaces with lead exposures over the action level, has the workplace supervisor implemented Lead training initially and annually, maintained copies of the training material, and documented the training on the employee's AF Form 55 or equivalent?

  Yes

  No

  N/A

• Did the workplace supervisor provide lead hazard training for workers with the potential of airborne exposures below the action level?

  Yes

  No

  N/A

• Are 29 CFR 1910.1025 and training materials readily available without cost to workplace personnel?

  Yes

  No

  N/A

• Does the workplace use the USAFSAM/OE Hazard Communication training template for HAZCOM and include lead hazards?

  Yes

  No

  N/A

Methylene Chloride (WMA 1.1)

Regulated Areas

• Has the workplace established a regulated area wherever exposure to airborne concentrations of methylene chloride can reasonably be expected to exceed the TWA PEL or STEL?

  Yes

  No

  N/A

• Are workplace personnel in regulated areas prohibited from engaging in non-work activities which may increase dermal or oral methylene chloride exposure, for example, eating, drinking, smoking, chewing tobacco or gum, or applying cosmetics (e.g. lip balm)?

  Yes

  No

  N/A

• Are the regulated area boundaries established which alerts employees that only authorized personnel will enter the area?

  Yes

  No

  N/A

• Are personnel who enter a regulated area provided the appropriate respirators and use them?

  Yes

  No

  N/A

Methods of Compliance

• Does the workplace supervisor prohibit employee rotation as a method of compliance with the PELs?

  Yes

  No

  N/A

• Where workplace personnel are exposed to methylene chloride above the TWA PEL or STEL, has the Air Force implemented feasible engineering controls and workplace practices to reduce exposure?

  Yes

  No

  N/A

Personal Protective Equipment

• Where respirators are required, do workplace personnel wear supplied-air respirators with full-face or hoods; or air-purifying full-face respirators with appropriate facepiece and filters or cartridges approved for methylene chloride or SCBA?

  Yes

  No

  N/A

• During emergency escape situations, are self-contained breathing apparatus units or air-purifying respirators with cartridges or canisters approved for methylene chloride provided to workers?

  Yes

  No

  N/A

• Does the provided protective clothing and equipment adequately protect against methylene chloride induced dermal and eye irritation?

  Yes

  No

  N/A

• Does the workplace have procedures for cleaning, laundering, repair, replacement, or disposal of protective clothing and equipment?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning correctly; PPE is available and used correctly in the workplace; and instructed personnel on the care and hygiene of their PPE?

  Yes

  No

  N/A

Hygiene Areas and Practices

• Are showers provided to remove solutions containing 0.1% or greater of methylene chloride from accidental skin contact?

  Yes

  No

  N/A

• Are emergency eyewash stations available for immediate use in locations where solutions containing 0.1% or greater of methylene chloride have potential for accidental eye contact?

  Yes

  No

  N/A

• Are equipment leaks or incidental spills in work areas contained, cleaned promptly by trained workers, and waste properly disposed?

  Yes

  No

  N/A

• Does the workplace have a housekeeping plan that covers topics from Appendix A of 1910.1052 and is approved by BE?

  Yes

  No

  N/A

Training and Information

• Did the workplace use the USAFSAM/OE developed training template for Hazard Communication and included methylene chloride hazards?

  Yes

  No

  N/A

• Has the workplace supervisor implemented methylene chloride training: 1) initial assignment, annually, and when a workplace change results in new or increased airborne exposure; 2) maintained copies of the training materials; and 3) documented training on employee’s AF Form 55 or equivalent?

  Yes

  No

  N/A

• Is a copy of OSHA Standard 29 CFR 1910.1052 and training materials readily available without cost to workplace personnel?

  Yes

  No

  N/A

Silica (WMA 1.1)

Regulated Areas

• Has the workplace established a Regulated Area wherever exposure to airborne concentrations of Respirable Crystalline Silica exceeds or can reasonably be expected to exceed the 8-hr ACGIH TLV-TWA?

  Yes

  No

  N/A

• Are warning signs posted at all entrances to Regulated Area(s) and are signage requirements met?

  Yes

  No

  N/A

• Does the Shop Supervisor provide each employee and the employee's designated representative entering a Regulated Area appropriate protective clothing and respirator?

  Yes

  No

  N/A

Methods of Compliance

• Has the workplace established and implemented a written exposure control plan for operations that involve airborne exposures at or above the 8-hour ACGIH TLV-TWA for respirable crystalline silica?

  Yes

  No

  N/A

• Does the workplace supervisor ensure required OEH hazard controls were implemented and functioning correctly (i.e., ventilation); workplace practices are in place (i.e., wet methods); and PPE is available and used correctly?

  Yes

  No

  N/A

• Where abrasive blasting is conducted using crystalline silica-containing blasting agents, or where abrasive blasting is conducted on substrates that contain crystalline silica, are appropriate precautions taken to protect the worker and the immediate work area?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor implemented respirable crystalline silica training: 1) initial assignment and annually; 2) maintained copies of the training material, and 3) documented training on employee’s AF Form 55 or equivalent?

  Yes

  No

  N/A

• Did the workplace supervisor utilize the USAFSAM/OE Hazard Communication training template and include respirable crystalline silica hazards?

  Yes

  No

  N/A

• Are copies of OSHA Standard 29 CFR 1910.1053, Respirable Crystalline Silica, and training materials readily available to workplace personnel?

  Yes

  No

  N/A

• ** Are there any special surveillance items required for this section?

  Air Sampling

  Process Hazard Assessment

• 10. Are Ventilation Systems or Dilution Ventilation used?

  Select Local Exhaust Ventilation Blasting Unit Paint Booth Battery Room Medical Lab Hood Dilution Ventilation

  • Local Exhaust Ventilation
  • Blasting Unit
  • Paint Booth
  • Battery Room
  • Medical Lab Hood
  • Dilution Ventilation

• Was ventilation system fully evaluated by BE, to include air sampling?

  Yes

  No

  N/A

• Has the system been surveyed as required (Quarterly or Annually)?

  Yes

  No

  N/A

• Does the supervisor ensure that local exhaust ventilation systems are used continually during all operations which they are designed to control and after cessation of the operations if the employee(s) remain in the contaminated area?

  Yes

  No

  N/A

• Is the ventilation system visibly clean and adequately maintained?

  Yes

  No

  N/A

• Do ventilation systems draw contaminants away from workers?

  Yes

  No

  N/A

• Do ventilation systems draw exhausted air back into the system or building?

  Yes

  No

  N/A

• Does the supervisor periodically check ventilation indicators IAW BE recommendations (e.g. manometers)?

  Yes

  No

  N/A

• Was ventilation system fully evaluated by BE, to include air sampling?

  Yes

  No

  N/A

• Has the system been surveyed as required (Quarterly or Annually)?

  Yes

  No

  N/A

• Is the ventilation system visibly clean and adequately maintained?

  Yes

  No

  N/A

• Do ventilation systems draw contaminants away from workers?

  Yes

  No

  N/A

• Do ventilation systems draw exhausted air back into the system or building?

  Yes

  No

  N/A

• Does the supervisor periodically check ventilation indicators IAW BE recommendations (e.g. manometers)?

  Yes

  No

  N/A

• Are blasting units exhausted in a manner that continuous inward flow of air is maintained at all enclosure openings during blasting and configured to minimize dust leakage? (29 CFR 1910.94(a)(3)(i))

  Yes

  No

  N/A

• When dust leaks at blasting units are noted, are repair requests made as soon as possible? (29 CFR 1910.94(a)(4)(i)(a))

  Yes

  No

  N/A

• Is dust on floors, ledges and around an abrasive blasting unit cleaned up promptly? (29 CFR 1910.94(a)(7))

  Yes

  No

  N/A

• Are blasting unit doors flanged and tight when closed? 29 CFR 1910.94(a)(3)(i)(e)(1)

  Yes

  No

  N/A

• Are dust collectors at blasting units configured so that accumulated dust can be emptied and removed without contaminating other work areas? (29 CFR 1910.94(a)(4)(iii))

  Yes

  No

  N/A

• Was ventilation system fully evaluated by BE, to include air sampling?

  Yes

  No

  N/A

• Has the system been surveyed as required (Quarterly or Annually)?

  Yes

  No

  N/A

• Is the ventilation system visibly clean and adequately maintained?

  Yes

  No

  N/A

• Do ventilation systems draw contaminants away from workers?

  Yes

  No

  N/A

• Do ventilation systems draw exhausted air back into the system or building?

  Yes

  No

  N/A

• Does the supervisor periodically check ventilation indicators IAW BE recommendations (e.g. manometers)?

  Yes

  No

  N/A

• Is aircraft spray painting only conducted in approved areas? (29 CFR 1910.94(c)(2), (c)(8))

  Yes

  No

  N/A

• Where downdraft booths are provided with doors, are the doors closed during spray painting? (29 CFR 1910.94(c)(6)(iii)(b))

  Yes

  No

  N/A

• Is mechanical ventilation operated during all spray painting operations? (29 CFR 1910.107(d)(2))

  Yes

  No

  N/A

• If methyl ethyl ketone (MEK) is used for solvent wipe down of aircraft (typically done in preparation for painting), is it accomplished in an area with ventilation recommended/approved by BE to remove flammable vapors?

  Yes

  No

  N/A

• Is paint or dope mixing done in a designated, BE-approved ventilated room or in a covered area outside?

  Yes

  No

  N/A

• Is vehicle battery charging done only in specifically designated areas?

  Yes

  No

  N/A

• Are the battery charging areas ventilated?<br>NOTE: Ventilation may be natural or mechanical, provided it is adequate for dispersal of airborne contaminants from offgassing batteries. (29 CFR 1926.441 (a)(1))

  Yes

  No

  N/A

• Was ventilation system fully evaluated by BE, to include air sampling?

  Yes

  No

  N/A

• Has the system been surveyed as required (Quarterly or Annually)?

  Yes

  No

  N/A

• Is the ventilation system visibly clean and adequately maintained?

  Yes

  No

  N/A

• Do ventilation systems draw contaminants away from workers?

  Yes

  No

  N/A

• Do ventilation systems draw exhausted air back into the system or building?

  Yes

  No

  N/A

• Does the supervisor periodically check ventilation indicators IAW BE recommendations (e.g. manometers)?

  Yes

  No

  N/A

• Was ventilation system fully evaluated by BE, to include air sampling?

  Yes

  No

  N/A

• Has the system been surveyed as required (Quarterly or Annually)?

  Yes

  No

  N/A

• Is the ventilation system visibly clean and adequately maintained?

  Yes

  No

  N/A

• Do ventilation systems draw contaminants away from workers?

  Yes

  No

  N/A

• Do ventilation systems draw exhausted air back into the system or building?

  Yes

  No

  N/A

• Does the supervisor periodically check ventilation indicators IAW BE recommendations (e.g. manometers)?

  Yes

  No

  N/A

Process Specific Ventilation

• Are machines that generate dust, vapors, mist, etc. connected to an effective exhaust ventilation system?

  Yes

  No

  N/A

• Is ventilation provided in areas where welding and cutting is conducted?

  Yes

  No

  N/A

• If internal combustion engines are operated indoors, is a BE-approved ventilation system used?

  Yes

  No

  N/A

• Is local exhaust ventilation provided in vehicle maintenance repair pits?

  Yes

  No

  N/A

• 11. Do employees work in an environment where hazardous chemicals are known to be present in such a manner that employees may be exposed under normal conditions of use or in a foreseeable emergency?

  Yes

  No

HAZCOM Program

• Has BE, PH, SEG, and CEF reviewed and approved the shop specific hazard training program? (AFI 90-821, para 2.6.9.3.3)

  Yes

  No

Written Work-Area Specific HAZCOM Program (AFI 90-821 para 3.1)

• Does the shop maintain a copy of a written workplace-specific HAZCOM program? (AFI 90-821, para 3.1) Must be readily accessible in either paper or electronic format.

  Yes

  No

Hazardous Chemical List (AFI 90-821 para 3.1.1)

• Does the HAZCOM program include a list of the hazardous chemicals known to be present? (AFI 90-821, para 3.1.1)

  Yes

  No

• Is each chemical entered into ESOH-MIS?

  Yes

  No

• Does the tab number or other identity used on the SDS cross-reference to the inventory. (AFI 90-821, para 3.1.1)

  Yes

  No

• Does supervisor annually reconcile the inventory of hazardous materials to the SDS on file (AFI 90-821, para 3.1.1) and document the reconciliation?

  Yes

  No

Non-Routine Tasks Involving Hazardous Chemicals (AFI 90-821 para 3.1.2)

• Are non-routine tasks present in the workplace? (AFI 90-821, para 3.1.2)

  Yes

  No

• Do T.O.s or OIs exist that adequately describe hazards associated with the non-routine tasks? (AFI 90-821, para 3.1.2.1)

  Yes

  No

• When temporary workers are performing duties in your shop are they being trained on hazards? (AFI 90-821, para 3.1.2.2)

  Yes

  No

Labels and Other Forms of Warning (AFI 90-821 para 3.1.3 & 29 CFR 1910.1200(f))

• Are labels easily cross-referenced with SDS and the list of hazardous materials? (AFI 90-821, para 3.1.1)

  Yes

  No

• Are original containers labeled properly? (Must identify at minimum: hazardous chemical, physical and health hazards, and target organ effects. Combination of pictures, words or symbols may be used.) (AFI 90-821, para 3.1.3)

  Yes

  No

• Are the transfer containers labeled with the following? (29 CFR 1910.1200(f))

• Identity of the hazardous material? (29 CFR 1910.1200(f)(i))

  Yes

  No

  N/A

• Appropriate hazard warnings? (29 CFR 1910.1200(f)(iii))

  Yes

  No

  N/A

• Name, address and phone # of manufacturer, importer or responsible party? (29 CFR 1910.1200(f)(1)(vi))

  Yes

  No

  N/A

Safety Data Sheets (SDS) (AFI 90-821 para 3.1.4)

• Does the shop maintain SDS for each hazardous chemical which they use? (AFI 90-821, para 3.1.4.1; 29 CFR 1910.1200(g))

  Yes

  No

• When a new SDS is received, but the old chemical is still on-hand, is the SDS which matched the old chemical retained as long as the old chemical is present in the work area? (AFI 90-821 para 3.1.4.1)

  Yes

  No

• Are SDS immediately accessible for every hazardous chemical (AFI 90-821, para 3.1.4.2)

  Yes

  No

• If SDSs are electronic, is there a back-up system in place? (AFI 90-821, para 3.1.4.2.3)

  Yes

  No

  N/A

• SDS on file must match the manufacturer and part number/trade name of the material on-hand.(AFI 90-821, para 3.1.4.1)

• Where personnel must travel between work area/shops during a work shift, how are personnel able to immediately obtain the required information in an emergency?

Contractor Operations (AFI 90-821 para 3.1.5)

• Are contractors informed of the hazardous materials that may affect their employees? (AFI 90-821, para 3.1.5)

  Yes

  No

  N/A

• Do contractors working in the area inform shop personnel of the hazards of the materials they are using? (AFI 90-821, para 3.1.5)

  Yes

  No

  N/A

Employee Information and Training (AFI 90-821 para 3.1.6)

• Are Supervisors and Employees who handle, use, or are potentially exposed to hazardous chemicals in the course of official AF duties provided HAZCOM training prior to the use of hazardous chemicals?

  Yes

  No

Supervisor Training (AFI 90-821 para 3.1.6.1)

• Do supervisors review USAFSAM supervisor HAZCOM training initially and as needed to maintain competency?

  Yes

  No

• Prior to assuming supervisory duties in a new work area, did supervisors review existing work area-specific HAZCOM training plan and expanded standard training, if required in that area?

  Yes

  No

  N/A

Initial Worker Training (AFI 90-821 para 3.1.6.2)

• Do workers receive comprehensive work area-specific HAZCOM training from their supervisors at the time of initial assignment in the work area?

  Yes

  No

• This training, at a minimum, will include the following:

• 3.1.6.2.1. The location and details of the work area-specific written HAZCOM program, including the hazardous chemical list and SDSs for the work area. (T-0)

  Yes

  No

• 3.1.6.2.2. Identification of operations or processes, including non-routine processes, in the work area where hazardous chemicals are present or used. (T-0) Supervisors may use the hazardous chemical authorization in EESOH-MIS or BE assessment letters as sources of information to meet this training requirement.

  Yes

  No

• 3.1.6.2.3. Identification of the hazard categories (e.g., flammability, carcinogenicity) or specific chemicals present in the work area. Including, but not limited to, those with specific regulatory requirements (e.g., asbestos, benzene, beryllium, cadmium, formaldehyde, hexavalent chromium, methylene chloride, and lead) and identification of chemicals that pose physical, health, simple asphyxiation, combustible dust, and pyrophoric gas hazards, as well as hazards not otherwise classified. (T-0)

  Yes

  No

• 3.1.6.2.4. Proper labeling of hazardous chemicals, including an explanation of the labels received on shipped containers and the work area labeling system. (T-0)

  Yes

  No

• 3.1.6.2.5. How to access and read SDSs, including the order of information and how employees can obtain and use the appropriate hazard information. (T-0)

  Yes

  No

• 3.1.6.2.6. Controls (engineering controls, administrative controls, and personal protective equipment) workers must use to minimize or eliminate exposure to hazardous chemicals while performing a specific process (e.g., the specific respirator for a specific spray-painting process). (T-0) Supervisors shall refer to the BE assessment letters for specific control requirements.

  Yes

  No

• 3.1.6.2.7. Emergency procedures, such as recognition of a spill or accidental chemical release (e.g., visual, odor, alarm) and escape procedures to include the locations of emergency eye wash stations, showers, and monitoring capabilities. (T-0)

  Yes

  No

Supplemental Worker Training (AFI 90-821 para 3.1.6.3)

• Is training provided for all potentially affected employees when a new chemical hazard is introduced to the work area?

  Yes

  No

• Has the supplemental training been reviewed and approved by BE, PH, SEG and F&ES?

  Yes

  No

Worker Knowledge Assessment (AFI 90-821 para 3.1.6.5)

• Did the work area supervisor annually assess worker knowledge of basic HAZCOM concepts and work-area specific HAZCOM procedures?

  Yes

  No

• Was the worker knowledge assessment documented in ARCNet?

  Yes

  No

HAZCOM Worker Knowledge Assessment

• Ask 5 workers the following questions to assess HAZCOM effectiveness: (Number of correct answers out of 5)

• 1. What processes and chemicals present hazards in your work area? What kind of hazards?

• 2. How can you access SDSs for the chemicals you use?

• 3. How can you find information on an SDS? Can you demonstrate?

• 4. How do you interpret the hazard symbols or wording on hazard labels and what precautions (controls, PPE, etc.) do you have to use when working with hazardous chemicals?

• 5. Please describe the most significant hazard in the shop.

Personal Protective Equipment

General Requirements

• Does the shop have a certified PPE list provided by BE to include all PPE in the shop?

  Yes

  No

  N/A

• Have workers who must wear PPE been trained? (29 CFR 1910.132(f)(1))

  Yes

  No

  N/A

• Is PPE maintained in a sanitary (away from contaminants) and reliable condition and not damaged or defective (cracks, discoloration, missing parts)? (29 CFR 1910.132 (a)(b))

  Yes

  No

  N/A

• What types of PPE are worn in this section?

  Select Eye Protection Gloves Aprons/Protective Clothing Respirators

  • Eye Protection
  • Gloves
  • Aprons/Protective Clothing
  • Respirators

Eye/Face Protection

• Type of Eye/Face Protection

  Select Safety Glasses/Goggles (Impact Protection Only) Chemical Splash Goggles Face Shields Other (specify)

  • Safety Glasses/Goggles (Impact Protection Only)
  • Chemical Splash Goggles
  • Face Shields
  • Other (specify)

• Specify

• Safety glasses/goggles are certified by Wing Safety. BE is responsible for certifying chemical protective-gear.

• Is the manufacturer’s identification clearly marked on the equipment?

  Yes

  No

  N/A

• Are lenses ANSI Z87.1 approved, in good condition, and free from scratches?

  Yes

  No

  N/A

• Are eye goggle headbands in good shape?

  Yes

  No

  N/A

• Are metal-framed glasses secured to the worker by a cord or strap?

  Yes

  No

  N/A

• Are lenses ANSI Z87.1 approved, in good condition, and free from scratches?

  Yes

  No

  N/A

• Is the manufacturer’s identification clearly marked on the equipment?

  Yes

  No

  N/A

• Are eye goggle headbands in good shape?

  Yes

  No

  N/A

• Are face shields only used as secondary means of protection against splash hazards?

  Yes

  No

  N/A

• Is the manufacturer’s identification clearly marked on the equipment?

  Yes

  No

  N/A

• Are face shield headbands in good shape?

  Yes

  No

  N/A

Chemical Protective Gloves

• What types of gloves are used?

  Select Nitrile Butyl Latex Leather Neoprene Polyvinyl Alcohol (PVA) PVC Other (specify)

  • Nitrile
  • Butyl
  • Latex
  • Leather
  • Neoprene
  • Polyvinyl Alcohol (PVA)
  • PVC
  • Other (specify)

• Specify

• Have breakthrough times for gloves been established?<br>http://www.chemrest.com

  Yes

  No

  N/A

Aprons/Chemical Protective Clothing

• Specify

Respiratory Protection (WMA 1.3)

Written Program Info

• Did the unit RPPA conduct a workplace-specific program evaluation, brief it to the Commander, document results, and share it with the Installation RPPA?

  Yes

  No

  N/A

• Does the current workplace-specific RP written plan meet the requirements stated in AFI 48-137 and 29 CFR 1910.134?

  Yes

  No

  N/A

• Did the shop supervisor identify deficiencies in the Respiratory Protection Program?

  Yes

  No

  N/A

• Are government-provided and BE-approved respirators used by Federal employees in the shop?

  Yes

  No

  N/A

• Are filtering facepiece devices (FFPD) approved and authorized by BE "for comfort purposes" in the workplace?

  Yes

  No

  N/A

General Requirements

• Does the workplace supervisor notify BE about any changes with processes that could affect exposure?

  Yes

  No

  N/A

• Is the foundation for the filter or cartridge change-out schedule adequately described in the written program?

  Yes

  No

  N/A

• Do all employees engaged in interior structural firefighting use SCBAs?

  Yes

  No

  N/A

• Was the unit respiratory protection program administrator designated by the Unit Commander and are they qualified by appropriate training or experience to manage the program IAW 29 CFR 1910.134(c )(3)?

  Yes

  No

  N/A

Fit Testing

• Are personnel prohibited from performing processes with a tight-fitting respirator when the fit test is overdue?

  Yes

  No

  N/A

• Are employees aware of requirements to report any changes in medical status, which may impact their ability to wear respiratory protection to their supervisor?

  Yes

  No

  N/A

• Have workers requested a respirator fit-test if they believe the fit of the respirator has changed or is unacceptable?

  Yes

  No

  N/A

Face-Piece Seal

• Are respirators not permitted to be worn by employees with facial hair that comes between the sealing surface of the facepiece and the face or interferes with valve function?

  Yes

  No

  N/A

• Are safety glasses, goggles, or other PPE worn and does not interfere with the seal of the facepiece to the face?

  Yes

  No

  N/A

• Do workers perform user seal checks in accordance with 29 CFR 1910.134, Appendix B-1, User Seal Check Procedures (Mandatory) or manufacturer's instructions before each use of tight-fitting respirators?

  Yes

  No

  N/A

Cleaning and Disinfecting

• Are respirators issued for the employee's exclusive use include proper cleaning & disinfecting procedures in 29 CFR 1910.134, Appendix B-2, Respirator Cleaning Procedures (Mandatory) or manufacturer-recommended procedures?

  Yes

  No

  N/A

• Are respirators issued to more than one employee properly cleaned & disinfected using procedures in 29 CFR 1910.134, Appendix B-2, Respiratory Cleaning Procedures (Mandatory) before being worn by different individuals?

  Yes

  No

  N/A

• Are emergency use respirators cleaned & disinfected using procedures in 29 CFR 1910.134, Appendix B-2, Respiratory Cleaning Procedures (Mandatory) before being stored or used by another worker?

  Yes

  No

  N/A

Storage

• Are respirators stored to prevent against damage, contamination, dust, sunlight, extreme temperatures, excessive moisture, damaging chemicals, and deformation of the facepiece and exhalation valve?

  Yes

  No

  N/A

• Are emergency respirators kept accessible to the work area and stored in clearly marked compartments or covers?

  Yes

  No

  N/A

Inspection

• Are respirators used in routine situations inspected before each use and during cleaning?

  Yes

  No

  N/A

• Are emergency respirators inspected at least monthly and in accordance with the manufacturer's recommendations?

  Yes

  No

  N/A

• Are emergency respirators checked for proper function before and after each use?

  Yes

  No

  N/A

• Are Self-contained breathing apparatuses (SCBA) inspected monthly, including regulators and warning devices and documented on AF Form 1071?

  Yes

  No

  N/A

• Are SCBA cylinders recharged when the pressure falls to 90% of the manufacturer's recommended pressure level?

  Yes

  No

  N/A

• Are respirators that fail inspection or are otherwise found to be defective removed from service?

  Yes

  No

  N/A

• Are NIOSH-approved respirators recommended by BE identified in the work center RP Plan? Are routine repairs conducted IAW the respirator manufacturer instructions in order to maintain the NIOSH certification?

  Yes

  No

  N/A

• Are respirator cartridges, filters, or canisters changed when the ESLI triggers or based on BE-approved change-out schedule?

  Yes

  No

  N/A

Breathing Air Quality

• Are maintenance activities (i.e., filter change-out, oil changes, routine preventive maintenance, etc.) for compressors used to provide breathing air to supplied-air respirators documented on AF Form 1071, Inspection/Maintenance Record and is a tag containing the most recent change date and signature of the person authorized by the employer to perform the change maintained at the compressor?

  Yes

  No

  N/A

• Are breathing air couplings incompatible with outlets for non-respirable air or other gas systems to prevent inadvertent servicing of supplied-air respirators with non-respirable air or gases?

  Yes

  No

  N/A

• Are hydrostatic tests for steel or non-steel air cylinders being accomplished IAW with T.O. 42B-1-22, Quality Control of Compressed and Liquid Breathing Air, Table 2-5 and 2-6?

  Yes

  No

  N/A

• Are stored cylinders protected from excessive temperatures, distanced from fuels, flammable materials, oils and in areas away from possible falling objects, excessive moisture, and electrical sources?

  Yes

  No

  N/A

• Does compressed breathing air meet ANSI- CGA Grade D specifications for breathing air, and verified by sampling once every 90 days?

  Yes

  No

  N/A

• Are compressors/air pumps situated to prevent entry of contaminated air into the air supply system?

  Yes

  No

  N/A

• Are compressors constructed to minimize moisture content so that the dew point at 1 atm is 10 degrees Fahrenheit below ambient temperature?

  Yes

  No

  N/A

• Are suitable in-line sorbent beds and filters in place and maintained/replaced following manufacturer's instructions to further ensure breathing air quality?

  Yes

  No

  N/A

• Is there a high-temperature alarm, a carbon monoxide alarm, or combination alarm, located close to the oil-lubricated compressor?

  Yes

  No

  N/A

• For compressors which are not oil-lubricated, is there a carbon monoxide alarm installed to verify levels do not exceed 10 ppm?

  Yes

  No

  N/A

• Are airline hoses maintained no longer than 300 feet in length (in multiples of 25 feet)?

  Yes

  No

  N/A

• Are atmosphere-supplying respirators which utilized compressed air identified and prohibited from using compressed oxygen?

  Yes

  No

  N/A

• Are the SCBA manufacturer breathing gas containers properly marked?

  Yes

  No

  N/A

Training and Information

• Has the workplace supervisor received Supervisor Respiratory Protection Program training for their current workplace?

  Yes

  No

  N/A

• Can employees demonstrate knowledge of respirator use, limitations, emergency procedures, inspections, user seal checks, maintenance, and storage?

  Yes

  No

  N/A

• Is re-training provided when there are changes in workplace processes, type of respirator, inadequacies in worker knowledge, or other situations where re-training appears to be necessary?

  Yes

  No

  N/A

• Are workers who wear voluntary-use respirators, provided training following the guidelines in 29 CFR 1910.134, Appendix D, (Mandatory) Information for Employees Using Respirators When Not Required Under the Standard?

  Yes

  No

  N/A

Occupational Health Management (WMA 1.2.0.1)

General Requirements

• Does the Supervisor maintain accurate rosters of personnel assigned to the workplace by updating the Occupational Health Supervisor Module in ASIMS Web at least every 3 months?

  Yes

  No

  N/A

• Does the Supervisor inform BE, PH and/or preventive medicine personnel of changes to workplace equipment, practices and/or procedures that may impact exposure to OEH hazards as soon as possible, but no later than 30 days?

  Yes

  No

  N/A

• Does the Unit commander, workplace supervisor(s), facility manager(s), and mission owners monitor, report, and track any identified deficiencies until closure?

  Yes

  No

  N/A

• Does the Workplace Supervisor complete OEH Self-Assessment Communicators in MICT and forward any findings and/or issues/concerns to BE?

  Yes

  No

  N/A

• Does the Workplace Supervisor ensure all OEH hazards are abated to the maximum extent possible and that all Airmen comply with OEH requirements?

  Yes

  No

  N/A

• Does the Workplace Supervisor ensure BE is informed promptly about job-related exposure, illness and pregnancy?

  Yes

  No

  N/A

Training and Information

• Does the workplace supervisor ensure required OEH hazard controls are implemented and functioning properly; PPE is available and used correctly in the workplace; and personnel are instructed on the care/hygiene of their PPE?

  Yes

  No

  N/A

• Are employees informed when they start, and at least annually, of (1) the existence, location, and availability of any employee exposure and medical records; (2) the person responsible for maintaining and providing access to these records; and (3) the right to records access?

  Yes

  No

  N/A

• Does the workplace use the USAFSAM/OE Hazard Communication training template and includes workplace specific hazard training and documents training in ARCNet?

  Yes

  No

  N/A

Risk Assessment Codes - RACs

• Does the shop have any open RACs?

  Yes

  No

• Has the supervisor posted the AF Form 1118 notifying the employees of the hazard?

  Yes

  No

• Is the 1118 posted near the hazard?

  Yes

  No

• For health related RAC’s 1, 2 or 3: Has the functional manager filled out AF Form 3 and returned to BE and Safety?

  Yes

  No

  N/A

• Has the functional manager reviewed the health RACs semi-annually?

  Yes

  No

  N/A

• Describe RAC, controls available and recommended actions:

Shop Personnel Listing

• Collect/verify current shop personnel listing.

• Shop Supervisor

  Sign

• Unit Commander

  Sign

• Public Health

  Sign

• Bioenvironmental Engineering

  Sign

• Wing Safety

  Sign