Respiratory Protection Checklist - I7G

• Company Name

• Date

  Date

• Completed By

Selection

• Have you selected and provided an appropriate respirator based on respiratory hazard(s)? (29 CFR 1910.134(d)(1)(i))

  Yes

  No

  N/A

• Are all respirators NIOSH-certified and used in compliance with the conditions of their certification? (29 CFR 1910.134(d)(1)(ii))

  Yes

  No

  N/A

• Have you identified and evaluated all respiratory hazard(s) in the workplace? (29 CFR 1910.134(d)(1)(iii))

  Yes

  No

  N/A

• Do you select respirators from a sufficient number of respirator models and sizes so that the respirator is acceptable to, and correctly fits, the user? (29 CFR 1910.134(d)(1)(iv))

  Yes

  No

  N/A

Respirators for IDLH Atmospheres

• For IDLH atmospheres do you provide a full facepiece pressure-demand SCBA certified by NIOSH or a combination full facepiece pressure-demand supplied-air respirator with auxiliary self-contained air supply? (29 CFR 1910.134(d)(2)(i)(A)&(B))

  Yes

  No

  N/A

• Are all oxygen-deficient atmospheres considered IDLH? (29 CFR 1910.134(d)(2)(iii))

  Yes

  No

  N/A

Storage

• Are all respirators stored appropriately? (29 CFR 1910.134(h)(2)(i))

  Yes

  No

  N/A

• Are all respirators packed and stored to prevent deformation of the facepiece and exhalation valve? (29 CFR 1910.134(h)(2)(i))

  Yes

  No

  N/A

• Are emergency respirators kept accessible to the work area? (29 CFR 1910.134(h)(2)(ii)(A)(B)&(C))

  Yes

  No

  N/A

• Are emergency respirators stored in compartments or in covers that are clearly marked as containing emergency respirators, and stored in accordance with any applicable manufacturer instructions? (29 CFR 1910.134(h)(2)(ii)(A)(B)&(C))

  Yes

  No

  N/A

Inspection

• Are all respirators used in routine situations inspected before each use, and during cleaning? (29 CFR 1910.134(h)(3)(i)(A))

  Yes

  No

  N/A

• Are all respirators maintained for use in emergency situations inspected at least monthly and in accordance with the manufacturer's recommendations? (29 CFR 1910.134(h)(3)(i)(B))

  Yes

  No

  N/A

• Are all respirators maintained for use in emergency situations checked for proper function before and after each use? (29 CFR 1910.134(h)(3)(i)(B))

  Yes

  No

  N/A

• Are all emergency escape-only respirators inspected before being carried into the workplace for use? (29 CFR 1910.134(h)(3)(i)(C))

  Yes

  No

  N/A

Repairs

• Are respirators that fail an inspection or are otherwise found to be defective, removed from service, and discarded, repaired, or adjusted? (29 CFR 1910.134(h)(4))

  Yes

  No

  N/A

• Are repairs made according to the manufacturer's recommendations and specifications for the type and extent of repairs to be performed? (29 CFR 1910.134(h)(4)(ii))

  Yes

  No

  N/A

Breathing Air Quality and Use

• Are employees using atmosphere-supplying respirators (supplied-air and SCBA) provided with breathing gases of high purity? (29 CFR 1910.134(i))

  Yes

  No

  N/A

• Do compressed and liquid oxygen meet the United States Pharmacopoeia requirements for medical or breathing oxygen? (29 CFR 1910.134(i)(1)(i))

  Yes

  No

  N/A

• Does compressed breathing air meet at least the requirements for Grade D breathing air described in ANSI/Compressed Gas Association Commodity Specification for Air, G-7.1-1989? (29 CFR 1910.134(i)(1)(ii))

  Yes

  No

  N/A

• Are provisions in place to ensure that compressed oxygen is not used in atmosphere-supplying respirators that have previously used compressed air? (29 CFR 1910.134(i)(2))

  Yes

  No

  N/A

• Do you ensure that oxygen concentrations greater than 23.5% are used only in equipment designed for oxygen service or distribution? (29 CFR 1910.134(i)(3))

  Yes

  No

  N/A

• For compressors that are not oil-lubricated, do you ensure that carbon monoxide levels in the breathing air do not exceed 10 ppm? (29 CFR 1910.134(i)(6))

  Yes

  No

  N/A

• Do you ensure that breathing air couplings are incompatible with outlets for non-respirable worksite air or other gas systems?

  Yes

  No

  N/A

Identification of Filters, Cartridges, and Canisters

• Do you ensure that all filters, cartridges and canisters used in the workplace are labeled and color coded with the NIOSH approval label? (29 CFR 1910.134(j))

  Yes

  No

  N/A

Fit Testing

• Do you conduct fit testing using the procedures set forth in Appendix A to 1910.134? (29 CFR 1910.134 Appendix A, 29 CFR 1910.134(f)(5))

  Yes

  No

  N/A

User Seal Check

• Do individuals who use a tight-fitting respirator perform a user seal check to ensure that an adequate seal is achieved each time the respirator is put on? (29 CFR 1910.134 Appendix B-1, 29 CFR 1910.134(g)(1)(iii))

  Yes

  No

  N/A

• Is the seal check performed appropriately? (29 CFR 1910.134 Appendix B-1, 29 CFR 1910.134(g)(1)(iii))

  Yes

  No

  N/A

Cleaning

• Are respirators cleaned appropriately? (29 CFR 1910.134 Appendix B-2, 29 CFR 1910.134(h)(1))

  Yes

  No

  N/A

Training

• Do you provide effective training to employees who are required to use respirators? (29 CFR 1910.134(k))

  Yes

  No

  N/A

• Is the training comprehensive, understandable, and given annually (or more often if necessary)? (29 CFR 1910.134(k))

  Yes

  No

  N/A

• Is the training provided before employees are required to use a respirator in the workplace? (29 CFR 1910.134(k)(3))

  Yes

  No

  N/A

• Did the program pass the checklist?

  Pass

  Fail

  N/A

• Comments & Actions

• Signature

  Sign