St. Olaf College

Respiratory
Protection Program





Section 2
POLICY DOCUMENTATION



  • Respirator Protection Compliance Plan
  • Routing Sheet for Written Plan
  • Documentation for Respirator Protection



    Facilities Homepage | Respiratory Protection TOC | Training Manual TOC
























    RESPIRATORY PROTECTION COMPLIANCE PLAN



    • A. The St. Olaf College respiratory protection program is designed to reduce employee exposure to air contamination. It includes the recognition and evaluation of inhalation hazards in our work environment, and the establishment of a respiratory protection policy that includes the selection, use, maintenance and fitting of respirators.



    Section 2 Table of Contents


    Facilities Homepage | Respiratory Protection TOC | Training Manual TOC
























    ROUTING SHEET FOR WRITTEN PLAN



    Due to the importance of this plan to the Health and Safety of St. Olaf College, please read, sign the routing form, and pass to the next person. When everyone has signed, return this form to the Compliance Manual, placing it in the envelope for the Coordinator of Environmental Health and Safety Programs.


    SUPERINTENDENT  __________________________________________________________
                        Signature                Title                  Date
    
    DIRECTOR OF
    PERSONNEL       __________________________________________________________
                        Signature                Title                  Date
    
                                           
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    
    
                    __________________________________________________________
                        Signature                Title                  Date
    



    Section 2 Table of Contents


    Facilities Homepage | Respiratory Protection TOC | Training Manual TOC
























    DOCUMENTATION FOR RESPIRATOR PROTECTION



    • A. The requirements for a Respiratory Protection program include medical surveillance, training, and fit testing of respirator uses and respirator maintenance and cleaning. This section includes the following documentation forms to verify that all requirements have been met:

      • 1. Annual Fit Test Roster

      • 2. Annual Respirator Qualitative Fit Test and Training

      • 3. Medical History for Respiratory Protection Use

      • 4. Medical Qualification for Respirator Use


    • B. Each respirator user is provided with a card for maintenance and cleaning records. Below is a sample of this card. However, the actual documentation is kept with each respirator.


                MAINTENANCE RECORD                               
                                                                 
                Respirator______________________________________ 
                               Make       Model       Size       
                                                                 
                User_____________________ Date Issued___________ 
                                                                 
                Date          Inspection/       Inspected by:    
                                Service                          
                                                                 
    



    Section 2 Table of Contents


    Facilities Homepage | Respiratory Protection TOC | Training Manual TOC