St. Olaf College
Respiratory
Protection Program
Section 5
RECORDKEEPING
Section 5 Table of Contents
FacilitiesHomepage | Respiratory Protection TOC | Training Manual TOC
Person Projected Actual
Responsible Completion Completion
Date Date
1.Identify
Program
Administrator.
Place his/her
name in the
Compliance
Manual. __________________ / _______________ / _______________
2.Program
Administrator
reads Standard
and Plan filling
in all blanks. __________________ / _______________ / _______________
3.Program
Administrator
duplicates forms
in Facilities
Application
Section. __________________ / _______________ / _______________
4.Determine the
areas that need
to be surveyed
for air
contaminants. __________________ / _______________ / _______________
5.Assign people to
do the surveying.
They will
complete columns
1-3 of the Air
Contaminant
Inventory and
Evaluation form
for any air
contaminants. __________________ / _______________ / _______________
6.Obtain MSDS's for
all air
contaminants
identified on the
inventory. __________________ / _______________ / _______________
7.Have the
contaminant
evaluated for
respirator use. __________________ / _______________ / _______________
8.The
Contaminant
Inventory and
Evaluation form
will be
completed. __________________ / _______________ / _______________
9.Purchase various
sizes of the
required
respirators. __________________ / _______________ / _______________
10.Schedule
Respirator
Protection and
Training&Fit
Testing. __________________ / _______________ / _______________
11.Conduct Training.
__________________ / _______________ / _______________
12.Insert docu-
mentation in the
manual. __________________ / _______________ / _______________
13.Send medical
questionnaires to
a physician for
evaluation. __________________ / _______________ / _______________
14.Review Medical
forms evaluated
by Physician to
ensure employee's
ability to use a
respirator. __________________ / _______________ / _______________
15.Arranges Physical
Exam for any employee
recommended for
exam if employer
is going to
require
respiratory
protection. __________________ / _______________ / _______________
16.Route Respiratory
Protection
Written Program
to all individuals
on sign off sheet
for their
signature. __________________ / _______________ / _______________
17.Evaluate program
yearly. __________________ / _______________ / _______________
18.Reschedule
training as
needed. __________________ / _______________ / _______________
19.Contact the
coordinator
of environmental
health and safety
whenever exposures
are expected to
change, new exposures
are anticipated, or
complaints are
received. _________________ / _______________ / _______________
20.St. Olaf will
contact the
coordinator of
environmental health
and safety whenever
changes in personnel,
equipment, processes,
etc,. or program
inadequacies make
updating necessary.________________ / _______________ / _______________
Facilities Homepage | Respiratory Protection TOC | Training Manual TOC

