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29 CFR 1910.134 respiratory protection program inspection
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Respiratory Protection Program Inspection
Mark P = Pass, F = Fail, N/A = Not Applicable for each item. Record notes for any F.
| # | Check Item | P | F | N/A | Notes / Action |
|---|---|---|---|---|---|
| Written Respiratory Protection Program | |||||
| 1 | Written respiratory protection program is current, site-specific and accessible | ||||
| 2 | Program administrator designated and trained | ||||
| 3 | Hazard assessment completed identifying respiratory hazards and exposure levels | ||||
| 4 | Respirator selection matches identified hazards and exposure levels | ||||
| Medical Evaluation | |||||
| 5 | Medical evaluations completed for all respirator users before fit testing | ||||
| 6 | Medical clearance records on file and current | ||||
| 7 | PLHCP (physician or other licensed healthcare professional) designated | ||||
| Fit Testing | |||||
| 8 | Annual fit testing completed for all tight-fitting respirator users | ||||
| 9 | Fit test records on file (employee name, respirator make/model/size, date, protocol) | ||||
| 10 | Fit test protocol follows OSHA-accepted method (QLFT or QNFT) | ||||
| 11 | Employees re-fit-tested after facial changes (weight, dental, surgery) | ||||
| Respirator Use & Seal Checks | |||||
| 12 | Users perform seal checks (positive and negative pressure) before each use | ||||
| 13 | Respirators used only by the assigned employee | ||||
| 14 | No facial hair that interferes with seal (tight-fitting respirators) | ||||
| 15 | Corrective lenses do not interfere with facepiece seal | ||||
| Respirator Condition | |||||
| 16 | Facepiece: no cracks, tears, distortion, or deterioration | ||||
| 17 | Head straps: elastic, no breaks, adjustments function correctly | ||||
| 18 | Valves: inhalation and exhalation valves function, no cracks or damage | ||||
| 19 | Cartridges/filters: correct type for hazard, not expired, change schedule followed | ||||
| # | Check Item | P | F | N/A | Notes / Action |
|---|---|---|---|---|---|
| Cleaning, Maintenance & Storage | |||||
| 20 | Cleaning and disinfecting procedures established and followed | ||||
| 21 | Respirators cleaned after each use (or end of shift for disposables) | ||||
| 22 | Respirators stored in clean, dry location away from contaminants | ||||
| 23 | Emergency respirators inspected monthly and after each use | ||||
| 24 | Defective respirators removed from service and repaired or replaced | ||||
| Training | |||||
| 25 | Initial training provided before respirator use | ||||
| 26 | Annual retraining completed for all respirator users | ||||
| 27 | Training covers: why respirator is needed, limitations, proper use, seal checks, maintenance, emergencies | ||||
| 28 | Training records on file with employee name, date and topics | ||||
| SCBA / Supplied-Air Systems (if applicable) | |||||
| 29 | SCBA cylinders fully charged (within 10% of rated pressure) | ||||
| 30 | Air supply meets Grade D breathing air quality standards | ||||
| 31 | Airline couplings are incompatible with non-breathing air outlets | ||||
| 32 | Escape bottle or egress respirator available for supplied-air users | ||||
| Voluntary Use & Program Evaluation | |||||
| 33 | Voluntary users provided Appendix D information | ||||
| 34 | Program evaluated at least annually for effectiveness | ||||
| 35 | Employee feedback on program solicited and documented | ||||
Deficiencies & Corrective Actions (reference item # from checklist)
| Item # | Deficiency description | Corrective action | Completed by / date |
|---|---|---|---|
Declaration
I declare that I have completed this respiratory protection program inspection and that all items have been assessed per OSHA 29 CFR 1910.134. Any deficiencies identified have been recorded and reported to the responsible person for corrective action.