MODEL HAZCOM PROGRAM SELF-AUDIT

CHECKLIST

Instructions: The OSHA Hazard Communication Standard requires employers to implement a

written hazard communication program at each workplace where hazardous chemicals are

present outlining the safety measures taken to protect employees from chemical hazards,

including the use of labels, Material Safety Data Sheets (MSDSs)—which under OSHA’s new

Globally Harmonized System or GHS rule, will become Safety Data Sheets (SDSs) as of June 1,

2016 and training and education about chemical safety. Complete this Checklist to determine if

the current workplace hazard communication program includes the elements required by OSHA

and the GHS rule.

YES/NO PERSON(S) RESPONSIBLE

DATE COMPLETED

WRITTEN PROGRAM

1. Is there a written hazard communication program for the workplace?

[ ] Yes

[ ] No

2. Is the written hazard communication program conspicuously posted?

[ ] Yes

[ ] No

3. Is the written hazard communication program readily accessible to all workers at all times?

[ ] Yes

[ ] No

4. Has an inventory of hazardous chemicals at the worksite been compiled?

[ ] Yes

[ ] No

5. Is the chemical inventory kept current when new chemical products are received?

[ ] Yes [ ] No

6. Are measures in place to ensure that after chemicals are re-classified as required by GHS (which must be done by June 1, 2015), the chemical inventory is accordingly revised and that such revisions are completed by June 1, 2016?

[ ] Yes [ ] No

7. Does the chemical inventory include information about hazardous chemicals introduced to the worksite by outside contractors and subcontractors?

[ ] Yes

[ ] No

8. Do workers and/or their representatives, e.g., union reps, safety committees, have access to the chemical inventory?

[ ] Yes [ ] No

9. Are all outside contractors and subcontractors notified of the worksite hazard communication program?

[ ] Yes [ ] No

10. Is there a system to ensure all outside contractors and subcontractors are notified of the hazardous chemicals at the site to which they may be exposed?

[ ] Yes [ ] No

11. Is there a system to ensure that all outside contractors and subcontractors notify us of hazardous chemicals they introduce to the worksite?

[ ] Yes [ ] No

12. Is the hazard communication program reviewed at least once a year?

[ ] Yes

[ ] No

LABELS & OTHER WARNING FORMS

1. Is there a system to ensure that all primary containers of hazardous chemicals introduced into the workplace have appropriate workplace labels supplied by the manufacturer or importer?

[ ] Yes

[ ] No

2. Is there a system to ensure that all secondary containers of hazardous chemicals introduced into the workplace have appropriate workplace labels?

[ ] Yes

[ ] No

3. Is there a system to ensure that labels are legible, in English and prominently displayed on containers?

[ ] Yes

[ ] No

4. Is there a system to ensure that labels have all required information?

[ ] Yes

[ ] No

5. Is there a system to ensure that current labels are replaced with the new labels required by GHS by June 1, 2016?

[ ] Yes [ ] No

6. Is there a system to ensure workers are aware of and know how to read labels?

[ ] Yes

[ ] No

7. Will workers receive the information and training necessary to read the new GHS labels by Dec. 1, 2013?

[ ] Yes [ ] No

8. Is there a system to ensure labels remain affixed and haven’t fallen off containers?

[ ] Yes

[ ] No

9. Is there a system to identify hazardous materials in: • Piping systems or pipes • Processing vessels

• Reaction vessels?

[ ] Yes

[ ] No

9. Are the above requirements applied to any alternatives used to provide hazard warning information, e.g., signs, placards or process sheets?

[ ] Yes

[ ] No

MATERIAL SAFETY DATA SHEETS/SAFETY DATA SHEETS

1. Is there a current MSDS/SDS for each hazardous chemical used in the worksite?

[ ] Yes [ ] No

2. Is the MSDS/SDS in English (or other language(s) spoken by workers)?

[ ] Yes [ ] No

3. Is there a system to ensure each MSDS/SDS is up-to-date and includes all required information?

[ ] Yes [ ] No

4. Are MSDSs/SDSs readily available to workers who work with hazardous chemicals during all shifts?

[ ] Yes

[ ] No

5. Is there a system for auditing the MSDS/SDS books?

[ ] Yes

[ ] No

6. Is there a system to ensure that every new hazardous chemical introduced into the workplace has an appropriate MSDS/SDS?

[ ] Yes

[ ] No

7. Is there a system to ensure that [ ] Yes

MSDSs/SDSs are updated and that old MSDSs/SDSs are replaced with updated ones when they’re received?

[ ] No

8. Are MSDSs/SDSs (or at least the key information from them) retained for at least 30 years?

[ ] Yes

[ ] No

9. Is there a system to ensure that by June 1, 2016, all MSDSs will be replaced with GHS-compliant SDSs?

[ ] Yes [ ] No

10. Will all workers receive information and training about how to use the new SDS by Dec. 1, 2013?

WORKER TRAINING & EDUCATION

1. Is hazardous chemical safety training provided by a person who’s knowledgeable about:

* The specific hazardous chemicals used

* This hazard communication program

* The OSHA Hazard Communication standard

* The new Globally Harmonized System rule

[ ] Yes [ ] No

2. Do workers receive chemical safety training:

* Prior to initial assignment to work involving exposure

* Upon introduction of new chemical hazards to their workplace for which they haven’t received prior training?

* Upon assignment to non-routine tasks involving exposure?

[ ] Yes [ ] No

3. Are workers trained on general chemical hazards?

[ ] Yes

[ ] No

4. Does training explain how the hazardous communication program

[ ] Yes

[ ] No

works?

5. Are workers trained to read labels? [ ] Yes

[ ] No

6. Are workers currently trained to use MSDSs/SDSs?

[ ] Yes

[ ] No

7. Are workers taught how to access and use hazardous chemical information from labels, MSDSs/SDSs and other sources?

[ ] Yes

[ ] No

8. By Dec. 1, 2013, will all workers be taught how to use the new GHS labels and SDSs?

[ ] Yes [ ] No

9. Are workers trained on measures to protect themselves from physical, health, simple asphyxiation, combustible dust and pyrophoric gas hazards as well as hazards not otherwise classified of the chemicals in their workplace?

[ ] Yes

[ ] No

10. Are workers trained on what to do if they find an unlabelled container or a hazardous chemical that doesn’t have an MSDS/SDS?

[ ] Yes

[ ] No

11. Are workers trained about the requirements of the OSHA Hazard Communication Standard, including the new GHS rules?

[ ] Yes

[ ] No

12. Does training include information on operations in work areas where hazardous chemicals are present?

[ ] Yes

[ ] No

13. Does training include methods and operations to detect the presence or release of a hazardous chemicals?

[ ] Yes

[ ] No

14. Does training address emergency evacuation procedures in the event of a chemical spill, fire or other emergency?

[ ] Yes

[ ] No

15. Are outside contractors and subcontractors notified of the hazardous chemicals they work with?

[ ] Yes

[ ] No

16. Are outside visitors to the worksite notified of hazardous chemicals to which they may be exposed?

[ ] Yes

[ ] No

17. Are steps taken to verify that workers understand and capable of following the training and instruction they receive?

[ ] Yes [ ] No

18. Is training documented, including:

* Trainer’s name

* Trainee’s name

* Date of training

* Brief description of training provided?

[ ] Yes [ ] No

19. Are training records retained for at least 30 years?

[ ] Yes [ ] No

Comments:

Checklist completed by: _______________________________________________

Position: ___________________________________________________________

Signature: ___________________________________________________________

Date: _______________________________________________________________