Free F418-031-000 Hazard Documentation Worksheet 1C - Washington

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Pages: 2
File Format: PDF
State: Washington
Category: Government
Author: Forms Management
Word Count: 102 Words, 776 Characters
Page Size: Letter (8 1/2" x 11")

Download F418-031-000 Hazard Documentation Worksheet 1C ( 86.4 kB)

Preview F418-031-000 Hazard Documentation Worksheet 1C
Division of Occupational Safety & Health MS: 44600
Date/Time WAC #

Classifi. Citation # Item # Grp Inst Inspection Report #

Abatement Period

/ / Description of observed hazards, conditions and practices

Measurements Method of measurement (tape measure, blueprints, employer statement, other)

Exposed employee Address

Occupation Phone number

# EEs exposed

Duration of hazard

Frequency of exposure

Equipment Type SN

Make HP RPMs

Model Voltage Amperage

Comments (Employee statement. Employer statement. How complied. PPE, guards, controls)

Abatement method to comply Discussed with employer regarding abatement assistance.
F418-031-000 hazard documentation worksheet - 1 c 1-07

(Grid on back side of paper)

F418-031-000 grid