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Annexure -1 : Respiratory Hazard inventory and e

SITE NAME: ________________________________ ELEMENT OWNER NAME: _____________________

RES

CHEMICAL-1

CHEMICAL-2

CHEMICAL-3
Sr. Departmen
Task No# Description of Task location/ area
No. t

1
2 YES
3
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5
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8
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10
11
12
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20
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CHEMICAL-4

DUST-1

DUST-2

FIBER-1
________________ DATE UPDATED:

AT & UP TO
TLV

ABOVE TLV UP
RESPIRATORY HAZARD

TO STEL

AT & ABOVE
IDLH
_____________________

EMERGENCY
inventory and employee fit test record

OXYGEN
DEFICIENT

UNDER WATER

DISPOSABLE
DUST MASK
NO

DDM-N-95

CARTRIDGE -
NOSE MASK-(-
p)
CARTRIDGE -
FACE MASK-(-p)
CARTRIDGE -
NOSE MASK-
(+p)
CARTRIDGE -
SUITABLE RPE

FACE MASK-
(+p)
LE RPE EMPLOYEE NAME [FIT TESTED / AUTHORISED( COMPAMY- CONTRACTOR)]
SUPPLIED AIR -

SUPPLIED AIR -

RESPIRATOR
CONTAINED
EXTERNAL

1 2 3 4 5 6 7 8 9 10
DIVING
SELF

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