PROGRAM CONTACT PERSON LIST

Asbestos Management.....................................................Larry Schueler AED..........................................................................Sheryl Jacobson AWAIR........................................................................Larry Schueler Bleacher Safety......................................................................... N/A Bloodborne Pathogens...................................................Sheryl Jacobson Community Right-to-Know...............................................Larry Schueler Compressed Gas Safety..................................................Bruce Anderson Confined Space Entry.....................................................Larry Schueler Emergency Action Planning...................................................Lynn Kuehn Employee Right-to-Know/Hazard Communication...................Larry Schueler Facilities Safety Management............................................Larry Schueler First Aid/CPR ............................................................Sheryl Jacobson Hazardous Waste Management..........................................Larry Schueler Hearing Conservation.....................................................Larry Schueler Indoor Air Quality..........................................................Larry Schueler Integrated Pest Management............................................Larry Schueler Laboratory Standard/Chemical Hygiene Plan.......................................N/A Lead Management.........................................................Larry Schueler Lockout/Tagout ...........................................................Larry Schueler Machine Guarding ..........................................................Larry Schueler Personal Protective Equipment..........................................Larry Schueler Playground Safety.........................................................Larry Schueler Radon Gas Safety............................................................Bernie Cruser Respiratory Protection.....................................................Bernie Cruser USTs/ASTs...............................................................................N/A Welding Cutting Brazing.................................................Bruce Anderson

Checklist of E/OHS Activities for Automatic External Defibrillator
Program Contact Person: Sheryl Jacobson School policy for use adopted in place? Yes No N/A Brand of AED? Medtronic Name of Medical Director? Year device was placed into use? September 28, 2008 Location(s) of devices: Building Name ECHO K-12 Location in Building Staff lounge Model # LifePac CR Plus Ref# 3200731-002

Have all software updates been installed? Yes No N/A Date of update installation: Expiration date of pads? Adult pads 8-28-2011, Infant 09-28-10 Expiration date of batteries?
(date)

Has staff been trained on operation of the device? Yes, all school nurses and Emergency responders are trained biannually. • • Most recent date of training August 2010
(date Note: Training is planned for summer of 2008.

Provider of training: Gene Hughes Ambulance at Granite Falls

Location of operators manual :It is located with the device in the staff work room. Are battery checks documented? Yes, The checks are documented monthly. The check sheet is located in the AED storage box. Notes: The AED’s were purchased through Pac 4 monies.

Checklist of E/OHS Activities for Asbestos Management
Program Contact Person: Bernie Cruser/Larry Schueler Is the Asbestos Management Plan in place? Yes No N/A Is the Plan current for all buildings? Yes No N/A Has the Plan (or Plans) been reviewed this school year? Yes No N/A The Plan is located at affected building _Main office. Training for Asbestos Awareness was conducted: annual refresher New PT employees received training on: no new part time staff hired.
(date)

.

Annual written notification has been prepared: yes Notification appeared in the following publication(s): Name of publication
(date)

.

Date Fall, 2009 .

Three-year re-inspection Surveillance was conducted: 6/20/2007 6-month Periodic Surveillance was conducted:04/09
(first date)

03-10-10
(second date)

All caution labels have been posted. Label locations:

Are supplies of repair materials adequate to meet the requirements of maintenance and repair of ACM? Yes No N/A

Asbestos Maintenance Supplies on Hand Tyvek suits 2 3 AO respirator Particulate filters 2 cases 8mill bags ½ roll

Is documentation of Operations and Maintenance available? Location: Main office

Status of the Asbestos repair and maintenance Work Order System: N/A Established, Pending Comments: asbestos repairs and removals are conducted by out sourced contractors. Note: All steam tunnels were repaired during the summer of 2009. Dislodged insulation was reattached and reinforced. Missing pipe insulation was replaced. A pipe that reportedly carried rain water from the roof was determined to be leaking during rain events. The pipe was capped to prevent buildup of water in the tunnel floor. It is believed that this moisture was the cause of insulation failure. LC 9-29-09 Note: Samples were taken of the ceiling spray-on and soft plaster for analysis. Significant damage has occurred and O&M is recommended. 11-9-09 LC The results determined the ceiling and plaster contain asbestos. Larry has asked for methods to abate or contain. Brian will review and submit a bid for containment. LC 4-13-2010 Click here to view 6month periodics

Checklist of E/OHS Activities for AWAIR
Program Contact Person: Larry Schueler Is the AWAIR Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Is the Safety Committee organized? Yes No N/A How often are meetings held? Quarterly Are minutes of the meeting maintained? This remains a goal for 2009-2010. Location: Posted: How is the program communicated to employees? Who is the Contact Person for OSHA 300? Toni Fredrickson Is the OSHA 300A Log completed for the previous calendar year? Yes Have the Logs been maintained for five (5) years? Yes

Location: Files in safe and the Activities Manual Is the Log posted from February 1 until April 30? Yes The location/s of the posted log: Staff work room Is information on injuries recorded on the Log with five (5) working days? Yes No N/A Note: click here to view Berkley Management and Procedure Guidelines for ECHO Charter School 2-17-09 Note: The chemical inventory (12-10-09) was brought up to date. LC

Safety Committee – Meeting Schedule
Date Location Time

District Safety Committee Members Member Larry Schueler Betty Lecy Cindy Skulstad Lynn Kuehn Pat Jacobson Bernie Cruser Bruce Anderson Marsha Lecy Position Lead Teacher Nursing Nursing Consulting Secretary Teacher Maintenance Ind-tech Instructor Kindergarten Building 1-12 1-12 1-12 1-12 1-12 1-12 1-12 1-12

Note: As a specific safety committee is not required I recommend the Wellness Committee be combined with the Health and Safety Committee.

Checklist of E/OHS Activities for Bleacher safety
Program Contact Person: Larry Schueler Is the BSM Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Has an annual survey of school bleachers been conducted? Yes No N/A Is the five-year recertification required by December 31, 2007 complete and submitted to the Minnesota Department of Labor and Industry? Yes No N/A Note: The school has no known bleachers that are required to be certified.
Openings and gaps: Openings limited to four-inch gap between the railings and between the footboards and seat boards, starting at a height of 56 inches or more. Retractable bleachers: They may contain openings of 9 inches or less If exempt from standards must have a safety management plan in place and an amortization schedule to plan for their future replacement Approved netting: Netting may be provided to prevent persons from falling through the bleachers between the seat and footboards Chain link fencing may be used but must be secured tightly to the underside of the bleachers. Railings: Bleachers 55 inches and under are exempt from railing requirements Bleachers with guardrails over 30 inches above grade must not contain openings greater than four inches, unless safety nets are installed. State building inspectors shall determine whether the safety nets and guardrail climb ability meet the requirements of the alternate design section of the State Building Code. Periodic inspections:

Bleacher footboards and guardrails must at a minimum be reinspected at least every five years and a structural inspection at least every ten years. The equipment has no rust, rot, cracks, or splinters, especially where it comes in contact with the ground There are no broken or missing components on the equipment (e.g., handrails, guardrails, protective barriers, steps, or rungs on ladders) and there are no damaged fences, benches, or signs on the playground

Note: the school now has two sets of aluminum bleachers for school events. The bleachers are less than 56inches high so are exempt from bleacher safety requirements. LC 4-19-2010

..\Bleachersafety

Checklist of E/OHS Activities for Bloodborne Pathogens
Program Contact Person: Cindy Skulstad/Betty Lecy Is the Bloodborne Pathogens Written Plan in place? Yes No Has the Plan been reviewed this school year? Yes No List job categories that may be at risk to exposure: Due of the size of the school “all staff” are considered “at risk”. Custodial support is available during the morning sessions of school. What is this school’s policy regarding Hepatitis B vaccinations for employees considered at risk versus employees considered not at risk in the Exposure Control Plan? All staff are offered HBV vaccine at no cost. The public health nurse Cindy Skulstad provides vaccination services. Is training provided at this school on methods and techniques to reduce exposure incidents? Training is provided annually during staff development sessions. New Employees: within days 10 of hiring Have the employees identified as first aid responders been given at a minimum Red Cross First Aid Training? Yes No N/A Are Exposure Control Kits available to staff? Yes No N/A Location(s): Kits are located in each desk. The janitors closet also contains clean-up materials but is often locked. Status of Declination forms: The forms remain on file in each employee personnel file. They are also stored in the Country side Public Health office.

How is blood or bodily-fluid-containing materials handled at this facility?

Policy regarding cleanup: When custodial help is available they typically will clean fluid spills. More often staff are required to clean affected spill areas.

Location of biohazard bags at school: Nurses office and library office. Approved disposal location for biohazardous waste: Countryside Public Health Note: Bloodborne pathogen training was conducted for all staff on 8-25-09. LC Note: Brian P provided train to all-staff during staff development days Aug. 2010. LC

Checklist of E/OHS Activities for Confined Space Entry
Program Contact Person: Larry Schueler Is the Confined Space Entry Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Have confined space areas been identified? Yes No N/A Have measurements to include CCI/ft been completed? Yes No N/A Are permit entry forms in place? Yes No N/A Location: Tunnel openings, boiler room and gym tunnel Are confined space labels in the proper locations? Yes No N/A Is a list of employees eligible to enter confined spaces complete? Yes No N/A Has training for affected employees completed? Yes No Date of completion: 2-17-2009

Confined Space Folder

Confined Space Inventory
Building: E.C.H.O. Charter School Building Contact: Bernard Cruzer Completed By: Lee Carlson
Room Identification Name Given Space Old Kitchen Area above kitchen Boiler Room Boilers #1 Boiler Room Boiler #2 Boiler Room Tunnel Gymnasium Above stage Tunnel by old gym Elevator pit Furnace stack Opening Dimension

Program Contact: Larry Schuler Date: 4/19/2010

Dimension Of Confined Space 32”X13’ 9’X43”X48” 9’X43”X48” 30”X53”Xlength of run 8’X12’X48”

Potential Hazards

Permit/ NonPermit NonPermit Permit required Permit required Permit Required NonPermit Required Nonpermit Nonpermit Permit required

Labeled

Photo ID #

32”X22” 16” round 16” round 46”X46” 30”X24” 3’ X 3’

LO2, Electrical LO2,Electrical, heat LO2,Electrical, heat LE, A LE, A LE, electrical,

no Yes Yes Yes No No

5’X5’ 24”X30”

Electrical, hydraulic Gases, dust, heat

No No

Checklist of E/OHS Activities for Community Right-to-Know
Program Contact Person: Larry Schueler Is the Community Right-to-Know Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Are quantities of stored and used designated hazardous materials documented and verified? Yes No N/A Note: (2) Tanks are located in custodial office. They are less than the required quantity to be reported. Where are the documents stored? Activity Manual Have the State Emergency Response Commission and local fire department been notified of hazardous materials on school grounds? Yes No N/A When were they notified? N/A
(date)

Has training been provided? Yes No N/A Date: N/A Presenter: N/A A review of facilities revealed quantities of all know hazardous chemical falls below reporting requirements. Therefore, no report was submitted to the Emergency Response Commission during 2007-2008 school year. No changes have been noted for school year 2010-2011. This program may change with the addition of the gymnasium and classrooms slated for 2011. LC

Inventory Form
Client: ECHO Charter School
Contact Person: Larry Schueler Hazardous Material Quantity Date: Sept. 5, 2007 Location Reported on Tier Two Installation Date(s)

# 2 Fuel oil

260 gal X 2 520 total gallons

Custodial room next to boiler room

N/A

Note: The minimum quantity of reportable chemicals is 10,000 lbs. The above fuel remains less than required for reporting. LC 9/5/2007 No changes in school year 2009-2010. LC

Checklist of E/OHS Activities for Emergency Action Planning
Program Contact Person: _Lynn Kuehn Is the Emergency Action Planning program in place and as outlined in the Minnesota Executive Order 93-27 and Model Crisis Management Plan? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Have the program and goals been approved by the School Board for the current school year? Yes No Are information maps posted to indicate travel routes in the event of fire, tornado shelter locations, and procedures during lockdown? Yes No Located where? Maps are located in each classroom. Are all drills timed and recorded? Yes No Responsible person: Lynn Kuehn Location of records: At Lynn’s desk and also a copy is maintained in the safe. Forms provided: Yes No Sept 5, 2009 Does this school coordinate drills with local government authorities to assure sheltering in school, evacuating to their homes or use of congregate care centers? Yes No N/A Has this school completed the Fire Marshall required Fire Safety and Emergency Evacuation Plan? Yes No N/A Training provided for affected staff? Yes No N/A

Checklist of E/OHS Activities for Employee Right-to-Know/Hazard Communication
Program Contact Person: Larry Schueler Is the Employee Right-to-Know/Hazard Communication Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Has the program been approved by the School Board for the current school year? Yes No Has the chemical inventory been completed for the following functional areas? Location of Chemical Inventory Form Art Instruction Custodians Food Service Science Rooms Shop (metals, wood, auto) Yes No N/A N/A Yes No N/A Activities Manual Yes No N/A Kitchen/Activities Manual Yes No N/A A survey revealed no chemicals Yes No N/A Activities Manual

Are MSDS available and located with the chemical inventory? Yes No Do the MSDS concur with the chemical inventory? Yes No Has training been provided for the following staff?
Art Instructors Custodians Food Service

Yes No N/A Science Yes No N/A Shop

Yes No N/A Yes No N/A

Yes No N/A Transportation Yes No N/A

Date of training:

Aug, 2010

Checklist of E/OHS Activities for Facilities Safety Management and Fire Safety in Schools
Program Contact Person: Larry Schueler Is the Facilities Safety Management program in place? Yes No Does this school use contracted services for the Management Assistant Program? Yes No N/A If no, who is the designated person or persons?

Fire and Life Safety in Schools
Program Contact Person: Larry Schueler Is the Fire Marshal approved Emergency Evacuation Plan in place for each district building? Yes No Most recent date of sprinkler electronics inspection:_________ N/A Most recent date of alarm inspection :_Aug, 2010________ N/A Most recent inspection of fire extinguishers: Aug. 2010 N/A Most recent inspection of fume hoods with fire suppressant :_Aug. 2010 N/A Are emergency lights tested at least biannually? Yes No N/A Science safety Checklist completed? Yes No N/A Note: Click to review Fire Safety Plan.

Facilities Safety Review
Building: E.C.H.O. Charter School
Mock-OSHA Review Area Art Dark Room Wood Shop Kitchen Metal Shop Halls, Gym, etc. Graphic Arts
Maintenance/Custodial

Date Review Completed 4-19-2010

N/A X

Recommendations

4-19-2010 4-19-2010 4-19-2010 4-19-2010 X 4-19-2010 4-19-2010 4-19-2010 4-19-2010

Transportation Grounds/Garage Chemistry/Life Science

Click here to view Facility Safety Report 2010

Checklist of E/OHS Activities for First Aid/CPR
Program Contact Person(s): Sheryl Jacobson Is the First Aid/CPR program in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Have the program and goals been approved by the School Board for the current school year? Yes No Has the District determined a provider in the event of a medical emergency? Yes No Cottonwood Ambulance will be dispatched , however The local provider determined travel time was estimated to be in excess of the 4-8 minute limit. Therefore Betty Lecy/ Pam Williams/Sara Dunphy will be the designated emergency response persons located within the district. Has training been provided for affected staff? Yes No Entire staff was trained Aug of 2006. The trainer was Gene Hughes. Date of training: Aug. 2010

Note: Training for CPR will again be offered to all-staff August of 2008. Note: Gene Hughes provided Training on CPR. Gene is from the Granite Falls Ambulance Assn. and provided training during staff development fall of 2010. In addition 11 persons attended training on the AED. The school nurse will be checking on the contents and condition of the first-aid kits located in the shop, boiler room and central office. LC 10/25/2010

Suggested Items to Be Included In Each Kit of Kits ITEM Gloves, 4-pack Gauze roller bandage 1” and 2” x 10-yds. Gauze compress bandage 3” x 3” individually packaged Adhesive bandages, assorted sizes, individually packaged Adhesive tape rolls Scissors, blunt-nosed Tweezers Packaged antiseptic, aqueous mercury preferred (Mercurochrome) Mild soap, capped squeeze bottle Elastic bandage, 4” Resuscitation mouthpiece Eyewash container and neutral sterile solution Empty plastic bag for application of ice (include “chemical ice” if ice is not available) ABC’s of First Aid Bold instructions on how to call 911 Telephone numbers of the Poison Information Center and the consulting health care provider.

Suggested Number 1-50 1 2 10 16 2 1 1 1 1 1 1 1 1 1 1 1 51-100 2 2 20 32 2 1 1 1 1 1 1 1 1 1 1 1 101-200 2 2 30 64 3 1 1 1 1 1 1 1 1 1 1 1

Status of First Aid Kits: note a first-aid kit is located in each class room.
Location Custodial Closet Class rooms Nurses Office Main Office Shop Contents Band aids, gauze, gloves, cleanup supplies, antiseptic Condition of Contents Good Good Good Good

Checklist of E/OHS Activities for Hazardous Waste Management
Program Contact Person(s) Primary Contact Person: Larry Schueler Secondary Contact Person: Bernie Cruser Is the Hazardous Waste Management program in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Have the program and goals been approved by the School Board for the current school year? Yes No Did this school generate ten gallons of waste per year? Yes No Note: In Greater Minnesota, schools generating ten gallons of waste per year or less do not need a license. Did this school generate 220 pounds or less per month hazardous waste (about ½ drum or less liquid)? Yes No Note: Wastes that do not count include antifreeze, cathode ray tubes, fluorescent lamps, lead acid batteries, pcb ballasts, photo fixer reclaimed on site, used oil and oil filters. Training for VSQG’s do not have training requirements however MPCA strongly recommends persons handling wastes be given training on best handling and safety risks associated. Has training been provided for affected persons? Yes No N/A Date Conducted: N/A Date Scheduled: N/A Has annual report and license application sent in? Yes No N/A

Checklist of E/OHS Activities for Hearing Conservation
Program Contact Person: Larry Schueler Is the Hearing Conservation Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Has the program been approved by the School Board for the current school year? Yes No Has the school been surveyed for noise hazards? Yes No Have sound level measurements been collected? Yes No Have the results been documented? Yes No Location: Activities Manual Has training been scheduled or completed for affected individuals this school year? Yes No N/A Date: Presenter: Lee Carlson Have regulatory changes occurred that may affect this program? No Note: The ceiling was lined with tin in the wood shop during the summer of 2010. Testing should be conducted to determine dBa at various locations in the room and at stationary tool locations. Soundproofing is recommended if noise levels exceed the plan standards. LC 10/25/2010

Sound Level Monitoring
Client: E.C.H.O. Charter Schools

Measuring Device: Digital Sound Level Meter

Calibration: Pre___________ Post___________

Reason for Testing: General Survey Affected Personnel: Custodial, maintenance Location Equipment Results Recommendations

Completed by:

Date:

Checklist of E/OHS Activities for Indoor Air Quality
Program Contact Person: Larry Schueler Is the IAQ Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Has an IAQ Committee been established? No. Has the annual cursory walk-through been conducted? Yes No Have the districts key building systems been evaluated? Yes No When was the evaluation completed? 3-2-2010 Who conducted the evaluation? Advanced Safety and Security Were occupied areas of the district evaluated using the EPA’s Tools For Schools check list or equivalent? • Teachers check list? An information fact sheet was provided all –staff. # of forms distributed # of Forms returned: • • Building maintenance checklist? Building ventilation checklist?
(date)

Training conducted Training has been scheduled for _fall 2010______________.
(date)

Has the District determined the mechanical ventilation rate of each occupied space? Yes No. Supportive technical services were conducted on: _3-2-2010.
(date)

Results of technical services are located? _Activities Manual Click here to view CO2 testing report

IAQ Survey Review Form
E.C.H.O. Charter Schools

Building: Building Contact: Program Contact:

Room Identification Contact individual

Water Intrusion

Ventilation proble ms

Building failures i.e. foundation or roof problems

Cleanliness/ Proper storage

O&M Carpets

Recommendations:

Walk-through conducted by ______________________Date ___________________

Checklist of E/OHS Activities for Integrated Pest Management
Program Contact Person: Bernie Cruser Is the IPM Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Has the annual monitoring been conducted to determine location and degree of infestation? Yes No A map of the problem area/areas has been developed. Yes No Has notice been given to parents regarding application activities? Yes No Location or publication used to notify parents: Student Handbook_________.

Checklist of E/OHS Activities for Laboratory Standard/Chemical Hygiene Plan
Program Contact Person :______N/A_____, CHO Is the Laboratory Standard/Chemical Hygiene Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Fume hood was tested on _______________.
(date)

Chemical inventory: Date of most recent survey Location of inventory listing Are Material Safety Data Sheets (MSDSs) located with inventory? Yes No N/A Are the MSDS readily accessible? Yes No N/A Has the DCFL Science Lab Checklist been completed? Yes No N/A Is training for affected personnel complete? Yes No N/A Date(s) of instruction: Roster signed? Yes No N/A Lesson plan outline available with roster? Yes No N/A Status of Emergency Eye Wash/Deluge Shower: Is flushing conducted weekly? Yes No N/A Is descriptive signage properly posted? Yes No N/A Is flushing activity documented? Yes No N/A

Note: No significant reportable quantities of chemicals were noted in the science rooms. LC 2/8/08 No changes to this program for 2010-2011. LC

Checklist of E/OHS Activities for Lead-in-Water Management
Program Contact Person: Larry Schueler Is the Lead-in-Water Management Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No This school completed testing of water supply taps 12/21/2000.
(date)

Note: No copies of test results could be located. A vague reference to testing that may have occurred during 1990 was located. The results apparently were satisfactory at that time.LC Note: Documents located indicate that the Elementary Building water fountains were tested for lead 12-29-89 by Jim Dolan, ECSU. The results were found to be less than 2ppb. The original documents are now filed in the Activities Manual. LC Is a map of all potable water taps available for review? Yes No N/A

Checklist of E/OHS Activities for Lead-in-Paint Management
Program Contact Person: Larry Schueler Is the Lead-in-Paint Management Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Testing for lead in paint on playground equipment: Note: All playground equipment has been replaced with lead free. Note: paint throughout building is in very good condition. Little peeling or flaking of paint can be documented. Results of evaluation for paint condition in rooms K-1: Building constructed post-1978; facility not applicable

Building constructed prior to 1978; paint determined to be in _Some damage_____________ condition

Checklist of E/OHS Activities for Lockout/Tagout
Program Contact Person: Bernie Cruser Is the Lockout/Tagout Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Is LO/TO equipment available? Yes No N/A Is the equipment appropriate for application? Yes No N/A If available, where is the equipment located? Custodial Office Is the equipment maintained in an orderly and readily usable condition? Yes No N/A Have affected personnel been trained as to methods and technique of use? Yes No N/A Are written procedures available for affected staff? Yes No N/A If available, the procedures are located where? Activities Manual Has the annual audit of energy control procedures been completed? Yes No Date or dates of completion:

Checklist of E/OHS Activities for Machine Guarding
Program Contact Person: Bruce Anderson Is the Machine Guarding Plan for each affected work area in place? Yes No Is the plan/plans current? Yes No Has the Plan been reviewed this school year? Yes No Has a survey of all district fixed equipment been conducted? Yes No When was the evaluation completed? _______________________ Who conducted the evaluation? _______________________ How are corrections documented? _______________________________ Is all fixed equipment safeguarded to meet OSHA criteria? Yes No Has the alternative MDE “best practices” criteria used to safeguard equipment? Yes No Has equipment determined not in compliance scheduled for repair or replacement? Yes No If replaced, was “best practices,” bid specification criteria used for procurement? Yes No Note: The wood shop tools were reviewed for guarding 4-19-2010. The equipment seems to meets OSHA standards.

Identified Fixed Equipment Locations Location Building/Buildings Staff Affected # of item

Bus Garage Wood Shop Custodial/Maintenanc e Welding Shop

Contracted technical services to review and recommend? _____N/A_____________. Name of person or contractor conducting survey? ____N/A_______________.
(date)

Results of technical services located where? __N/A______________________ Checklist for minimum requirements: • Power outage protection provided for required equipment • Emergency stops provided for required equipment • Safe work practice placards at applicable fixed tool stations • Proper guards provided and used • Color coding as prescribed by OSHA standards • Non-slip surfaces by each piece of equipment • Fixed equipment secured to prevent “walking” or movement Has a log of employee accidents and near misses been established and used? Yes No Annual training for affected staff is provided? Yes No Training conducted ____________. Training has been scheduled for ____________. (date)
(date)

Checklist of E/OHS Activities for Playground Safety
Program Contact Person: Bernie Cruser Is the Playground Safety program in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Surfacing: The equipment has adequate protective surfacing under and around it and the surfacing materials have not deteriorated Loose-fill surfacing materials have no foreign objects or debris Loose-fill surfacing materials are not compacted and do not have reduced depth in heavy use areas such as under swings or at slide exits General Hazards: There are no sharp points, corners, or edges on the equipment There are no missing or damaged protective caps or plugs There are no hazardous protrusions and projections There are no potential clothing entanglement hazards, such as open Shooks or protruding bolts There are no pinch, crush, and shearing points or exposed moving parts There are no trip hazards, such as exposed footings on anchoring devices and rocks, roots, or any other environmental obstacles in the play area Deterioration of the Equipment: The equipment has no rust, rot, cracks, or splinters, especially where it comes in contact with the ground

There are no broken or missing components on the equipment (e.g., handrails, guardrails, protective barriers, steps, or rungs on ladders) and there are no damaged fences, benches, or signs on the playground All equipment is securely anchored Security of Hardware: There are no loose fastening devices or worn connections, such as Shooks Moving components, such as swing hangers or merry-go-round bearings, are not worn Drainage: The entire play area has satisfactory drainage, especially in heavy use areas such as under swings and at slide exits Leaded Paint: The leaded paint used on the playground equipment has not deteriorated as noted by peeling, cracking, chipping, or chalking There are no areas of visible leaded paint chips or accumulation of lead dust General Upkeep of Playgrounds: The entire playground is free from miscellaneous debris or litter such as tree branches, soda cans, bottles, glass, etc. There are no missing or full trash receptacles Click here to view playground file.

Checklist of E/OHS Activities for Personal Protective Equipment
Program Contact Person: Bernie Cruser Is the Personal Protective Equipment Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Has a survey of potential workplace hazards been completed? Yes No N/A Date(s) activity was conducted:04-19-2010_______________________ Have recommendations been completed for appropriate equipment? Yes No Has training been completed for the following departments? Art and Photo Custodial Kitchen Maintenance Science Laboratories Technical Education Transportation Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No N/A

Grounds keeping/Garage Yes No N/A

Personal Protective Equipment Assessment

Location: Custodial/Maintenance Employee: B Cruser Cutting Latex Vinyl Leather Neoprene Impact Splash Shield Muffs Plugs Neo Apron Denim Steel Toes Metatarsal Hard Hat

Location: Shops, metal/wood Employee: Bruce Anderson

Location: Kitchen Employee: Joyce Lecy

Location: Employee:

X X X X X X X X X X X X X

Hand

Face Ear Body Foot Head

Hazard(s)

Sound, heat, impact, chemical, body fluids Good

Sound, Heat, chemical, impact, vapor Good

Heat, chemical

Good

Comments on Availability, Condition, & Storage

Completed by Lee Carlson

Date 4/19/10

Checklist of E/OHS Activities for Radon Gas Safety
Program Contact Person: Bernie Cruser Is the Radon Gas Safety Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Testing was last conducted: 11-07-2000 through 06-06-2001.
(date)

Results of tests:
Room Name & No. Avg. Radon Conc. pCi/l Recommendation

Music Room C Vera’s Room H Monitor returned damaged little gym Cafeteria Library Room L Marsha’s Room E

0.3 0.2 No results 0.6 0.2 0.3

Testing was also previously conducted: 03-05-1990 through 02-20-1991.
(date)

Results of tests:
Room Name & No. Avg. Radon Conc. pCi/l Recommendation

Custodians Office Head Start Gymnasium

4.1 1.3 1.1

Exceeds recommended 4.0 level

Training is not requirement of this program. However if elevated levels are determined training of affected persons is recommended.

Date training complete: N/A Testing is / is not now in progress:

Checklist of E/OHS Activities for Respiratory Protection
Program Contact Person: Larry Schueler/Bernie Cruzer Does this school provide respirators for voluntary use? Yes No N/A If the school allows employees to use respirators voluntarily the following is mandatory. 1. Read and follow instructions provided by manufacturer. 2. Choose respirators certified for use against contaminants of concern. 3. Do not wear respirators in atmospheres containing contaminants not designed to protect from those contaminants. 4. Keep track of respirators so that you do not mistakenly wear someone else’s respirator. Is the Respiratory Protection program in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Date of review: 11-6-09 Are all employees in this program identified? Yes No N/A
Employee Bernie Cruser Larry Schuler Bryan Nielson Intended Use Light duty dust, est. Voluntary use Type of Respirator AO STAR, ½ mask AO STAR, ½ mask Medical Exam/ Questionnaire N/A N/A Date of Medical N/A N/A Date of Fit Test N/A N/A

Fit testing was completed on

N/A.
(date)

Type of testing protocol; Irritant Smoke (Stannic Chloride) or Bitrex (Denatonium Benzoate)

Condition and location of respirators: Condition: The respirator was disassembled and cleaned. Valve flaps were found in good condition. Straps were serviceable. 12-10-2009 Location(s): Metal cabinet custodial room Are the appropriate adequate accessories on hand? Yes No N/A Verified by L. Carlson

Equipment on Hand Cartridges Respirator Type ½ mask Respirator Brand AO American Optical 3m Location Metal cabinet custodial room Next to metal cabinet Valve Flaps? Good Straps? Good Organic (1) box Particulate (1) box Combination None

½ mask

Good

Good

Installed

Note: I could not locate replacement filters for the AO ½ mask respirator. Two boxes of filters are available for a 3M respirator are available but no respirator to fit. 12-10-09 LC Respirators were checked today and found in good condition. LC 4-19-2010

Checklist of E/OHS Activities for Underground and Aboveground Storage Tanks
NO UNDERGROUND OR ABOVE GROUND FUEL STORAGE TANKS AT THIS LOCATION. Program Contact Person: ___N/A________________________ Is the Underground and Aboveground Storage Tanks Plan in place? Yes No N/A Is the Plan current? Yes No N/A Has the Plan been reviewed this school year? Yes No N/A Have forms for inventory tracking been provided? Yes No N/A Do existing records accurately reflect purchase use correlation? Yes No N/A Are all USTs registered with the Minnesota Pollution Control Agency? Yes No N/A Are removals or additions of tanks anticipated in this facility? Yes No N/A Notes:

Checklist of E/OHS Activities for Welding and Brazing Safety
Program Contact Person(s) Bruce Anderson Department Contact: Bruce Anderson • • • Metals Shop Bruce Anderson Art (jewelry) Custodial N/A N/A

Is the Welding and Brazing Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No Method or methods used to control airborne particulate matter? None

Has training been conducted for affected personnel? Yes No Type • • • of welding equipment available Electric arch…………………. Yes No N/A Wire feed/TIG MIG………. Yes No N/A Electric spot weld………… Yes No N/A

Personal Protective Equipment: availability and condition • • • • • Gloves………… Yes No N/A Goggles………… Yes No N/A Welding mask………… Yes No N/A Apron………… Yes No N/A Steel toed shoes………… Yes No N/A

Describe location of welding activities, example; out-of-doors, booth, floor, all of the above: Note: The welding shop does not have adequate ventilation. It is recommended that ventilation be provided.

A used fume hood has been located at Hutchinson. It is hoped it can be installed the summer of 2010.Bruce has talked with Airtech of Redwood falls about installation. LC

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