Read and heed all instructions provided by the manufacturer on use, maintenance, cleaning and care, and warnings regarding the respirators limitations. Choose respirators certified for use to protect against the contaminant of concern.
2017年12月28日 · Form for Voluntary Respirator Use: Appendix D. Some COA employees, students, or affiliates may choose to use filtering facepiece respirators, also referred to as N95 or N99 disposable dust masks, on a voluntary basis during activities that involve exposures to low-level, non-hazardous nuisance dust or other similar particulate. According to the COA
N95 Respiratory Mask Request Form
Information Regarding N95 Masks; Employee Information; Questionnaire; Results; How to receive your N95 mask
Some employees, students, or affiliates may chose to use filtering facepiece respirators, also referred to as N95 or N99 disposable dust masks, on a voluntary basis during activities that involve exposures to low-level, non-hazardous nuisance dust or other similar particulate.
Voluntary Respirator Use Agreement – Stanford Environmental …
2023年4月14日 · Employees that would like to wear a N95 respirator for comfort purposes but who are not required should complete this Voluntary Respirator Use Agreement form. Submit a copy of the completed form to your supervisor for his/her records (retain records for as long as you use the respirator).
For use by UAB Employee Health N95 Respiratory Protection Program This Follow-Up N95 Respirator Use Form has been reviewed according to protocol and is deemed acceptable by the UAB Hospital Physician.
N95 Respirator User Initial Questionnaire.doc (Revised 10.22.2014) (USE THIS FORM FOR N95 USE IN COMPLIANCE WITH Cal/OSHA SECTION 5199 AEROSOL TRANSMISSABLE DISEASE STANDARD ONLY) INSTRUCTIONS: Your supervisor must allow you to answer this questionnaire at a time and place that is convenient to you.
N95 Voluntary Respirator Use Form | PennEHRS - University of …
N95 Voluntary Respirator Use Form N95 Voluntary Respirator Use Form. Last Revised: May 04, 2023. Information for Employees who voluntarily Use Respirators. Attachment. N95 Respirator Voluntary Use Form. 3160 Chestnut Street Suite 400 …
the employee, have employee initial each box, sign the form (both employee and reviewer) and maintain a readily retrievable copy of the signed form. 1. FILTERING FACEPIECE RESPIRATORS AND OSHA REQUIREMENTS [ ] OSHA considers NIOSH-certified filtering facepiece respirators, such as N-95 (also called dust masks) as true respirators.
N95 (Respiratory Isolation Mask) Appendix C to Sec. 1910.134: OSHA Respirator Medical Evaluation Questionnaire (Mandatory) To the employee: Can you read? Yes No Your employer must allow you to answer this questionnaire during normal working hours, or at a time and place that is convenient to you.