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PROGRAM CONTACT PERSON LIST

Asbestos Management........................................................Dale Wieme

AED........................................................................................N/A

AWAIR......................................................................Caren Hoversten

Bleacher Safety............................................................... Dale Wieme

Bloodborne Pathogens..................................................Caren Hoversten

Community Right-to-Know...................................................Dale Wieme

Compressed Gas Safety.......................................................Dale Wieme

Confined Space Entry.........................................................Dale Wieme

Emergency ActionPlanning..................................................Dale Wieme

Employee Right-to-Know/Hazard Communication.......................Dale Wieme

Facilities Safety Management...............................................Dale Wieme

First Aid/CPR ............................................................Caren Hoversten

Hazardous Waste Management..............................................Dale Wieme

Hearing Conservation.........................................................Dale Wieme

Indoor Air Quality..............................................................Dale Wieme

Integrated Pest Management................................................Dale Wieme

Laboratory Standard/Chemical Hygiene Plan.......................................N/A

Lead Management.............................................................Dale Wieme

Lockout/Tagout ...............................................................Dale Wieme

Machine Guarding .......................................................Mark Greenwood

Personal Protective Equipment.............................................Dale Wieme

Playground Safety.............................................................Dale Wieme

Radon Gas Safety..............................................................Dale Wieme

Respiratory Protection.......................................................Dale Wieme

USTs/ASTs...............................................................................N/A

Welding Cutting Brazing...............................................................N/A

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Checklist of E/OHS Activities for Asbestos Management

Program Contact Person: Dale Wieme

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 _Principals Office.

Training for Asbestos Awareness was conducted: 5/11/2009

New PT employees received training on: no new part time staff hired.(date)

Annual written notification has been prepared: Summer 09

(date)

Notification appeared in the following publication(s):

Name of publication Date Fall, 2009

Three-year re-inspection Surveillance was conducted: 6/10/2010 .

6-month Periodic Surveillance was conducted:12/14/2009(first date)

06/10/2010(second date)

All caution labels have been posted.Label locations:

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

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Asbestos Maintenance Supplies on Hand

Tyvek

suits

AO

respirator

Particulate

filters

8mill

bags

Is documentation of Operations and Maintenance available?

Location: Principals Office

Status of the Asbestos repair and maintenance Work Order System: N/AEstablished, Pending

Comments:

Click here to view 6month periodics

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Checklist of E/OHS Activities for AWAIR

Program Contact Person:Caren Hoversten

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?

Are minutes of the meeting maintained? This remains a goal for 2010-2011.

Location:

Posted:

How is the program communicated to employees? Before School Workshops

Who is the Contact Person for OSHA 300? Caren Holverten

Is the OSHA 300A Log completed for the previous calendar year? Yes

Have the Logs been maintained for five (5) years? Yes

Location: District / School Office

Is the Log posted from February 1 until April 30? Yes

The location/s of the posted log: Office

Is information on injuries recorded on the Log with five (5) working days? YesNo N/A

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Safety Committee Meeting Schedule

Date Location Time

District Safety Committee Members

Member Position BuildingBruce Houck

Caren Holversten

Dale Wieme

Jan Lensing

Peggy Meyer

Bruce Buckert

Mike Pochardt

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

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Checklist of E/OHS Activities for Bleacher safety

Program Contact Person: Dale Wieme

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 andsubmitted 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 footboardsand 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 anamortization schedule to plan for their future replacement

Approved netting:

Netting may be provided to prevent persons from falling through the bleachersbetween the seat and footboards

Chain link fencing may be used but must be secured tightly to the underside of thebleachers.

Railings:

Bleachers 55 inches and under are exempt from railing requirements

Bleachers with guardrails over 30 inches above grade must not contain openingsgreater than four inches, unless safety nets are installed.State building inspectors shall determine whether the safety nets and guardrail climbability meet the requirements of the alternate design section of the State BuildingCode.

Periodic inspections:

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Bleacher footboards and guardrails must at a minimum be reinspected at least everyfive years and a structural inspection at least every ten years. The equipment has norust, 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:

..\Bleachersafety

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Checklist of E/OHS Activities for Bloodborne Pathogens

Program Contact Person: Caren Hoversten

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:

Coaches, Industrial Arts Instructor, Secretary, P.E. Teacher, Custodian,Maintenance Staff

What is this schools policy regarding Hepatitis B vaccinations for employeesconsidered at risk versus employees considered not at risk in the ExposureControl Plan?

All staff are offered HBV vaccine at no cost.

Is training provided at this school on methods and techniques to reduceexposure incidents? Training is provided annually during staff developmentsessions.

New Employees: Yes

Have the employees identified as first aid responders been given at a minimumRed Cross First Aid Training? Yes No N/A

Are Exposure Control Kits available to staff? Yes No N/A

Location(s): All rooms have gloves

Status of Declination forms: The forms remain on file in each employeepersonnel file Contact Caren Holversten in 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, Custodian Office / Area

Approved disposal location for biohazardous waste: Yes, Note: Bloodborne pathogen training was conducted for all staff on 8-17-10. BP

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Checklist of E/OHS Activities for Compressed Gas Safety

Program Contact Person(s) Dale Wieme

Primary Contact Dale Wieme

Department Contacts: Dale Wieme

Art N/A

Custodial N/A

Metals Shop/Ag. FFA Mark Greenwood

Science N/A

Transportation N/A

Is the Compressed Gas Plan in place? Yes No

Is the Plan current? Yes No

Has the Plan been reviewed this school year? Yes No

Has the facility been surveyed for compressed gas inventories? Yes No N/A

Has training been conducted for affected personnel? Yes No N/A

Are records established / maintained for gas inventory? Yes No N/A

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Checklist of E/OHS Activities for Confined Space Entry

Program Contact Person: Dale Wieme

Is the Confined Space Entry Plan in place? YesNo N/A

Is the Plan current? Yes No N/A

Has the Plan been reviewed this school year? YesNo N/A

Have confined space areas been identified? YesNo N/A

Have measurements to include CCI/ft been completed? Yes No N/A

Are permit entry forms in place? YesNo N/A

Location: Activities Manual

Are confined space labels in the proper locations? YesNo N/A

Is a list of employees eligible to enter confined spaces complete? YesNo N/A

Has training for affected employees completed? Yes No

Date of completion: 5/11/2009

Confined Space Folder

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Confined Space Inventory

Building: Lynd Public School

Building Contact: DaleWieme Program Contact: Dale Wieme

Completed By: Brian Parrie Date: 10/19/2010

RoomIdentificationName GivenSpace

OpeningDimension

DimensionOf ConfinedSpace

PotentialHazards

Permit/Non-Permit

Labeled PhotoID #

Basement(Storage) 5x4 5x4x300 Electric Heat

Non-Permit

YesTunnel

Use LOTO procedures to eliminate hazards of electricity and heat.

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Checklist of E/OHS Activities for Community Right-to-Know

Program Contact Person: Dale Wieme

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 documentedand verified? Yes No N/A

Note:.

Where are the documents stored?

Have the State Emergency Response Commission and local fire departmentbeen 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

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Inventory Form

Client: Lynd Public School

Contact Person: Dale Wieme Date: 10/19/2010

HazardousMaterial Quantity Location

Reported onTier Two

InstallationDate(s)

N/A N/AN/A N/A

Note: The minimum quantity of reportable chemicals is 10,000 lbs. The abovefuel remains less than required for reporting. BP 10/19/2010

No changes in school year 2010-2011. BP

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Checklist of E/OHS Activities for Emergency Action Planning

Program Contact Person: _Dale Wieme

Is the Emergency Action Planning program in place and as outlined in theMinnesota 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 currentschool year? Yes No

Are information maps posted to indicate travel routes in the event of fire,tornado shelter locations, and procedures during lockdown? YesNo

Located where? Maps are located in each classroom.

Are all drills timed and recorded? Yes No

Responsible person: Lynn Kuehn

Location of records: At Lynns 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 assuresheltering in school, evacuating to their homes or use of congregate carecenters? Yes No N/A

Has this school completed the Fire Marshall required Fire Safety and EmergencyEvacuation Plan? Yes No N/A

Training provided for affected staff? Yes No N/A

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Checklist of E/OHS Activities for Employee Right-to-Know/HazardCommunication

Program Contact Person: Dale Wieme

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 schoolyear?Yes No

Has the chemical inventory been completed for the following functional areas?

Location of Chemical InventoryForm

Art Instruction Yes No N/A

Custodians Yes No N/A Custodial Area (Bsement)

Food Service Yes No N/A Kitchen Office

Science Rooms Yes No N/A A survey revealed no chemicals

Shop (metals, wood, auto) Yes No N/A Office (Ind. Tech.)

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 Yes No N/A Science Yes NoN/A

Custodians Yes No N/A Shop Yes NoN/A

Food Service Yes No N/A Transportation Yes No N/A

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Date of training: Aug, 17,2010

Physical Hazard Assessment

Hazard(Noise, Heat, Radiation)

Building Location Labeled

Heat, NoiseLynd P.S Wood Shop

Heat, Noise Lynd P.S.Boiler room

Heat Lynd P.S.Kitchen

Heat Bus GarageBus Garage

Affected Employees

Name Department

Mark Greenwood Ind. Tech./ ArtDale Wieme Custodian/ MaintenancePeggy Meyer Food ServiceDale Wieme Transportation

Completed by: Brian Parrie Date: 10/17/2010

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Contact List for Employee Right-to-Know Program

DepartmentKey Contact for Department

(Person responsible for locating MSDS)

Art Mark Greenwood

BiologyN/A

Consumer Life ScienceN/A

Custodial/MaintenanceDale Wieme

Food Service Peggy Meyer

PhotoN/A

Chemistry/ScienceN/A

Shop/ WeldingN/A

Shop/ WoodMark Greenwood

Transportation

Dale Wieme

Completed by: Brian Parrie Date: 10/19/2010

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Checklist of E/OHS Activities for Facilities Safety Managementand Fire Safety in Schools

Program Contact Person: Dale Wieme

Is the Facilities Safety Management program in place? Yes No

Does this school use contracted services for the Management AssistantProgram? Yes No N/A

If no, who is the designated person or persons? N/A

Fire and Life Safety in Schools

Program Contact Person: Dale Wieme

Is the Fire Marshal approved Emergency Evacuation Plan in place for eachdistrict building? Yes No

Most recent date of sprinkler electronics inspection:_________ N/A

Most recent date of alarm inspection: September, 2010________ N/A

Most recent inspection of fire extinguishers: June, 2010 N/A

Most recent inspection of fume hoods with fire suppressant: Aug. 2009_______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.

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Facilities Safety Review

Building: Lynd Public School

Mock-OSHA ReviewArea

Date ReviewCompleted N/A Recommendations

Art 10/19/2010

Dark Room 10/19/2010 N/A

Wood Shop 10/19/2010

Kitchen 10/19/2010

Metal Shop 10/19/2010 N/A

Halls, Gym, etc. 10/19/2010

Graphic Arts 10/19/2010 N/A

Maintenance/Custodial 10/19/2010

Transportation 10/19/2010

Grounds/Garage 10/19/2010

Chemistry/Life

Science

10/19/2010 N/A

Click here to view Facility Safety Report 2010

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Checklist of E/OHS Activities for First Aid/CPR

Program Contact Person(s): Caren Hoversten

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 currentschool year? Yes No

Has the District determined a provider in the event of a medical emergency?Yes No

The local provider determined travel time was estimated to be in excess of the4-8 minute limit. Therefore Lynd Fire Departmentwill be the designatedemergency response persons located within the district.

Has training been provided for affected staff? Yes No

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Suggested Items to Be Included In Each Kit Suggested Numberof Kits

ITEM 1-50 51-100 101-200

Gloves, 4-pack 1

Gauze roller bandage 1 and 2 x 10-yds. 2 Gauze compress bandage 3 x 3 individually packaged 10 2Adhesive bandages, assorted sizes, individually packaged 16 3Adhesive tape rolls 2 Scissors, blunt-nosed 1 Tweezers 1 Packaged antiseptic, aqueous mercury preferred(Mercurochrome)

1 1

Mild soap, capped squeeze bottle 1 Elastic bandage, 4 1 Resuscitation mouthpiece 1 Eyewash container and neutral sterile solution 1

Empty plastic bag for application of ice (include chemicalice if ice is not available)

1 1

ABCs of First Aid 1 Bold instructions on how to call 911 1 Telephone numbers of the Poison Information Center and theconsulting health care provider.

1 1

Status of First Aid Kits: note a first-aid kit is located in each class room.

Location Contents Condition of Contents

Custodial Closet Good

Class rooms Good

Nurses Office Good

Main Office Good

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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 currentschool 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 orless do not need a license.

Did this school generate 220 pounds or less per month hazardous waste (about 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 VSQGs do not have training requirements however MPCA stronglyrecommends persons handling wastes be given training on best handling andsafety 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

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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 schoolyear?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 schoolyear? Yes No N/A

Date:

Presenter: Lee Carlson

Have regulatory changes occurred that may affect this program? No

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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

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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 beenestablished? No.

Has the annual cursory walk-through been conducted? Yes No

Havethedistrictskeybuilding systems been evaluated? Yes No

When was the evaluation completed? Pending

Who conducted the evaluation? Advanced Safety and Security

Wereoccupied areas of the district evaluated using the EPAs Tools For Schoolscheck 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?

Training conducted(date)

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

Has the District determined the mechanical ventilation rate of each occupiedspace? 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

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E.C.H.O. Charter Schools

Building:

Building Contact: Program Contact:

Room IdentificationContact individual

WaterIntrusion

Ventilationproble

ms

Building failuresi.e. foundation or

roof problems

Cleanliness/Properstorage

O&MCarpets

Recommendations:

Walk-through conducted by ______________________Date ___________________

Checklist of E/OHS Activities for Integrated Pest Management

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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 ofinfestation? 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/ChemicalHygiene Plan

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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)

The results indicate air velocity to be: satisfactory, unsatisfactory.

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 thescience rooms. LC 2/8/08

Checklist of E/OHS Activities for Lead-in-Water Management

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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 testingthat may have occurred during 1990 was located. The results apparently weresatisfactory at that time.LCNote: Documents located indicate that the Elementary Building water fountainswere tested for lead 12-29-89 by Jim Dolan, ECSU. The results were found tobe less than 2ppb. The original documents are now filed in the ActivitiesManual. 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 playgroundequipment has been replaced with lead free.

Note: paint throughout building is in very good condition. Little peeling orflaking of paint can be documented.

Results of evaluation for paint condition in rooms K-1:

Building constructed post-1978; facility not applicableBuilding constructed prior to 1978; paint determined to be in _Somedamage_____________ condition

Checklist of E/OHS Activities for Lockout/Tagout

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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 NoN/A

Have affected personnel been trained as to methods and technique of use? YesNo 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:

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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 forprocurement? Yes No

Note: The wood shop tools were reviewed for guarding 4-19-2010. Theequipment seems to meets OSHA standards.

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Identified Fixed Equipment Locations

Location Building/Buildings Staff AffectedBus Garage

Wood ShopCustodial/Maintenance

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 ____________.(date)

Training has been scheduled for ____________.

(date)

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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 itand 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 havereduced 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 S-hooks 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 anchoringdevices and rocks, roots, or any other environmental obstacles in theplay area

Deterioration of the Equipment:

The equipment has no rust, rot, cracks, or splinters, especially whereit comes in contact with the ground

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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 S-hooks

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 useareas such as under swings and at slide exits

Leaded Paint:

The leaded paint used on the playground equipment has notdeteriorated as noted by peeling, cracking, chipping, or chalking

There are no areas of visible leaded paint chips or accumulation oflead dust

General Upkeep of Playgrounds:

The entire playground is free from miscellaneous debris or litter suchas tree branches, soda cans, bottles, glass, etc.

There are no missing or full trash receptacles

Click here to view playground file.

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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 Yes No N/A

Custodial Yes No N/A

Grounds keeping/Garage Yes No N/A

Kitchen Yes No N/A

Maintenance Yes No N/A

Science Laboratories Yes No N/A

Technical Education Yes No N/A

Transportation Yes No N/A

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Personal Protective Equipment Assessment

Location:

Custodial/Maintenance

Location:

Shops,metal/wood

Location:

Kitchen

Location:

Employee: B Cruser Employee:BruceAnderson

Employee:Joyce Lecy

Employee:

Hand

Cutting XLatex

Vinyl X XLeather X XNeoprene X

Face

Impact XSplash X XShield X

EarMuffs XPlugs

BodyNeo Apron XDenim X

FootSteel Toes

Metatarsal

Head Hard Hat

Hazard(s)

Sound, heat,impact, chemical,

body fluids

Sound, Heat,chemical,

impact,vapor

Heat,chemical

Comments onAvailability,Condition, &Storage

Good Good Good

Completed by Lee Carlson Date 4/19/10

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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 0.3

Veras Room H 0.2

Monitor returneddamaged little gym

No results

Cafeteria 0.6

Library Room L 0.2

Marshas Room E 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 4.1 Exceeds recommended

4.0 levelHead Start 1.3

Gymnasium 1.1

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

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Date training complete: N/A

Testing is / is not now in progress:

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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/AIf the school allows employees to use respirators voluntarily the following ismandatory.

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

elses 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 Intended

Use

Type of

Respirator

Medical Exam/

Questionnaire

Date of

Medical

Date of

Fit TestBernie Cruser Light dutydust, est.

AO STAR, mask

N/A N/A N/A

Larry Schuler Voluntaryuse

AO STAR, mask

N/A N/A N/A

Fit testing was completed on N/A.(date)

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

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Condition and location of respirators:

Condition: The respirator was disassembled and cleaned. Valve flapswere 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

CartridgesRespirator

TypeRespirator

Brand LocationValveFlaps? Straps? Organic Particulate Combination

mask AOAmericanOptical

Metalcabinetcustodialroom

Good Good (1) box (1) box None

mask 3m Next tometalcabinet

Good Good Installed

Note: I could not locate replacement filters for the AO mask respirator. Twoboxes of filters are available for a 3M respirator are available but no respiratorto fit. 12-10-09 LC

Respirators were checked today and found in good condition. LC 4-19-2010

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Checklist of E/OHS Activities for Underground and Aboveground

Storage Tanks

NO UNDERGROUND OR ABOVE GROUND FUEL STORAGE TANKS AT THISLOCATION.

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 NoN/A

Are removals or additions of tanks anticipated in this facility? Yes No N/A

Notes:

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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) N/A

Custodial 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, allof the above:

Note: The welding shop does not have adequate ventilation. It is recommendedthat ventilation be provided.

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