Special Resources » Forms: Environmental Health & Safety
Download forms for workplace safety and health. Examples: job hazard analysis forms, confined entry permit form, TRI forms, building evacuation plan form, JCAHO medical errors reporting form, ergonomics cost / benefit form, etc.
The following is the collection of special resources throughout the library. Click on main category / sub-category for that section of the library OR Click on resource title for immediate access to the resource.
Construction » Contractor Safety Manual
Sample construction safety programs, rules, policies, checklists, SOPs
Sample construction safety programs, rules, policies, checklists, SOPs
Construction Jobsite Loss Control Survey [26060] 
Checklist of safety items that should be observed at construction job sites
Checklist of safety items that should be observed at construction job sites
Construction » Risk Management
Risk management and insurance related issues in the construction industry
Risk management and insurance related issues in the construction industry
Fire Safety Construction Requirements [19406] Full text of a safety policy & procedure that can be used when renovating existing structures
Emergency Response Agreements Checklist ![[pdf]](graphics/file_pdf.gif)
[18909]
Checklist currently in use by the US National Weather Service
[18909] Checklist currently in use by the US National Weather Service
Essential Corporate Documents and Records Kit Checklist [26903]
To recover after an emergency or disaster, you will need to access your organization's essential records
To recover after an emergency or disaster, you will need to access your organization's essential records
School Emergency Preparedness Plan & Forms [8864]
This two volume model program can be adapted to the needs of your site
This two volume model program can be adapted to the needs of your site
Driver's Medical Examination: Fitness to Drive Form [12123]
US DOT medical examination report for commercial fitness determination
[12123] US DOT medical examination report for commercial fitness determination
FMCSA Drive Medical Examination Form [20710]
Download the medical exam form used to determine qualification of CMV drivers
Download the medical exam form used to determine qualification of CMV drivers
Drivers and Vehicles » Fleet Policies
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.
Sample fleet-related company policies - vehicle use, drivers, seat belts, etc.
MVR Statement [16147]
Sample form that can be signed by a driver acknowledging MVR point system policies
[16147] Sample form that can be signed by a driver acknowledging MVR point system policies
VA-Virginia Office of Fleet Management Services [19671]
Fleet rules and regulations for state agencies in Virginia
Fleet rules and regulations for state agencies in Virginia
Drivers and Vehicles » Motor Vehicle Records
Guidance on driver selection criteria, what to look for in an MVR
Guidance on driver selection criteria, what to look for in an MVR
AR-Arkansas State Vehicle Safety Program ![[doc]](graphics/file_doc.gif)
[17550]
Point system used for the state's fleet drivers - including sample forms
[17550] Point system used for the state's fleet drivers - including sample forms
NC-North Carolina Forms for Driver License [15893]
The Driver Privacy Protection Act - Form 1 required
The Driver Privacy Protection Act - Form 1 required
Motor Carrier and Highway Safety Forms and Publications [5733]
Various forms & other guidance documents to help motor carriers achieve compliance
Various forms & other guidance documents to help motor carriers achieve compliance
Drivers and Vehicles » Vehicle Inspections
Procedures for inspecting trucks, buses, cargo tanks, etc. Pre-trip inspections.
Procedures for inspecting trucks, buses, cargo tanks, etc. Pre-trip inspections.
Motor Vehicle Safety, Vehicle Inspection & Snomobile Pre-Trip Checklists [18883]
Sample checklists and safety rules for motor vehicle safety, snomobiles and snowcats
[18883] Sample checklists and safety rules for motor vehicle safety, snomobiles and snowcats
Hearing Conservation Checklist [18896]
Sample Format for Audiometric Test Records & Hearing Conservation Program Checklist
[18896] Sample Format for Audiometric Test Records & Hearing Conservation Program Checklist
Cranes, Hoists And Slings Checklist [18907]
Sample checklist and safety rules for the use of cranes, hoist and lsings
[18907] Sample checklist and safety rules for the use of cranes, hoist and lsings
Equipment Safety » Farm Machinery Safety
Farm equipment safety, tractor safety, ROPS, baler safety, etc.
Farm equipment safety, tractor safety, ROPS, baler safety, etc.
Forklift Safety Program [23322]
Text of a safety program for forklifts includes forklift safety forms
Text of a safety program for forklifts includes forklift safety forms
Equipment Safety » Lockout/Tagout
Equipment electrical safety, lockout/tagout programs, preventing electrical shoc
Equipment electrical safety, lockout/tagout programs, preventing electrical shoc
Control of Hazardous Energy Sources Checklist [18889]
Sample lockout/tagout checklist and safety rules
[18889] Sample lockout/tagout checklist and safety rules
Hand and Power Tool Safety Checklist [18904]
Sample checklist and safety rules for the use of hand and power tools
[18904] Sample checklist and safety rules for the use of hand and power tools
Hot Work Permit Program [3334]
Example of a hot work permit program for welding, flame cutting and soldering
[3334] Example of a hot work permit program for welding, flame cutting and soldering
Hot Work Permit Template and Checklist [18879]
Sample hot work permit template, safety checklist and procedures
[18879] Sample hot work permit template, safety checklist and procedures
Geology - Soil Mechanics » Excavation Safety
Resources on excavation and trenching safety requirements
Resources on excavation and trenching safety requirements
Trenching And Excavation Operations Checklist [18886]
Sample trenching safety checklist and standard operating procedures
[18886] Sample trenching safety checklist and standard operating procedures
Maintenance » Maintenance Equipment
Guidance & checklists for vehicle preventive maintenance procedures
Guidance & checklists for vehicle preventive maintenance procedures
Light Vehicle Preventive Maintenance Checklists [21059]
Series of service checklists based on mileage
Series of service checklists based on mileage
Accident/Illness Reporting and Recording Procedures & Forms [18903]
Sample procedures and forms in use by a US government agency
[18903] Sample procedures and forms in use by a US government agency
Truck Driver Accident Interview Form [27829]
Includes sections on crash data information, rollover data, fire data, jackknife data, cargo shift data and more
[27829] Includes sections on crash data information, rollover data, fire data, jackknife data, cargo shift data and more
Witness Statement of Accident/Incident [33498]
Example of a sample form for those who witness an accident in the workplace
[33498] Example of a sample form for those who witness an accident in the workplace
Compressed Gas Safety Checklist [18894]
Checklists for compressed gas safety, hydrogen safety, cylinder inspections
[18894] Checklists for compressed gas safety, hydrogen safety, cylinder inspections
Confined-Space Pre-entry Checklist [27067]
Checklist must be filled out whenever workers enter a permit required space
[27067] Checklist must be filled out whenever workers enter a permit required space
DOT Hazardous Materials Documents [3570]
Download format forms & documents from the Office of Hazardous Materials - pdf format
Download format forms & documents from the Office of Hazardous Materials - pdf format
Battery Charging and Storage Operations Checklist [18900]
These systems may include lead acid batteries, lithium chloride batteries, and other similar devices
[18900] These systems may include lead acid batteries, lithium chloride batteries, and other similar devices
Flammable & Combustible Liquid Storage Checklist [18901]
Sample checklist and safety rules for safe storage of flammable and combustible liquids
[18901] Sample checklist and safety rules for safe storage of flammable and combustible liquids
Complying with OSHA's Hazard Communication Standard [23113]
Includes a sample written hazcom program and forms
Includes a sample written hazcom program and forms
National Institutes of Health Hazard Communication Program [5121]
Full text of the NIH's Hazcomm Program including checklist & form
[5121] Full text of the NIH's Hazcomm Program including checklist & form
Canada: Workplace Inspections [17611]
Sample Inspection Check Sheet and guidance for conducting a safety inspection
Sample Inspection Check Sheet and guidance for conducting a safety inspection
Chemical Safety Checklist - Laboratories [27877]
Use this form to document periodic lab inspections as designated in your CHP
Use this form to document periodic lab inspections as designated in your CHP
Construction Jobsite Safety Inspection Checklist [25913]
To be used to inspect job sites for safety compliance
[25913] To be used to inspect job sites for safety compliance
Electrical Residential Safety Checklist [26886]
Checklist to make certain your residence is electrically safe
Checklist to make certain your residence is electrically safe
Electrical Workplace Safety Checklist [26887]
Checklist to make certain your workplace is electrically safe
Checklist to make certain your workplace is electrically safe
Heat Stress: General Workplace Review [18828]
Sample questions of what to ask when investigating heat stress in the workplace
Sample questions of what to ask when investigating heat stress in the workplace
Laboratory Employee Training Checklist [14056]
Employee training checklist form to document safety training (pdf)
[14056] Employee training checklist form to document safety training (pdf)
Laundry Health & Safety Inspection Checklists [29020]
Checklists of potential safety hazards in an industrial laundry
Checklists of potential safety hazards in an industrial laundry
Process Hazard Analysis Evaluation of External Forces [16843]
Includes human factors, facility siting issues, and external events (earthquake, floods, etc.)
Includes human factors, facility siting issues, and external events (earthquake, floods, etc.)
Safety Guidelines for the Home Work Space [9145]
Sample safety checklist for home-based telecommuters
Sample safety checklist for home-based telecommuters
Safety Inspection Checklists [27278]
Office Safety Checklist, Laboratory Safety Checklist, Shop Safety Checklist
Office Safety Checklist, Laboratory Safety Checklist, Shop Safety Checklist
![[xls]](graphics/file_xls.gif){kind=small}
OSHA-7 Form Notice of Alleged Safety and Health Hazards [28177] Download the form and the instructions
Personal Protective Equipment Safety Checklist [18912]
Sample program checklist form for evaluating the need for PPE
Sample program checklist form for evaluating the need for PPE
PPE Hazard Assessment Form [21599]
Selection of the proper personal protective equipment for a job is important
Selection of the proper personal protective equipment for a job is important
PPE Hazard Review Forms [23124]
Use the following charts and tables to complete a hazard assessment of your worksite
Use the following charts and tables to complete a hazard assessment of your worksite
Respiratory Protection Checklist & Program [18895]
Sample respiratory protection program and checklist, respirator medical evaluation questionnaire
[18895] Sample respiratory protection program and checklist, respirator medical evaluation questionnaire
Sample Safety Committee Meeting Report & Guidelines [18775]
Provides guidance for safety committees and a sample form (pdf)
[18775] Provides guidance for safety committees and a sample form (pdf)
Machine Shop Authorization Form [26471]
Sample form to authorize use of machine shop equipment (pdf)
[26471] Sample form to authorize use of machine shop equipment (pdf)
Machine Shop Safe Work Practices Evaluation Forms [26730]
Example of safety training evaluation forms for saws, sanders, presses, grinders, etc
Example of safety training evaluation forms for saws, sanders, presses, grinders, etc
Shop Safety Inspection Checklist [18780]
Advice on how to conduct a shop safety inspection plus checklist
[18780] Advice on how to conduct a shop safety inspection plus checklist
Wood Shop Authorization Form [26469]
Example of a form authorizing a worker to use woodworking equipment (pdf)
[26469] Example of a form authorizing a worker to use woodworking equipment (pdf)
Walking - Working Surfaces Checklist [18899]
Walking - Working Surfaces Checklist also includes ladders and scaffolds
[18899] Walking - Working Surfaces Checklist also includes ladders and scaffolds