PROGRAM CONTACT PERSON LIST

Asbestos Management..............................................................Jo Pyle AED..............................................................................Mary Carter AWAIR.................................................................................Jo Pyle Bleacher Safety..................................................................... Jo Pyle Bloodborne Pathogens........................................................Mary Carter Community Right-to-Know........................................................Jo Pyle Compressed Gas Safety............................................................Jo Pyle Confined Space Entry..............................................................Jo Pyle Emergency Action Planning.................................Superintendent/Principals Employee Right-to-Know/Hazard Communication............................Jo Pyle Facilities Safety Management.....................................................Jo Pyle First Aid/CPR ..................................................................Mary Carter Hazardous Waste Management...................................................Jo Pyle Hearing Conservation..............................................................Jo Pyle Indoor Air Quality...................................................................Jo Pyle Integrated Pest Management.....................................................Jo Pyle Laboratory Standard/Chemical Hygiene Plan...................................Monica Headlee Lead Management..................................................................Jo Pyle Lockout/Tagout ....................................................................Jo Pyle Machine Guarding ..................................................................Jo Pyle Personal Protective Equipment..................................................Jo Pyle Playground Safety..................................................................Jo Pyle Radon Gas Safety...................................................................Jo Pyle Respiratory Protection.............................................................Jo Pyle USTs/ASTs............................................................................Jo Pyle Welding Cutting Brazing....................................................John Lanoue

Checklist of E/OHS Activities for Automatic External Defibrillator

Program Contact Person: Mary Carter School policy for use adopted in place? Yes No N/A Brand of AED? Zoll Model # Name of Medical Director? No one at this time. Mary will check on. Year device was placed into use? 2006 Location(s) of devices: Building Name Tracy High School Tracy Elementary Location in Building (1) Across from Main Office (1) hallway by west side gymnasium Locker Banks by second Grade entry

Have all software updates been installed? Yes No N/A Date of update installation: May 2006 Expiration date of pads? 9-2009 Expiration date of batteries? 2015, or when battery indicator has reached onehalf life left (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: Oct, 2008
(date

Provider of training: Mary Carter

Location of operators manual: School nurse office at high school , and at the Elementary School nurses office or available online. Are battery checks documented? Yes, a check list is available at each AED station

Notes: The AEDs were purchased by the local medical clinic. The effort was coordinated between the PTO and the clinic. Note: Brian Michelson is the instructor and teaches AED and CPR to students in Health class.

Checklist of E/OHS Activities for Asbestos Management

Program Contact Person: Jo Pyle 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: the original plans along with updates are located at each building_. Training for Asbestos Awareness was conducted New PT employees received training on N/A
(date)

3/3/06 .

Annual written notification has been prepared; Fall of 2008 Notification appeared in the following publication(s): Name of publication Spotlight
(date)

Date August 2008

Three-year re-inspection Surveillance was conducted: 7/12/07. 6-month Periodic Surveillance was conducted: 11/08
(first date)

05/09
(second date)

All caution labels have been posted. Label locations: Boiler room tunnels

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 Bags Glove bags 6 mil sheeting Respirators Respirator filters

Is documentation of Operations and Maintenance available? Location: Yes

Status of the Asbestos repair and maintenance Work Order System: N/A Established, Pending Comments: All repairs are outsourced. Repair materials are not routinely used. **For information regarding the medical review and questionnaire, see the Respiratory Protection Program. ** Note: The tunnels were crawled today (4/14/09). The tunnels are limited in scope and are in very good condition. One elbow is damaged and should be repaired. Almost all of the hot water lines are located above the ceiling tile.

Checklist of E/OHS Activities for AWAIR

Program Contact Person: Jo Pyle 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? Attempt quarterly Are minutes of the meeting maintained? Location: teachers work rooms Posted: District office How is the program communicated to employees? All staff development meetings Who is the Contact Person for OSHA 300? Jeanette H. Is the OSHA 300A Log completed for the previous calendar year? Yes Have the Logs been maintained for five (5) years? Yes Location: Jeanettes office and the Activities Manual Is the Log posted from February 1 until April 30? The location/s of the posted log: Staff lounges Is information on injuries recorded on the Log with five (5) working days? Yes No N/A Yes

Safety Committee Meeting Schedule

Date Location Time

District Safety Committee Members Member Position Building

Checklist of E/OHS Activities for Bleacher safety

Program Contact Person: Jo Pyle 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
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

Checklist of E/OHS Activities for Bloodborne Pathogens

Program Contact Person: Mary Carter, School Nurse 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: School nurse Playground supervisor Custodians Art Secretaries Industrial Arts Bus drivers Special ed Coaches What is this schools policy regarding Hepatitis B vaccinations for employees considered at risk versus employees considered not at risk in the Exposure Control Plan? All staff are given the opportunity to receive the 3 part HBV vaccine at no cost. Is training provided at this school on methods and techniques to reduce exposure incidents? Annual training is provided by the school nurse. New Employees: _within ten days of employment 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): all rooms are provided kits Status of Declination forms: the forms are maintained by the school nurse

How are blood or bodily-fluid-containing materials handled at this facility? Policy regarding cleanup: Custodial staff routinely clean up all fluid spills.

Location of biohazard bags at school: Nurses office Approved disposal location for biohazardous waste: Tracy Hospital

Checklist of E/OHS Activities for Compressed Gas Safety

Program Contact Person(s) Jo Pyle Department Contacts: Maintenance Jo Pyle Metals Shop John Lanoue Industrial Tech. John Lanoue

Bus Garage Bob Bruder

Is the Compressed Gas 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 the facility been surveyed for compressed gas inventories? Yes No N/A Has training been conducted for affected personnel? Yes No N/A Date: summer 2008 Are records established/maintained to monitor gas inventory? Yes No N/A

COMPRESSED GAS FIELD REVIEW

Compressed Gas Inventory
Date: Feb. 13, 2009 Department: Metals Shop Location: Metals Shop Room Cylinders: O2 ___(5)_________ Acetyl _(2)___________ NH4 ____________ Program Contact Person : Lee Carlson Department Responsible Person: John Lanoue

CO2 __(4)__________ Argon __(2)__________ Argon/CO2__(5)__________ Other( helium) __(1)__________

Compliance Check List

No
1. Are cylinders in well-ventilated area? 2. Are cylinders stored separate from flammable by at least 20 feet? 3. During storage are oxygen cylinders separated from fuel gas cylinders, unless on welding cart? 4. Are cylinders kept away from sources of heat (below 130 F)? 5. Are safety chains used at all times on both full and empty cylinders? (2/3rds from top of cylinder) 6. Are empty cylinders maintained separate from full cylinders? 7. Are cylinders kept away from sources of ignition such as electricity, excessive heat or oily rags? 8. Are carts designed specifically for gas cylinders available? 9. Are damaged cylinders, valves/hoses removed from service? 10. Are all cylinders properly labeled with the contents?

Yes
X X X X X X X X X X

Checklist of E/OHS Activities for Confined Space Entry

Program Contact Person: Jo Pyle 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: Activities Manual 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: 2/25/05 Note: Confined space entry activities at this school are limited to licensed contractors only. School staff does not enter confined space areas.

Confined Space Inventory

Building: Tracy High School Building Contact: Jo Pyle Date: 2-11-09
Room Identification Name Given Space Boiler room Boiler #1 Boiler Room Boiler #2 Boiler Room Tunnel (2)Chimney stacks Opening Dimension Dimension Of Confined Space 7X3X3.5 7X3X3.5 100X15X4 30 round X 24 high Potential Hazards Permit/ NonPermit/Alternat e Permit Permit Non-permit Permit Labeled Photo ID #

Program Contact: Lee Carlson

18 18 4X15 18X18

Ele.O2, Heat Ele.O2, Heat Heat, electricity Particulate matter, heat

Yes Yes Yes No

Building: Tracy Elementary School Building Contact: Jo Pyle Date: 2-11-09

Room Identification Name Given Space Boiler Boiler Boiler Boiler room #1 Room #2 Opening Dimension Dimension Of Confined Space 7X3X3.5 7X3X3.5 Potential Hazards Permit/ NonPermit/Alternat e Permit Permit Labeled Photo ID #

Program Contact: Lee Carlson

18 18

Ele.O2, Heat Ele.O2, Heat

Yes Yes

Note: View entry points with this link Confined Space Photos.

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

Program Contact Person: Jo Pyle 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 Where are the documents stored? Custodial office /Activities 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? Winter, 2006
(date)

Has training been provided? Yes No N/A Date: 2/25/05 Presenter: Steve Musser Note: Pat Sommervold typically submits the Tier Two form. The forms were prepared and sent 2/5/2009. A signed copy has been sent t the local fire department. Jo Pyle keeps records on heating oil usage. The oil is used only in case of emergencies. If the oil is not used after two years an attempt is made to burn. A fuel stabilizer is used to keep the fuel in good condition.

Inventory Form
Client: Tracy Public Schools
Contact Person: Jo Pyle Hazardous Material Quantity Date:2-11-09 Location Reported on Tier Two Installation Date(s)

#2 Fuel Oil #2 Fuel Oil

10,000 gal 10,000 gal

High School Elementary

Yes Yes

Mid 90s 02

Checklist of E/OHS Activities for Emergency Action Planning

Program Contact Person: Chad Anderson 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: Chad Anderson, High School, Elementary School

Location of records: At each building principals respective offices Forms provided: Yes No 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: Jo Pyle 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? Form Art Instruction Custodians Food Service Science Rooms Shop (metals, wood, auto) Yes No N/A Yes No N/A Board room/ Custodial office Yes No N/A Lead cooks desk Yes No N/A Lab prep room Yes No N/A Location of Chemical Inventory

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 Transportation

Yes No N/A Yes No N/A Yes No N/A

Checklist of E/OHS Activities for Facilities Safety Management and Fire Safety in Schools
Program Contact Person: Jo Pyle 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: Jo Pyle 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 July, 08 N/A Most recent inspection of fire extinguishers__8-30-08 N/A Most recent inspection of fume hoods with fire suppressant 08-08 N/A Are emergency lights tested at least biannually? Yes No N/A Science safety Checklist completed? Yes No N/A

Facilities Safety Review

Building:
Mock-OSHA Review Area Art Dark Room Wood Shop Kitchen Metal Shop Halls, Gym, etc. Graphic Arts
Maintenance/Custodial

Date Review Completed

N/A

Recommendations

Transportation Grounds/Garage Chemistry/Life Science

Fire and Life Safety Checklist

ART X Emergency phone numbers posted and MSDS available X Flammable liquids and combustibles stored properly COMPRESSED GAS X Cylinders chained in place so they cannot fall over X Valve covers in place when cylinder not in use

SPRAY BOOTH X Fire control sprinkler heads kept clean X Mechanical ventilation provided when spraying is done in enclosed area X NO SMOKING signs posted in spray areas, paint rooms, booths, and storage X Spray area at least 20 from flames, sparks, operating electrical motors BOILER ROOM X Fire extinguisher mounted and accessible X No combustibles stored in boiler room X Two exits CORRIDORS, ENTRANCES, STAIRS X All decorations, artwork in corridors limited to 25% of wall surface X All EXIT corridors and hallways free of obstructions X All EXIT doors open in the direction of exit without effort X All EXIT doors posted as exits with letters 5 high and wide X All EXIT signs visible and with working lights, if lighted X Appropriate fire extinguishers are mounted within 75 of outside areas containing flammable liquids and within 10 of any inside storage area for such materials X Buildings over two levels have doors that close automatically in stair tower X Fire extinguishers free from obstruction or blockage X Fire extinguishers provided for the types of materials in the area where used Class A Ordinary combustible material fires Class B Flammable liquid, gas, or grease fires Class C Energized-electrical equipment fires X Fire extinguishers serviced, maintained, and tagged every year X No dead-end corridor >20 X Non-exit doors, passages, and stairways labeled, NOT AN EXIT X Panic hardware on all exit doors and rooms with occupancy of 50 or more X Sprinkler heads protected by metal guards, when exposed to physical damage ELECTRICAL X Extension cords used for permanent wiring X 36 clear access to all electrical control panels for emergency shutdown EXTERIOR X Dumpsters stored at least 5 from any combustible buildings, doors, and windows

GYM X Stage curtain must be flame retardant HOME EC X Outlets within 6 of a water source must be GFC KITCHEN X Exhaust hood, ducts, and filters clear of any grease accumulation X X X X X Fire extinguisher within 30 of cooking equipment (min. 40BC) Hood with auto fire extinguishing system inspected every 6 months Means to shut off gas supply to the cooking equipment for emergency MSDS available Outlets within 6 of a water source must be GFC

SCIENCE LABS CHEMICALS X Chemicals stored in open lab work area kept to a minimum X Neutralizing chemicals and spill kits readily available FIRE SAFETY X Aisles serving work areas on 2 sides at least 42 wide; those serving work areas on one side only must be 36 X Flammable liquids stored in refrigerated equipment in closed containers X Flammable/combustible liquids and chemicals must not be stored in fume hoods or on the floor, except in original container X Refrigerators, freezers, or coolers that store or cool flammable liquids must be of explosion-proof construction and properly labeled X 2A-20BC or larger rated fire extinguisher for each 3,000 feet of lab; travel distance must not exceed 50 from anywhere in room STORAGE X Acids stored in approved cabinets X Chemical storage area must have inventory X Chemical storage area properly ventilated X Chemicals properly labeled X Chemicals stored in approved containers (original shipping package) X Flammable liquids stored in approved cabinets X Shelves used for chemical storage should have lip or guard to prevent chemicals from falling off X Storage cabinets and rooms locked against unauthorized entry

VENTILATION X Hood tested every year X Lab hoods achieve 100 lfm X Means provided for manually shutting down ventilation equipment

STORAGE ROOMS X Room used for storage of combustibles must have 1-hour fire-rated walls (sheet rock or plaster) and fire-rated doors (or solid core 1.75 thick wood doors) with self-closer (or automatic fire sprinklers in them) TECHNICAL LAB AREAS X Compressed gas cylinders (oxygen, acetylene, propane, etc.) secured so they cannot fall over X Emergency stop buttons colored red X Fire extinguishers located within 30 of hazardous processes (painting, welding, and woodworking)mounted and inspected X Flammable liquids stored in approved cabinets X Oil-soaked, greasy, or paint-soaked rags stored in metal containers with lids X Solvent wastes and flammable liquids are kept in fire-resistant, covered containers until they are removed from the worksite X Worksite clean and orderly with clear paths to exit

Completed by ___________________________Date

Checklist of E/OHS Activities for First Aid/CPR

Program Contact Person(s): Mary Carter 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 The local provider determined travel time was estimated to be within the 4-8 minute limit. Therefore Tracy Ambulance will be the designated emergency response provider. The local provider determined travel time was estimated to be in excess of the 4-8 minute limit. Therefore N/A will be the designated emergency response person located within the district. Has training been provided for affected staff? Yes No Note: Training is provided alternative years. One year is dedicated to first-aid and the next to CPR. Note: First-aid kits are located in Metals shop, wood shop, ag shop, boiler room and none at the elementary

Checklist of E/OHS Activities for Hazardous Waste Management

Program Contact Person(s) Primary Contact Person: Jo Pyle Secondary Contact Person: Richard Hanson 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 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 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: Jo Pyle 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: Have regulatory changes occurred that may affect this program? No Note: Several years of sound testing results indicate this program should be considered limited. Personal Protective equipment is (ear muffs, foam ear plugs, etc.) is recommended during certain operations such as lawn mowing.

Checklist of E/OHS Activities for Indoor Air Quality

Program Contact Person: Jo Pyle 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? Yes No Have the program and goals been approved by the School Board for the current school year? Yes 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? Aug, 1999 Who conducted the evaluation? MacNeil Environmental, Inc. Were occupied areas of the district evaluated using the EPAs Tools For Schools check list or equivalent? Yes Teachers check list? An information fact sheet was provided all staff. # of forms distributed 30 # of Forms returned: 30 Building maintenance checklist? Building ventilation checklist?
(date)

Training conducted Training has been scheduled for _______________.

(date)

Has the District determined the mechanical ventilation rate of each occupied space? Yes No. Supportive technical services were conducted on: May 15, 2000.
(date)

Results of technical services are located? Activities manual

IAQ Survey Review Form

Building: Tracy High School Building Contact: Jo Pyle Program Contact: Jo Pyle

Room Identification Contact individual Chemistry Lab Monica Headlee Food Service Wood Shop Mike Perterraeins Library Laurie Fox Ag Shop John Lanoue

Water Intrusion Not at time Not at time Not at time Not at time Not at time this this this this this

Ventilation proble ms Acceptable Acceptable Acceptable Acceptable Acceptable

Building failures i.e. foundation or roof problems Okay Okay Okay Okay Okay

Cleanliness/ Proper storage Okay Okay Okay Okay Okay

O&M Carpets Satisfactory Satisfactory Satisfactory Satisfactory Satisfactory

Notes: Jo conducts frequent surveys of HVAC systems. The filters are serviced as needed which is usually 4 times per year. All floor drains are functioning properly and should not present IAQ issues. No water intrusions were observed.

Walk-through conducted by: _Lee Carlson____ Date: _4/15/09

IAQ Survey Review Form

Building: Tracy Elementary School Building Contact: Program Contact: Jo Pyle

Room Identification Contact individual

Water Intrusion

Ventilation problems

Food Service

Not at this time Not at this time Not at this time Not at this time Not at this time Problems on exterior wall

Food Service/dish washing Halls Library Ag Shop Staff Lounge

Acceptable/food odors are limited to kitchen area Acceptable/ excessive moisture not present Acceptable Acceptable Acceptable Acceptable

Building failures i.e. foundation or roof problems Okay

Cleanliness/ Proper storage Okay

O&M Carpets

N/A

Okay

Okay

N/A

Okay Okay Okay Possible ground water intrusion

Okay Okay Okay Good

Satisfactory Satisfactory Satisfactory Satisfactory

Recommendations: The area around the building has been tiled out. This may reduce past moisture problems.

Walk-through conducted by: _Lee Carlson___ Date: _4/015/09

Checklist of E/OHS Activities for Integrated Pest Management

Program Contact Person: Jo Pyle 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: Spotlight, Aug, 2007.

Checklist of E/OHS Activities for Laboratory Standard/Chemical Hygiene Plan

Program Contact Person: Monica Headlee , 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 _5/08/08______________.
(date)

The results indicate air velocity to be: satisfactory, unsatisfactory. Chemical inventory: Date of most recent survey: fall, 2008 Location of inventory listing: Chemistry lab 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: the deluge shower is not available.11-06-08

Fume Hood Evaluation

Chemical Hygiene Officer: Monica Headlee Hood: Location: ROOM 152

FIELD TEST (lf/min)

>100 lf/min >100 lf/min X Pass achieved) Sash Height: 24 Used as Storage? Yes No Clean? Yes No

>100 lf/min >100 lf/min

>100 lf/min >100 lf/min

Fail (face velocity of 100 lf/min cannot be

Comments: This fume hood operated adequately when sash was in full open position.

Completed by: Lee Carlson

Date: 5/8/08

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

Program Contact Person: Jo Pyle 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 _7/13/2000.
(date)

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: Jo Pyle 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. Date completed: N/A Yet to be tested: N/A 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 ____good__________ condition

Checklist of E/OHS Activities for Lockout/Tagout

Program Contact Person: Jo Pyle 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: 1/10/02

Checklist of E/OHS Activities for Machine Guarding

Program Contact Person: Jo Pyle 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

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

Automotive Shop Wood Shop Custodial/Maintenanc e Welding Shop Ag Shop Bus Garage Art Scene shop Science Contracted technical services to review and recommend? __________________. Name of person or contractor conducting survey? ___________________.
(date)

Results of technical services located where? ________________________ 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: Jo Pyle 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 Note: The playground is located at the elementary building. The lead custodian at that facility monitors the condition of the playground. 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 Note: View playground equipment with this link Playground Photos.

Checklist of E/OHS Activities for Personal Protective Equipment

Program Contact Person: Jo Pyle 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:__________________________ 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

Building: High School_______
Location: Boiler room Employee: Jo Pyle Location: Kitchen Employee: Location: Maintenance Employee: Joe Pyle Location: Tech Shop Employee: Paul Skoglund, Mike Peterreins Location: Science Rooms Employee: Monica Headlee, Jacob Scandrett

Hand

Hot Glove Latex Vinyl Leather Neoprene Impact Splash Shield Respirator Muffs Plugs Neo Apron Denim Steel Toes Metatarsal Hard Hat

X X

X X

X X X

X X

Face

X X X

X X X X X X X X

Ear Body Foot Head

Hazard(s)

Chemicals, scalding water, heat, Knives, .

Chemicals, scalding water, heat, hot environment, body fluids

Chemicals, electricity, heat Body fluids, impact

body fluids, gas cylinders, heat, impact

body fluids, chemicals, open flame,

Comments on Availability, Condition, & Storage

Completed by __Lee Carlson______________ Date 3-25-2008

Checklist of E/OHS Activities for Respiratory Protection

Program Contact Person: Jo Pyle 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 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: __2-13-08_____________ Are all employees in this program identified? Yes No N/A
Employee Jo Pyle Intended Use Misc. voluntary Type of Respirator mask Medical Exam/ Questionnaire N/A Date of Medical N/A Date of Fit Test 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: ____new__________ Location(s):__custodial area__________________ Are the appropriate adequate accessories on hand? Yes No N/A Verified by: Lee Carlson Note: The respirators were checked on 3-25-2008 and found to be in like new condition. The respirators are located in the gray cabinet in the boiler room. The particulate filters are also located in the same area. LC

Checklist of E/OHS Activities for Underground and Aboveground Storage Tanks

Program Contact Person: Jo Pyle Is the Underground and Aboveground Storage Tanks Plan in place? Yes No Is the Plan current? Yes No Has the Plan been reviewed this school year? Yes No 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:

Underground/Aboveground Storage Tank Status

Tank No.

Location

Size

Contents

Registered

Install date

#1 #2 #3 #4

Bus garage Bus Garage High School Elementary School

1000 gal 400 gal 10,000 gal 10,000 gal

#2 diesel fuel gasoline #2 fuel oil #2 fuel oil

? ? Yes Yes

2006 2006 1995? 2002

Regulated Tanks:Motor fuel tanks larger than 110 gallons Non-regulated Tanks:Heating oil tanks Requirements for All USTs: Tank must be registered with MPCA Requirements for Regulated Tanks:Annual tightness testing and inventory control Tank must be updated, replaced, or removed by December 22, 1998 Upgrades: --Overfill protection --Corrosion protection STPI approved --Leak detection Tightness Testing Results on File: Dates of past testing:____________________ Records on file:________________________

Checklist of E/OHS Activities for Welding and Brazing Safety

Program Contact Person(s) John Lanoue Department Contact: Metals Shop/Ag. FFA John Lanoue 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?

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: