INTRODUCTION / ORGANIZATION
For more information contact:
Procedures, Records, and Forms
SPPM Forms Index
Forms may be available in the following formats:
- Paper forms from University Stores (US) or the administering department.
- PDF templates from the Business and Safety Policies and Procedures Manuals (BPPM and SPPM). See “Hints on using the PDF version” for information about using PDF templates.
- Automated FileMaker Pro templates. See the Procedures, Records, and Forms FileMaker web page.
- Online forms available from the administering department website.
|Title / Primary Purpose||Formats Available
|5.66||Chemical Collection Request (WSU1280) Rev. 10-94|
For proper disposal or recycling of chemical substances.
|3.34||Fall Protection Work Plan Rev. 10-92|
To document actions taken to prevent falls. Required when working ten feet or more above the level below.
|7.10||Full-Size Van Driver Safe Driving Practices Acknowledgment Statement (WSU1426) Rev. 7-09|
To record driver acknowledgment of risks and recommended safe driving practices for operating a full-size van.
|7.10||Full-Size Van Driver Valid License to Drive and Driving Experience Statement (WSU1427) Rev. 7-09|
To record manager/supervisor and full-size van driver acknowledgment of responsibilities prior to and during the driver’s assignment to operate a full-size van.
|2.52||Hazard Notification (WSU1247) rev. 1-09|
To report safety hazards or unsafe practices.
|2.24||Incident Report (WSU1131) Rev. 1-08|
To report accidental injury or work-related illness involving WSU employee or third party; may also be used for property damage.
|Online: HRS website
|5.10||Safety Data Sheet (SDS) Request (WSU 1391) Rev 9-17|
To request an SDS for each hazardous chemical in the workplace.
|2.46||Public-Access Defibrillator use Agreement (WSU1477) Rev. 12-09|
To request approval to install and use an automated external defibrillator (AED) in a University location.
|3.24||Respirator Authorization / Respirator Fit-Testing and Training Record |
To authorize the use of respirators and provide a record of respirator fit-testing and respirator use training.
|Environmental Health and Safety|
|2.50||Safety Inspection Checklist (WSU1250) Rev. 10-07|
To conduct self inspection of department / work area and document findings and corrective actions.
|2.12||Safety, Health, and Security Committee Meeting Agenda and Minutes|
|2.16||Safety Orientation Checklist (WSU 1249) Rev. 1-13|
To document review of safety procedures.
|2.26||Supervisor's Accident Investigation Report (WSU 1246) Rev. 8-97|
To document an accident investigation.
|2.26||Witness/Injured Person Statement (WSU 1315) Rev. 9-13|
To record a description of an accident.