Office of Procedures, Records, and Forms

INTRODUCTION / ORGANIZATION
1.20
Revised 9-17

For more information contact:
   Procedures, Records, and Forms
   509-335-2005

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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.
SPPM
Reference
Title / Primary Purpose
Formats Available
5.66
Chemical Collection Request (WSU1280) Rev. 10-94
For proper disposal or recycling of chemical substances.
EH&S website
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.
PDF
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.
PDF
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.
PDF
2.52
Hazard Notification (WSU1247) rev. 1-09
To report safety hazards or unsafe practices.
PDF
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.
PDF
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.
PDF
3.24
Respirator Authorization / Respirator Fit-Testing and Training Record
(Rev. 2-00)
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.
PDF
2.12
Safety, Health, and Security Committee Meeting Agenda and Minutes PDF
2.16
Safety Orientation Checklist (WSU 1249) Rev. 1-13
To document review of safety procedures.
PDF
2.26
Supervisor's Accident Investigation Report (WSU 1246) Rev. 8-97
To document an accident investigation.
PDF
2.26
Witness/Injured Person Statement (WSU 1315) Rev. 9-13
To record a description of an accident.
PDF