Professional Documents
Culture Documents
Has the Plan (or Plans) been reviewed this school year? Yes No N/A
5/11/09
(second date)
Tunnel system
Air handlers
Status of the Asbestos repair and maintenance Work Order System: N/A
Established, Pending
**For information regarding the medical review and questionnaire, see the
Respiratory Protection Program.**
Checklist of E/OHS Activities for AWAIR
Has the Plan been reviewed this school year? Yes No N/A
Is the OSHA 300A Log completed for the previous calendar year? yes
Have the Logs been maintained for five (5) years? yes
Is information on injuries recorded on the Log with five (5) working days? Yes
No N/A
Safety Committee – Meeting Schedule
.
.
The Surrounding area task force has been discontinued. The Health and Safety
Committee has been reorganized. Lee will be serving on the committee. LC 4-
16-09
Checklist of E/OHS Activities for Bleacher safety
Has the Plan been reviewed this school year? Yes No N/A
Note: The 5 year bleacher Safety inspection was conducted 10/25/2007. All
bleachers were found to be in good condition. Documentation was prepared
and sent to the Minnesota Department of Labor and Industry.
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:
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 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:
6. The bleachers located at the football field (BL 1951) have been retrofitted
to meet standards contained in the Minnesota Bleacher Safety Act. Nylon
braded safety netting has been installed under the entire bleacher
section. While currently safe, plans are to replace the existing bleachers
as funds become available.
All bleachers are currently in good condition and have been maintained in a high
state of repair.
If you would have questions you may contact the Mt. Lake School District at 507-
427-2325.
Sincerely,
Mark Peters
Buildings and Grounds
Checklist of E/OHS Activities for Bloodborne Pathogens
Department Contacts:
Maintenance 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
Location:
Cylinders:
O2 ___1_________ CO2 ____________
Acetyl ____1________ Argon ____________
NH4 ____________ Argon/CO2_____2_______
Other ____________
Has the Plan been reviewed this school year? Yes No N/A
Has the Plan been reviewed this school year? Yes No N/A
Have the State Emergency Response Commission and local fire department
been notified of hazardous materials on school grounds? Yes No N/A
Date:
Presenter:
Note: Mark Peters sent the Tier Two form to the Emergency Response
Commission on 1/30/08. The Mt. Lake fire Department was notified at the
same time. A copy of the form was posted in the Activities Manual.
The Tier Two was updated by Mark. The form was updated online. I will be
locating the user name and password. Hard copies are to be prepared for the
local fire department.LC 3-16-2009
Inventory Form
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
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
Note: the cameras have been installed and now waiting for final adjustments.
Checklist of E/OHS Activities for Employee Right-to-Know/Hazard
Communication
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?
Are MSDS available and located with the chemical inventory? Yes No
Note: Training is provided for custodial staff during the summer. Taher provides
training for the kitchen staff. Chemical inventories are completed each year by
Musser Environmental Consulting Inc.
Contact List for Employee Right-to-Know Program
Wade Nelson
Biology
Connie Riskey
Consumer Life Science
Mark Peters
Custodial/Maintenance
Joan Nickel/Taher
Food Service
Donna Peterson
Photo
Wade Nelson
Chemistry/ Science
Tom Appel
Shop—Welding
Donna Peterson
Shop—Wood
Mark Peters
Transportation
Does this school use contracted services for the Management Assistant
Program? Yes No N/A
Is the Fire Marshal approved Emergency Evacuation Plan in place for each
district building? Yes No
Most recent inspection of fume hoods with fire suppressant: New hood installed
in 2007. A contract for inspection has been signed for inspections with Fairmont
Fire and Safety
Note: The Science Safety Checklist was delivered to Wade Nelson 2-19-2008.
Facilities Safety Review
Dark Room
Wood Shop
Kitchen
Metal Shop
Graphic Arts
Maintenance/Custodial
Transportation
Grounds/Garage
Chemistry/Life Science
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
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
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)
Completed by ___________________________Date
Checklist of E/OHS Activities for First Aid/CPR
Have the program and goals been approved by the School Board for the current
school year? Yes No
The local provider determined travel time was estimated to be within the 4-8
minute limit. Therefore Mt. Lake Ambulance Service 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.
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
½ 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 VSQG’s do not have training requirements however MPCA strongly
recommends persons handling wastes be given training on best handling and
safety risks associated.
Has annual report and license application sent in? Yes No N/A
Checklist of E/OHS Activities for Hearing Conservation
Has the program been approved by the School Board for the current school
year? Yes No
Has training been scheduled or completed for affected individuals this school
year? Yes No N/A
Date:
Presenter:
Have the program and goals been approved by the School Board for the current
school year? Yes No
Were occupied areas of the district evaluated using the EPA’s Tools For Schools
check list or equivalent?
• Teachers check list? An information fact sheet was provided all –staff.
# of forms distributed 55 # of Forms returned: 29
Has the District determined the mechanical ventilation rate of each occupied
space? Yes No.
Has the annual monitoring been conducted to determine location and degree of
infestation? Yes No
Has notice been given to parents regarding application activities? Yes No N/A
Has the Plan been reviewed this school year? Yes No N/A
Chemical inventory:
Are Material Safety Data Sheets (MSDSs) located with inventory? Yes No N/A
Has the Science Safety Lab Checklist been completed? Yes No N/A
Date(s) of instruction:
Is a map of all potable water taps available for review? Yes No N/A
Has the Plan been reviewed this school year? Yes No N/A
Have affected personnel been trained as to methods and technique of use? Yes
No N/A
Has the annual audit of energy control procedures been completed? Yes No
Is the Machine Guarding Plan for each affected work area in place? Yes No
Has the alternative MDE “best practices” criteria used to safeguard equipment?
Yes No
Has a log of employee accidents and near misses been established and used?
Yes No
Annual training for affected staff is provided? Yes No
Surfacing:
General Hazards:
There are no pinch, crush, and shearing points or exposed moving parts
Security of Hardware:
Drainage:
The entire play area has satisfactory drainage, especially in heavy use
areas such as under swings and at slide exits
Leaded Paint:
Has the Plan been reviewed this school year? Yes No N/A
Results of tests:
Has training is not requirement of this program. However if elevated levels are
determine present training of affected persons is recommended.
Note: No records could be located that indicated testing for radon in the past.
I recommend that areas below grade be tested.
Checklist of E/OHS Activities for Respiratory Protection
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
else’s respirator.
Has the Plan been reviewed this school year? Yes No N/A
Are all USTs registered with the Minnesota Pollution Control Agency? Yes No
N/A
Notes:
Underground Storage Tank Status
Upgrades:
--Overfill protection
--Corrosion protection STPI
approved
--Leak detection