These checklists are provided by the Maine Department of Labor SafetyWorks! program as a guide to assist employer in compliance with safety and heath regulations. It is the responsibility of the employer to modify these documents to meet site-specific hazards.
Asbestos Operations & Maintenance Program
Blood Borne Pathogens
- Exposure Control Plan (MS Word)
- Hepatitis B Vaccination or Declination Record (MS Word)
- Hepatitis B Vaccination Declination (MS Word)
- Sharps Log (MS Word)
Chemical Hygiene Plan Template
Confined Space
Contact List - Safety Meeting Template
Control of Hazardous Energy
- Control of Hazadous Energy Sources Ver. 1 (MS Word)
- Control of Hazadous Energy Sources Ver. 2 (MS Word)
- Energy Control Procedures Periodic (MS Word)
- Inspections of Authorised Employee Form (MS Word)
- Energy Control Procedures Template (MS Word)
- Lock Removal Procedure Template (MS Word)
- LOTO Training Template (MS Word)
- Sample Procedure: Dump Body Trucks (MS Word)
- Sample Procedure: Front End Loaders (MS Word)
- Sample Procedure: Waste Water Pumps (MS Word)
Cranes and Slings
Electrical Safety
Emergency Action - Fire Prevention- WP Violence
Ergonomics
Fall Protection
Fire Departments
Flammable Liquids
Forklift Checklist
Hazard Communications
Occupational Noise Exposure
OSHA Record Keeping
Pandemic Preparedness
Personal Protective Equipment
Respiratory Protection
- Medical Evaluation Checklist (MS Word)
- Qualitative Respirator Fit Testing All Methods (MS Word)
- Qualitative Respirator Fit Testing Saccharin Only (MS Word)
- Respirator Fit Testing Checklist (MS Word)
- Respirator Medical Evaluation Form (MS Word)
- Respirator Selection Logic (MS Word)
- Respiratory Protection Program Template (MS Word)
- Respiratory Protection Program Template for N-95 Users (MS Word)
- Written Respiratory Protection Program Evaluation Checklist (MS Word)