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Facility: Safeway, Inc <br /> Date: Tracy Distribution Center <br /> Time: <br /> Inspected by: <br /> Inspection `� Comments-must note the date any deficiency is corrected <br /> \ -4-77777, 7-77 <br /> ::Personal�'r.9 sCt ve kqu�pm rtL ' t� .rann. ,r. ... <br /> 1. Does the facility have a written Personal Protective <br /> Equipment program, reviewed annually? <br /> 2. Has a PPE assessment been made for each job? <br /> 3. Do JSA's or job element charts contain specific PPE <br /> requirements? <br /> 4. Is appropriate PPE readily available on all shifts? <br /> 5. Is PPE maintained in a reliable, sanitary condition an <br /> stored properly? <br /> G: Respir o" P06WWon,C�tp art► <br /> 1. Is there a written Respiratory Program? <br /> 2.Are respirators selected on the basis of the hazard to <br /> which the employee is exposed? <br /> 3.Are respirators cleaned, disinfected, properly stored, <br /> and inspected? <br /> 4. Is there documentation that employees are medically <br /> capable of wearing respirators safely? <br /> 5. Is there documentation that all employees have been <br /> initially trained in respirator use and selection, including <br /> fit testing? <br /> 6. Is the program evaluated annually? <br /> 7.Are employees who choose to wear respirators(or <br /> NIOSH-certified"dust masks")where respirators are no <br /> required, included in the program? <br /> Fi:"HearingortserYtion Pro rams <br /> 1. Is there a written hearing conservation program? <br /> 2. Is PPE provided and available where needed? <br /> Page 3 of 8 <br /> Safeway - Privileged Document 4/13/2011 <br />