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will be scheduled include but are not limited to: changes in Site conditions, changes in the work schedule/plan, newly discovered hazards, and incidents occurring during Site work. 8.4 Medical Surveillance The medical surveillance section of the Health and Safety Plan describes how worker health status is monitored at this Site. Medical surveillance is used when there is the potential for worker exposure to a hazardous substance at levels above Cal/OSHA Permissible Exposure Limits (PELs) or if there is no PEL above other published limits. The purpose of a medical surveillance program is to medically monitor worker health to ensure that personnel are not adversely affected by Site hazards. The provisions for medical surveillance at this Site are based on the Site characterization and job safety analysis found in Section 5 of this HASP and are consistent with Cal/OSHA requirements identified in Cal/OSHA T8 CCR, Section 5192(f). 8.4.1 Site Medical Surveillance Program Medical surveillance requirements are based on a worker's potential for exposure as determined by the Site characterization and job safety analysis documented in Section 5 and JSAs within Appendix A of this HASP and in compliance with the requirements of Cal/OSHA T8 CCR, Section 5192(f)(2). Based on Site information and the use of direct reading instruments, anticipated limited use of respirators(less than 30 days per year), and the absence of an employee-staffed HAZMAT team, a limited medical surveillance program is required and will be implemented at this Site. The medical surveillance program provides that: 1. Workers assigned to tasks requiring the use of respirators receive medical examinations in accordance with Cal/OSHA T8 CCR Section 5144 to ensure they are physically capable to perform the work and use the equipment, and 2. If a worker is injured, becomes ill, or develops signs or symptoms of possible over-exposure to hazardous substance or health hazards, medical examinations are provided to that worker as soon as possible after the occurrence and as required by the attending physician. 3. These medical examinations and procedures are performed by or under the supervision of a licensed physician or other licensed health care professional such as a physician assistant or nurse practitioner, and are provided to workers free of cost, without loss of pay, and at a reasonable time and place. In addition, the need to implement a more comprehensive medical surveillance program will be re-evaluated after any apparent over-exposure. 8.4.2 Medical Recordkeeping Procedures Medical recordkeeping procedures at Roux are consistent with the requirements of Cal/OSHA T8 CCR Section 3204, Access to Employee Exposure and Medical Records, and are described in the company's overall safety and health program. A copy of that program is available on request from Roux's HR department in our Islandia, New York office. The following items are maintained in worker medical records: • Respirator fit test and selection; • Physician's medical opinion of fitness for duty (pre-placement, periodic, termination); • Physician's medical opinion of fitness for respirator protection (pre-placement, periodic); and • Exposure monitoring results. 3989.0001 S.104/HSP Site-Specific Health and Safety Plan I ROUX 127