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HAZWOPER 1910.120 COMPLIANCE CHECKLIST FORM B (ICS-208-CG SSP-K) Purpose: The HAZWOPER 1910.120 Compliance Checklist is to ensure that incident response operations are in compliance with Title 29, Code of Federal Regulations Part 1910.120, Hazardous Waste Operations and Emergency Response. It also identifies how other ICS forms can be used to satisfy the HAZWOPER requirements. This is an optional form. Preparation: The HAZWOPER 1910.120 Compliance Checklist is completed by the Safety Officer or his/her staff as frequently as necessary whenever the Safety Officer wants to ensure regulatory compliance. It is best used in conjunction with the Site Safety Plan Enforcement Log (ICS- 208-CG SSP-H). The Site Safety Plan Forms (A-G)best meet some of the requirements. The Incident Action Plan is suited to address other requirements, and the Safety Officer should ensure the IAP addresses them. Other requirements are performance based and are best evaluated on scene by the Safety Officer or his/her staff. Distribution: The HAZWOPER 1910.120 Compliance Checklist should be maintained by the Safety Officer. Instructions: Item# Item Title Instructions I Incident Name Print the name assigned to the incident. 2 Date/Time Enter date (month, day, year)prepared. Pre ared 3 Operational Period Enter the time interval for which the assignment applies. 4 Supervisor/Leader The Supervisor/Leader who receives this form will enter their name here. 5 Location of Site Enter the site location. 6.a. Cites These are the regulatory cites within 1910.120. The major headings are highlighted in bold. Informational cites or cites that are duplicative are not included. 6.b. Requirement This lists the requirement in a question format. Some require documentation or some form of action. 6.c. ICS Form Lists those ICS Forms that cover the requirement. IAP designations means it should be covered in IAP, it does not guarantee it is covered. The Safety Officer must ensure this. 6.d. Check Block Enter the check if the site satisfies the requirement. 6.e. Comments This provides information on where else the requirement may be met. The user may also enter comments. 7 Prepared by Enter the name and position of the person completing the worksheet.