Overview of site production activities (annual tonnage, products, shipping methods, etc...)

Number of employees, typical job tasks, mining method (stone quarry, excavated S&G, dredge, etc...)

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Respirable Crystalline Silica (RCS)

If yes, what are the primary sources of visible dust?

What are the primary controls the site uses to control dust (water truck, spray bars, enclosed transfer points, etc...)?

What are the primary housekeeping practices at the site (water hose, dry shoveling, compressed air blow down, vacuum, other)?

If so, what type(s) of respiratory protection are available for employee use?

What are the typical welding methods and applications at the site (basic plant maintenance, mobile equipment wear parts, etc...)

Other Air Contaminants & Respiratory Hazards

What are the primary noise sources at the site? (plant - screens, crushers, mobile equipment, etc...)

What are the secondary noise sources at the site? (customer trucks, tools/maintenance, etc...)

Noise and Physical Hazards

What type primarily (plugs or muffs) and noise reduction rating (NRR)?

If yes, was appropriate follow up and retraining provided in accordance with MSHA 30 CFR Part 62?

Group Standard - Respirable Crystalline Silica and Total Dust

Group Standard - Workplace Noise

Any ergonomic or other risks identified during survey? (QC sample collection & processing, maintenance, mobile equipment operation, etc...)

Other Group Standards - Ergonomics, Whole Body Vibration, Hand-Arm Vibration

Summary of Observations

Summary and Perception of Overall IH Risk

Any significant safety-related issues or compliance deficiencies?

Any best practices or other notable accomplishments the site has made with respect to H&S?

Signature of H&S Professional Who Lead Survey/Audit