Guides & Toolkits

Workbook for Designated Substance Assessments 12 366-BPV-01-IMOT © 2024, Workplace Safety & Prevention Services (WSPS) 1 877 494 WSPS (9777) | 905 614 1400 | WSPS.CA APPLICATION – WORKSHEET 2: IS WORKER EXPOSURE LIKELY? 1. In what form does the substance enter the facility? ______________________________________________________________________________________________________ Product title: ________________________________________________________________________________________ Type of container: ____________________________  Size of Container: _________________________________ 2. Is this form altered during use or in the operation?     YES     NO If YES, indicate altered form: ______________________________________________________________________ 3. Is there a possibility of the substance being released into the workplace environment during normal use?  YES     NO If YES, indicate the stage of the operation or areas where this can occur. ____________________________________________________________________________________________________ 4. If YES to Question 3, specify the job functions and approximate number of employees who might be exposed: Job Function Number of Employees ___________________________________________________ ____________________________________________ ___________________________________________________ ____________________________________________ ___________________________________________________ ____________________________________________ ___________________________________________________ ____________________________________________ ___________________________________________________ ____________________________________________ WSPS.CA

• Cover
• SECTION VI: REFERENCES AND RESOURCES
• SECTION V: CONTROL PROGRAMS
• Guidelines For Worksheet 1: Is The Designated Substance Present?
• Guidelines For Worksheet 2: Is Worker Exposure Likely?
• Guidelines For Worksheet 3: Process Description
• Guidelines For Worksheet 4: Walk Through
• Guidelines For Worksheet 5: Walk Through Conclusions
• Guidelines For Worksheet 6: Is A Control Program Necessary?
• Additional Pages
• SECTION III: ASSESSMENT
• Introduction
• Assessment – Worksheets 3: Process Description
• Assessment – Walk Through Survey
• Assessment – Worksheet 4: Walk Through
• Assessment – Worksheet 5: Walk Through Conclusions
• SECTION II: APPLICATION
• Introduction
• Application – Worksheet 1: Is the Designated Substance Present?
• Application – Worksheet 2: Is Worker Exposure Likely?
• SECTION I: INTRODUCTION
• Purpose of this Workbook
• Assessing Designated Substances
• Decision Diagram For Assessing Designated Substances
• Workbook Format
• SECTION IV: ASSESSMENT CONCLUSION
• Introduction
• Conclusions Worksheet 6: Is A Control Program Necessary?