Respiratory Protection Self-Inspection Checklist
Form Template
This checklist applies to the use of either atmosphere-supplying or air-purifying respirators being worn, voluntarily or otherwise, for comfort or to protect health.
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The checklist is divided into three sections. Section One should be used if filtering dust mask respirators are used. Section Two should be used if respirators other than dust masks are used. Section Three should be used if respirators are required to protect individuals from exposure to air contaminants above applicable limits.
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