UW LOTO Field Procedure
For equipment and systems that are not routinely repaired or serviced, or require partial shutdowns, and where change management of practices are not robust, then the UW LOTO Field Procedure…
Confined Space Evaluation Form
If you suspect a space meets the definition of a permit-required confined space, but you do not have a permit to enter, do not enter the space. Complete the Confined Space Evaluation form…
UW LOTO Procedure
For equipment that is routinely maintained and serviced, requires a full shutdown for servicing, and has good change management practices in place, the UW LOTO Procedure form can be used. …
LOTO Lock Removal Form
The LOTO Lock Removal Form (Word) includes directions and specific information a department or unit must document when an Authorized Person (lock owner) is unable or unavailable to remove…
Lockout/Tagout Authorized Person(s) Periodic Review
The Lockout/Tagout Authorized Person(s) Periodic Review is used to inspect the Authorized Person’s role and responsibility established in the hazardous energy control program and…
Lead Work Plan Template
Use the Lead Work Plan Template (Word) when lead exposure is assumed or known to be at or above 10 micrograms of airborne lead per cubed meter during an eight-hour TWAe.
Metallic Lead Use Area-Storage Area Inspection Template
Use the Metallic Lead Use Area-Storage Area Inspection Template (Word) when conducting inspections of metallic lead use areas and metallic lead storage areas.
Accident/Incident Report Form
An Accident/Incident Reporting form for use when in the field to document an incident when internet access is unavailable.
Respirator Request Form
University supervisors submit a Respirator Request Form to EH&S, when respiratory hazards are first identified, when processes change that may impact respiratory hazards, and…
Food Establishment Plan Review Application
All plans for new and remodeled food service establishments must be submitted to EH&S for review and approval. Complete a Food Establishment Plan Review Application for a…
Shop Safety Orientation Training Record
Shops can use this template to document shop-specific safety training.Refer to the Shop and Maker Space Safety page for more information.
Permit-Required Confined Space (PRCS) Entry Form
The Permit-Required Confined Space (PRCS) Entry Form is required for entry into any permit-required confined space. The PRCS Entry Form may be used for either an alternative methods entry or a…
PRCS Rescue Service Evaluation Form
Rescue services for confined spaces must be specially qualified, trained, and equipped personnel to enter and remove Entrants from confined spaces. This could be a special unit within a local…
Lockout/Tagout Equipment-Specific Procedure Periodic Review
The Lockout/Tagout Equipment-Specific Procedure Periodic Review (Word) includes directions and content for the review of an equipment-specific lockout/tagout procedure.Refer to the UW…
Research MRI Medical Safety Screening Form
All persons MUST complete and submit the Research Magnetic Resonance Imaging (MRI) Medical Safety Screening Form prior to entry into MR suite or as directed.
Hearing Loss Prevention Self-Audit Form
The purpose of the Hearing Loss Prevention Self-Audit Form (Word) is for University units to audit their compliance with the Hearing Loss Prevention Program.
This form applies if the…