Table D Optional PSM Wksht

PSM On-Site Consultation Agreements (29 CFR 1908)

Table D Optional PSM Wksht

OMB: 1218-0281

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Table D: Assessment of the Employer’s Written Schedule for Implementing Process Hazard Analysis Recommendations (Optional)


Spot-check location

Describe the recommended action item, including the estimated completion date

29 CFR 1910.119 (e)(5)

Was the Action Item Completed?

Yes/No

29 CFR 1910.119 (e)(5)

Additional Evaluation Findings/Corrective Actions


















File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorFarquah, Opeyemi - OSHA
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File Created2023-09-08

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