Onsite Consultation Agreements (29 CFR Part 1908) State Projects

Occupational Safety and Health Onsite Consultation Agreements (29 CFR Part 1908)

Table D Optional PSM Wksht (for PSM Eval Wksht)

Onsite Consultation Agreements (29 CFR Part 1908) State Projects

OMB: 1218-0110

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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















1218-0110

Expiration: 4-30-28




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