WHMIS Survey FormID=31443

  • WHMIS Program Survey

  • Instructions to use this form:

    Read the question then determine the status of

    Yes it's in place and your company can produce evidence that the system element is in place,

    Not Sure or

    No, not that I know of and your company isn't able to provide a evidence. 

    Based on the results of your survey, CORSafety will provide a series of solutions to aid in improving your program.

  • Part 1 - Safety Data Sheets

  • PT 1 - (a) Has a chemical inventory been prepared?

  • PT 1 - (c) Has inventory been checked to ensure each controlled product has a corresponding SDS?

  • PT 1 - (d) Are SDS's avalable to workers?                 

  • PT 1 - (e) Is there a central catalogue of all SDS's?   

  • PT 1 - (h) Is there a system to ensures that controlled products are accompanied by an SDS during purchasing?

  • PT 1 - (i) A system of checks is done to ensure supplier SDS has all information required?.

  • Part 2 - Labels

  • Image field 135

  • Pt 2 - (a) Controlled products are all received and checked for supplier labels?

  • PT 2 - (b) A system of workplace labeling exists on site for decanted products?

  • PT 2 - (c) Labels have all required information?

  • PT 2 - (d) Labels are legiable?                       

  • PT 2 - (e) A method of education and coding / identification is available for:

    Pipes and piping systems

  • PT 2 (f) A system of placarding or posting work areas where controlled products are not in or could be edited from equipment, processes, etc.

  • Part 3 - Education / Training

  • PT 3 - (a) Do the workers know what hazardous materials are present?

  • PT 3 - (b) Are they aware of the requirements of WHMIS and of their own provincial health and safety legislation?

  • PT 3 - (c) Do they know how to safely handle, store and dispose of the hazardous materials with which they work according to legislation where applicable?

  • PT 3 - (d) Are they aware of the potential hazardous effects of the materials with which they are

    working?

  • PT 3 - (e) Are they familiar with emergency and first aid?

  • PT 3 - (f) Do they understand the use and purpose of control systems, including ventalation and personal protective equipment?

  • PT 3 - (g) Do they know how to interpret a supplier or workplace label and what it means in terms of doing their jobs safely?

  • PT 3 - (h) Do they know where they can get a copy of the SDS's?

  • PT 3 - (i) Do they know how to interpret the information on a SDS and how to use it to carry out their jobs safely?

  • PT 3 - (j) Are they aware of their right to refuse to do unsafe work?

  • PT 3 - (k) Are they aware of their responsibility to use the information they have learned to work safely with hazardous materials?

  • PT 3 - (l) Do they accept personal responsibility of using hazardous materials safely?

  • PT 3 - (m) Have workers completed job specific hazardous materials training?

  • PT 3 - (n) Are workers able to understand the information delivered to them during training?

  • PT 3 - (o) Are workers well motivated and committed to safety and health on the job?

  • PT 3 - (p) Are provisions made for training new, part-time and casual workers?

  • PT 3 - (q) Are contractors and visitors to the area protected?

  • PT 3 - (r) Is there evidence that the objectives of an effective training program have been met?

  • PT 3 - (s) Is there a system of initiating safe work procedures from SDS information? Training in Safe Work Practices?

  • PT 3 - (t) Does the worker have adequate education in labeling systems of WHMIS?

  • Part 4 - Programs

  • PT 4 - (a) Is there an outline of the program in writing which is job specific?

  • PT 4 - (b) Are there standard safe work procedures on site?

  • PT 4 - (c) Are there emergency

    procedures for:

    1. Fire
    2. Chemical spill and clean up
    3. Fugitive emmissions
    4. First Aid Response
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