The following checklist has been adapted from the DEC inspection form [44-15-19 (2/96)] for Worker Protection Standard (WPS) compliance. Only the formatting has been changed. The number in parentheses next to the item refers to the applicable page(s) of the EPA How to Comply manual*. Use this checklist periodically to review your operationís compliance with the WPS.

CENTRAL LOCATION - WORKERS/HANDLERS (23)

Document Location:

Information Provided: [ ] Application List [ ] Safety Poster [ ] Emergency Information

1. Is the information legible, up-to-date and accessible to workers/handlers? (24)
   
   
2. Does the application list provide necessary information? (23)
   
   
   • Location & description of area?
   • Product name, EPA Reg. No., & active ingredient(s) of the pesticide?
   • Time & date the pesticide is to be applied?
   • Restricted-entry (REI) for pesticide?

   
   
   

3. Is the information posted within the required time? (verify with workers/handlers) (24)
   
   
4. Does the location and description of the treated area allow workers/handlers to distinguish the area from other areas on the establishment? (23)
   
   
5. Is the pesticide safety poster the EPA WPS safety poster? (23)
   
   Check that it contains the basic concepts required by WPS. (101)
   
   
6. Is the required emergency information of the nearest medical facility displayed near the safety poster? (24)
   
   
   • Name
   • Telephone
   • Address of facility

SAFETY TRAINING FOR WORKERS/HANDLERS (25-27)

1. Have all agricultural workers who enter treated areas and handlers received pesticide safety training within required time frames? (25)
   
   
   1. How is this training documented?
      
      Certification card ____ Certificate ____ Employer card _____
      
      Other ______________________________ (27)
      
      
2. Is safety training conducted by a qualified instructor? (26)
   Conducted by:
   
   How are they qualified? Certified Applicator / Authorized By DEC (26)
   
   
3. Is the type of training material used in compliance with WPS? (27)
   If non-EPA, check for equivalency. (103)

EMPLOYER INFORMATION EXCHANGE

1. If the establishment uses a commercial applicator, has complete pesticide application information been provided to the establishment by the commercial applicator? (33)
   
   
   • Specific location & description of treated area
   • Time & date
   • Product name, EPA Reg. No., & active ingredient
   • Re-entry interval (REI)
   • Posting & oral warning notification
   • Other requirements concerning protection

   
   
   

2. Does the agricultural establishment provide location, label, REI and PPE information to commercial applicator employers about their own pesticide application(s) that the commercial pesticide applicator may encounter? (34)

PROTECTION - Notice About Applications For Workers

1. When the label allows an option "Notify workers orally, by posting warning signs or both," what is the establishmentís notification policy? (41)
   Oral / Posting / Both
   
   
2. Is this establishment in compliance?
   
   Does oral notification include items listed? (44)
   
   
   • Understandable translation
   • Location
   • Time
   • Instructions

   
   Are posting standards met? (42)
   
   When are they placed? (24 hours or less)
   
   When are they removed? (within 3 days REI expired)
   
   Is posting sign WPS sign? (42)
   
   Are locations of posting in compliance? (42)
   
   

   • Road access
   • Established walking route
   • Each border with labor camp
   • Other

   In greenhouses all treated areas must be posted
   
   Points where workers enter _____ Doorways _____ Aisles _____ Bench _____

   Other ______________________________

RESTRICTIONS DURING & AFTER APPLICATIONS FOR WORKERS

1. Who is allowed in the treated area during the application?
   (Only trained & equipped handlers doing handling tasks are allowed in treated area) (45)
   
   
   1. Are steps taken to assure the treated area is vacated by unprotected persons? (45)
      
      
   2. Greenhouse/Nursery - Has "Keep out zone" been followed? (51-53)
      
      
2. Are workers prohibited from entering in or doing hand labor tasks in treated area during REI? (45)
   
   
3. Are workers prohibited from entering into treated areas until the inhalation exposure level on the product label or ventilation criteria is reached? (Early-entry no contact) (46)
   
   
4. Has the 4 hour minimum and label inhalation exposure level or ventilation criteria been met before workers are allowed entry? (Early-entry contact, short term tasks, no hand labor)
   
   
   1. Was safety training provided before entering into treated area? (65)
      
      
   2. Was adequate instruction given on PPE? (65)
      
      
      • How to use
      • Take off
      • Importance of washing after removing
      • Recognizing & prevention of heat stress
        
        
   3. Was adequate labeling information given? (63)
      
      
      • Human hazard statement
      • First aid
      • Poisoning symptoms
      • PPE required
      • Other precautions

RESTRICTIONS DURING APPLICATIONS FOR HANDLERS

1. How do they assure no contact to persons other than trained/equipped handlers? (73)
   
   
2. When handling skull/crossbones pesticides, is monitoring done every 2 hours? (73)
   
   By sight / Voice contact / Both
   
   
3. Greenhouse: During fumigant applications, is constant visual or voice contact provided? (73)
   
   a. Was the person monitoring a trained handler & had immediate access to label defined PPE? (73)

SPECIFIC INSTRUCTIONS FOR HANDLERS

1. Do handlers receive proper information about label requirements related to safe use? (75)
   
   
   • Signal word
   • Human hazard statement
   • PPE requirement
   • First aid
   • Environmental precautions

   
   
   

   How?

   1. Are handlers provided access to labeling during handling? (verify) (75)
      
      
   2. How are handlers trained to safely and correctly use all equipment for handling pesticides?
      
      
   3. Does the training comply with WPS? (27)

EQUIPMENT SAFETY FOR HANDLERS

1. Is equipment inspected & repaired before each day for leaks, clogging, damaged parts? (77)
   
   
   1. Is equipment cleaned of residue if handled by untrained or ill equipped people? (77)

PPE FOR HANDLERS/EARLY ENTRY (See PPE exceptions: 79)

1. Is appropriate PPE provided? (79)
   
   
   1. Is PPE clean and in operable condition? (79)
      
      
   2. Is PPE used correctly? (79)
      
      
   3. Does employer provide instruction on use? (79)
      
      
   4. Is PPE inspected before use each day? (80)
      
      
   5. Are policies in place to prevent PPE from being taken home? (79)
      
      
   6. Are there designated areas for handlers/early-entry workers personal clothing & PPE storage away from pesticide storage & use areas, preventing contamination? (79)
      
      
   7. Are steps taken to prevent heat illness? (79)
      
      
   8. Is proper information provided to people who clean or launder PPE? (81)
      
      how to protect themselves; taking precautions when handling; PPE may be contaminated; wash separately; potential harmful effects of pesticide exposure; how to clean PPE correctly; if reuse PPE, cleaned before reusing according to manufacturers instructions; keep contaminated PPE away from other clothing; thoroughly dry PPE before storage; or store clean PPE from other personal clothing and contaminated areas; place in well ventilated area
      
      
   9. Are expired, clogged, or damaged dust/mist filters replaced in a timely manner?
      
      
   10. Are gas/vapor canisters replaced according to product labeling & when expired or the first indication of odor?
       
       
   11. Are coveralls or other absorbent material that are heavily contaminated with danger or warning pesticides discarded & not reused? (80)
       

       How are they disposed of?

MITIGATION - DECONTAMINATION SITE FOR WORKERS

1. Are decontamination sites for workers provided for 30 days after the end of REI? (29)
   
   
2. Is the decontamination site located outside of areas being treated with pesticides or area under REI and located within 1/4 mile of activities?
   
   (Not allowed inside unless stored in containers to prevent contamination and it is in the area where workers are performing early entry tasks in order to be accessible within 1/4 mile)

   
   

3. For Early-entry: Do the workers have a clean place to remove their PPE? (67)
   
   
4. For Early-entry: Are necessary supplies provided for decontamination site for early-entry workers? (67)
   
   
   • Water
   • Soap
   • Single use towels
   • Emergency eye flushing (when protective eyewear is required)

DECONTAMINATION SITE FOR HANDLERS

1. Are sites provided for the duration of the handling task? (29)
   
   
2. For mixing activities & aerial loading sites: Is a decontamination site provided in treated or REI area provided with soap, towels, clean change of clothing in closed containers & the water is running tap water or is in a closed container? (30)
   
   Decontamination site location:
   
   (For other handling activities, the site must be at the access point within 1/4 mile from the nearest point reachable by vehicles. For pilots, the site must be at the loading site or in the aircraft).
   
   
3. Do handlers have the necessary supplies available: soap, water, single use towels, clean change of clothes; and have immediate access to eye-flush when the label requires protective eyewear? (31)
   
   
4. Are provisions of soap, clean towels and enough water to allow handlers to wash thoroughly after removing PPE available? (31)

EMERGENCY ASSISTANCE

1. Are all requirements below followed when a worker/handler has been poisoned or injured by a pesticide? (36)
   
   Provide emergency transportation, product name, EPA Registration No., active ingredient, antidote, first aid, statement of practical treatment, how pesticide was used, circumstances of exposure
   
   
2. Did site employer take any action to prevent or discourage a worker from complying with Worker Protection Standard requirements?
   
   (i.e. use of PPE, decontamination site or asking for emergency assistance) (19)
   
   If yes, specify:

*The Worker Protection Standard for Agricultural Pesticides: How to Comply. US Environmental Protection Agency 735-B-93-001. July 1993

[Order How to Comply manual from National Service Center for Environmental Publications (NSCEP)]