NAU Supervisor’s Safety Checklist
This form is designed to help NAU Supervisors and Principal Investigators assure that the individuals they supervise have the knowledge and training they need in order to work safely and comply with applicable safety regulations at NAU. Visit the NAU Environmental Health & Safety (EHS) Supervisor Safety webpage for links to resources.
Employee name:
Employee job description:
Employee job location:
Employee date of hire:
Supervisor name and department:
Check all conditions that apply for your employee and use checkboxes to track of the employee’s completion of associated training. (Note: Official training records must also be maintained.)
Employee will be working in a laboratory.
Top of Form
If checked, employee will need:
Online Chemical Hygiene Training
Review of Chemical Hygiene Plan (CHP)
Review of site-specific SOPs
Site-specific training on chemical hazards, proper chemical storage, labeling systems and location of Safety Data Sheets (SDS)
Employee could be exposed to potentially hazardous chemicals (ex: paints, cleaners, glazes, corrosive products) in a non-laboratory setting
Bottom of Form
If checked, employee will need:
Online Hazard Communication Training
Review of site-specific SOPs
Site-specific training on chemical hazards,proper chemical storage,labeling systems and location of Safety Data Sheets (SDS)
Employee could be exposed toblood or other potentially infectious materials.
If checked, employee will need:
InitialBloodborne Pathogens Training (contact biosafety staff to schedule)
Employee will be working with samples containing biological hazards (e.g. viruses, bacteria).
If checked, supervisor and employee will need to contact the NAU Biosafety Office for guidance.
Employee will be working with lasers, radioactive isotopes or x-ray equipment.
If checked, employee will need:
To contact NAU’s Radiation Safety Officer
Online Radiation Safety Training
Employee will be generating, storing, or disposing of potentially hazardous materials (eg. used cleaning/painting products, laboratory or biological waste).
If checked, employee will need:
Online Hazardous Waste Training
Employee will be working with sources of hazardous energy
If checked, employee will need:
Lockout/Tagout Training
Employee will be working in confined spaces
If checked, employee will need:
Confined Space Training
Employee will be working with known or assumed asbestos containing materials.
If checked, employee will need:
Asbestos Awareness Training
Employee will be driving his/her own vehicle OR a state vehicle for NAU business.
If checked, employee will need to:
Register as an Authorized Driver through LOUIE
Employee will be conducting fieldwork.
If checked, employee will need:
To participate in the NAU Field Safety Checklist for each project
Employee will be supervising employees and/or students.
If checked, employee will need:
Online Supervisor Safety Training
Employee will use the following hazard controls during the course of their work (check all that apply). Note: Supervisors must train employees in the proper use of hazard controls.
Splash goggles
Impact Safety Glasses
Chemically Protective Gloves
Lab coat
Steel-toed footwear
Traction devices for winter activities
Safe work practices with sharps (needles, glass, etc.)
Safe Lifting Techniques
Respirator
Fume hood
Biosafety Cabinet
Standard Operating Procedures (SOPs)
Fall Protection Devices
Rigging Equipment
Hearing Protection
Other
Describe any other job-specific safety considerations for this job description:
I have reviewed the potential hazards and necessary hazard controls associated with this job description:
Supervisor Signature/Date:
Employee Signature/Date:
Maintain a copy of this record and associated training documentation for the duration of employment.