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UNITED STATES
DEPARTMENT OF LABOR

General. This section applies to all occupational exposures to ___ or to (specify those uses or classes of uses of ___ [Chemical Abstracts Service Registry Number 0000] which are covered by the standard, including, where appropriate, the type of exposure to be regulated by the standard) except as provided in paragraph (a)(2).

Exemptions. This section does not apply to (insert those uses or classes of uses of ___ which are exempted from compliance with the standard, including, where appropriate,

Workplaces where another Federal agency is exercising statutory authority to prescribe or enforce standards or regulations affecting occupational exposure to _____ or

Definitions.

___ means (definition of the substance, group of substances, or combination of substances, to be regulated).

Action level means an airborne concentration of ___ of (insert appropriate level of exposure).

Note:
Where appropriate, consider an action level as a limitation on requirements for periodic monitoring (para. (e)(3)), medical surveillance (para. (n)), training (para. (o)), labels (para. (p)(3)), and other provisions.

Assistant Secretary means the Assistant Secretary of Labor for Occupational Safety and Health, U.S. Department of Labor, or designee.

Authorized person means any person specifically authorized by the employer whose duties require the person to enter regulated areas or any person entering such an area as a designated representative of employees for the purpose of exercising the opportunity to observe monitoring procedures under paragraph (r) of this section.

Director means the Director, National Institute for Occupational Safety and Health, U.S. Department of Health, and Health Services, or designee.

Emergency means in any occurrence such as, but not limited to, equipment failure, rupture of containers, or failure of control equipment which may result in a massive release of _____ which is (insert appropriate quantitative or qualitative level of release which constitutes an emergency).

OSHA Area Office means the Area Office of the Occupational Safety and Health Administration having jurisdiction over the geographic area where the affected workplace is located.

Time weighted average limit (TWA). Within (insert appropriate time period) of the effective date of this section, the employer shall assure that no employee is exposed to an airborne concentration of _____ in excess of: (insert appropriate exposure limit or when it is determined by the Secretary that there are available suitable substitutes for uses or classes of uses that are less hazardous to humans, the proposal shall permit no occupational exposure) as an eight (8)-hour-time-weighted average.

(Where the Secretary finds that suitable substitutes for _____ may exist, the determination of the _____ level shall include consideration of the availability, practicability, relative degree of hazard, and economic consequences of the substitutes.)

Ceiling limit (if appropriate). Within (insert appropriate time period) of the effective date of this section, the employer shall assure that no employee is exposed to an airborne concentration of ___in excess of: (insert exposure limit) as averaged over any: (insert appropriate time period) during the working day.

Dermal and eye exposure. (As appropriate).

Within (insert appropriate time period) of the effective date of this section, the employer shall (If eye exposure to ___does not create a risk of cancer, insert exposure level or criteria which will prevent other adverse health effects of eye exposure to ___if any. If eye exposure creates a risk of cancer, insert exposure level or criteria which represents the level of eye exposure to ___).

Use. Within (insert appropriate time period and additional information requirements if appropriate), of the effective date of this standard or within thirty days of the introduction of ___ into the workplace, every employer who has a place of employment in which ___ is present shall report the address and location of each place of employment to the OSHA Area Office and an estimate of the number of employees exposed.

Emergencies. Emergencies, and the facts obtainable at that time, shall be reported within (insert appropriate number) hours of, or during the first federal working day after, the time the employer becomes aware of the emergency to the OSHA Area Office, whichever is longer. Upon request of the OSHA Area Office, the employer shall submit additional information in writing relevant to the nature and extent of employee exposures and measures taken to prevent future emergencies of a similar nature.

Initial monitoring. Each employer who has one or more workplaces where (specify the types of workplaces subject to the monitoring requirement) shall, within (insert appropriate period) of the effective date of this section (insert requirements for initial monitoring, as appropriate).

Frequency. (Insert, if appropriate, provisions prescribing the minimum frequency at which monitoring must be repeated, the conditions under which such frequency must be increased or may be reduced, and conditions under which such routine monitoring may be discontinued (for example, where the action level is not exceeded). Where appropriate, specify different frequency requirements for certain types of workplaces where, for example, exposure levels are subject to greater or less variability.)

Additional monitoring. (Insert, if appropriate, provisions for monitoring, in addition to the requirements (if any) of paragraph (e)(3). This may include a production, process, control or personnel change which might result in new or additional exposure to _______,

or whenever the employer has any other reason to suspect a change which might result in new or additional exposures to ____________.)

Accuracy of measurement. (Insert requirements for accuracy of methods of measurement or detection used to comply with the paragraph).

General. The employer shall assure that respirators are used where required pursuant to this section to reduce employee exposures to or below the permissible exposure limits and in emergencies. Compliance with the permissible exposure limits may not be achieved by the use of respirators except:

Where respiratory protection is required under this section, the employer shall select and provide at no cost to the employee, the appropriate type of respirator from Table 1 below and shall assure that the employee wears the respirator provided.

Table 1 - Respiratory Protection

for ______

(The table will contain a listing of the appropriate type of respirator for various conditions of exposure to ______).

The employer shall select respirators from those approved by the National Institute for Occupational Safety and Health under the provisions of 30 CFR part 11.

Alarms. Where there is the possibility of employee exposure to _____ due to the occurrence of an emergency, a general alarm shall be installed and maintained to promptly alert employees of such occurrences.

Evacuation. Employees not engaged in correcting the emergency shall be restricted from the area and shall not be permitted to return until the emergency is abated.

Provision and use. Where employees are exposed to eye or skin contact with ______ (insert criteria which trigger this requirement as appropriate), the employer shall, within (insert appropriate time period) of the effective date of this section provide at no cost to such employees, and assure that such employees wear, appropriate protective clothing or other equipment in accordance with 29 CFR 1910.132 and 1910.133 to protect the area of the body which may come in contact with ______.

General. The employer shall, within appropriate time period of the effective date of this section, implement a housekeeping program to minimize accumulation of _____.

Specific provisions. The program shall include (insert appropriate elements).

General. The employer shall assure that no waste material containing _____ is dispersed into the workplace, to the extent practicable.

The employer shall label, or otherwise inform employees who may contact waste material containing ______, the contents of such waste material.

Hygiene facilities and practices. Where employees are exposed to airborne concentrations of _____ in excess of the permissible exposure limits specified in paragraph (c)(1), or where employees are required to wear protective clothing or equipment pursuant to paragraph (j) of this section, or where otherwise found to be appropriate, the following facilities shall be provided by the employer for the use of those employees and the employer shall assure that the employees use the facilities provided.

[Specify appropriate hygiene facilities and practices such as]:

Change rooms. The employer shall provide clean change rooms in accordance with 29 CFR 1910.141(e).

The employer shall provide shower facilities in accordance with 29 CFR 1910.141(d)(3).

Initial examinations. Within (insert appropriate time period) of the effective date of this section or thereafter at the time of initial assignment, the employer shall provide each employee specified in paragraph (n)(1) of this section an opportunity for a medical examination, including at least the following elements:

A physical examination which shall include: (insert specific tests, procedures, etc., pertinent to the health hazards posed by _____.) Where appropriate, provide that the examining physician shall conduct such additional examinations and tests as are needed according to his professional judgment).

Note:
Where appropriate, require or permit different medical protocols, or different frequencies of medical examinations, for separate sub-populations of employees covered under paragraph (n)(1).

Additional examinations. If the employee for any reason develops signs or symptoms commonly associated with exposure to _____, the employer shall provide appropriate examination and emergency medical treatment.

Information provided to the physician. The employer shall provide the following information to the examining physician:

The physician's opinion as to whether the employee has any detected medical condition which would place the employee at an increased risk of material impairment of the employee's health from exposure to _____

The employer shall instruct the physician not to reveal in the written opinion specific findings or diagnoses unrelated to occupational exposure to _____

The training program shall be provided at the time of initial assignment, or upon institution of the training program, and at least (insert appropriate time period) thereafter, and the employer shall assure that each employee is informed of the following:

Note:
Specify, as appropriate, some or all of the following information, or any other appropriate information. Where appropriate, require training programs with different contents, or different frequencies, for separate subpopulations of the employees specified in paragraph (o)(1).

The emergency procedures developed, as required by paragraph (i) of this section;

The employer shall post signs to clearly indicate all workplaces. (Specify as appropriate the description of the area to be signposted such as "where employees are exposed to ____________," or "where exposures exceed the action level," or "where exposures exceed the PEL," or "which are regulated areas"). The signs shall bear the following legend:

DANGER

(insert appropriate trade or common names)

CANCER HAZARD

AUTHORIZED PERSONNEL ONLY

Where airborne concentrations of _____ exceed the permissible exposure limits, the signs shall bear the additional legend: "Respirator Required" or "Respirator May Be Required" as appropriate.

The employer shall assure that the precautionary labels required by this paragraph are readily visible and legible. The labels shall bear the following legend:

DANGER

CONTAINS _____

CANCER HAZARD

Note:
Utilize the clause "POTENTIAL CANCER HAZARD" if it is appropriate to include a signs and labels provision for a Category II potential carcinogen.

The employer shall also comply with any additional requirements involving transfer of records set forth in 29 CFR 1910.20(h).

Note:
Include other recordkeeping requirements if appropriate.

Employee observation. The employer shall provide affected employees, or their designated representatives, an opportunity to observe any monitoring of employee exposure to _____ conducted pursuant to paragraph (e) of this section.

Effective date. This section shall become effective (insert effective date).

Appendices. The information contained in the appendices is not intended, by itself, to create any additional obligations not otherwise imposed or to detract from any existing obligation. (In normal circumstances three appendices will be included in each standard, an "Appendix A - Substance Safety Data Sheet," an "Appendix B - Substance Technical Guidelines," and an "Appendix C - Medical Surveillance Guidelines." Insert additional appendices or delete any of the suggested appendices as appropriate.)