Forms and Checklists

Provides the forms and checklists used by the Consultative Services Bureau.

Title and Description	Document Number	Effective Date
Action Request Form To be used in conjunction with APN 13 - OSH Division Quality Policy. Document Owner/Reviewer: Judyth Forte, State Plan Coordinator, judyth.forte@labor...	APN 13, Action Request	2013-03-01
Case File Summary Case File Summary form.		2014-06-23
Consultant Checklist Guidelines Provides the guidelines for consultant's conducting onsite visits.		2014-06-23
Customer Satisfaction Survey Customer Satisfaction Survey form.		2025-06-16
Emailing Reports Guide to emailing reports to employer.		2017-06-01
Field Notes Form for field notes..		2015-01-15
Field Notes (Detailed) Form for detailed field notes.		2014-07-01
Logging Onsite Safety Checklist Checklist for logging.		2014-06-01
New Employee Cut-Loose Checklist and Tracking Log CSB training tracking form for new employees. It is a cut-loose checklist and tracking log.	Checklistandtrackinglog	2023-06-16
On the Job Evaluation (PDF) On the Job Evaluation (OJE) of Safety and Health Consultants for Initial Surveys (PDF).		2018-04-18
On the Job Evaluation (Word Fill-in) On the Job Evaluation (OJE) of Safety & Health Consultants for Initial Surveys (WORD).		2018-04-18
Preliminary Findings Form for preliminary findings.		2014-07-01
Request for Extension of Original Abatement Date Form to request an extension of an abatement due date.		2024-07-12
Screening Report Form 98 Sampling form.		2025-06-16
SHARP Approval Form (PDF Fillable) Approval form for SHARP (PDF Fillable).		2023-02-20
SHARP Approval Form (WORD) Form for SHARP approvals.		2023-02-20
SHARP Construction Package (PDF Fillable) For construction sites.		2025-06-16
SHARP Construction Package (WORD) For Construction sites only		2025-06-16
SHARP Letter of Intent Letter for SHARP intent.	LetterOfIntent_04172025.docx	2025-04-17
SHARP Survey Overview Consultative SHARP survey overview.		2014-07-01
Supplementary Case File Summary Supplementary Case File Summary form.		2014-06-23