California Code of Regulations
Title 8 - Industrial Relations
Division 1 - Department of Industrial Relations
Chapter 4 - Division of Industrial Safety
Subchapter 7 - General Industry Safety Orders
Group 16 - Control of Hazardous Substances
Article 109 - Hazardous Substances and Processes
Appendix B-III - Abbreviated Respiratory Questionnaire
A. Identification Data of Appendix B-III.
NOTE: Non-textile employers may substitute sections A. Identification, and B. Occupational History Table from Appendix B-II in lieu of section
PRESENT WORK AREA
If working in more than one specified work area, X area where most of the work shift is spent. If "other," but spending 25% of the work shift in one of the specified work areas, classify in that work area. If carding department employee, check area within that department where most of the work shift is spent (:if in doubt, check "throughout"). For work areas such as spinning and weaving where many work rooms may be involved, be sure to check the specific work room to which employee is assigned--if he works in more than one work room within a department classify as 7 (all) for that department.
Use actual wording of each question. Put X in appropriate square after each question. When in doubt record No. When no square, circle appropriate answer.
