A Written Respiratory Program is required in any workplace where respirators are required by label, restricted material permit condition, or regulation. These documents provide employers with information to assist in developing their own Written Respiratory Program. Note that the Sample documents are GUIDELINES only. Each employer must customize the written program to reflect their actual program, specific to their company. Please contact the Tulare County Agricultural Commissioner if you have questions.
Sample "Voluntary Respiratory Use Posting". Must be displayed with the A-8 or A-9 whenever employees are allowed to use respirators on a voluntary basis (When not required by label, Restricted Material Permit Conditions, or Regulation.)
Sample Written Respiratory Program by Kern County Agricultural Commissioner - It is required that you customize this document to reflect your actual program. There are portions that require you to develop procedures specific to your company and its WRITTEN PROGRAM. You will be held responsible for all elements of your WRITTEN PROGRAM. Make sure it reflects what you are actually doing.
Sample Written Respiratory Program by San Diego County Agricultural Commissioner- It is required that you customize this document to reflect your actual program. There are portions that require you to develop procedures specific to your company and its WRITTEN PROGRAM. You will be held responsible for all elements of your WRITTEN PROGRAM. Make sure it reflects what you are actually doing.
Generic Guidelines for Development of a Written Respiratory Program, California Department of Pesticide Regulation
Medical Evaluation Questionnaire - To be completed by employees prior to using a respirator. Must be submitted to a physician for evaluation. The completed form is confidential medical information and must not be in the possession of the employer.
Protecting Yourself from Breathing Pesticides on Farms, Pesticide Information Series A-5, also available in Spanish, and Punjabi at the California Department of Pesticide Regulation.
Additional information may be found on the California Department of Pesticide Regulation website at http://cdpr.ca.gov under "Respiratory Protection Compliance Assistance"
Tulare County Agricultural Commissioner/Sealer of Weights and Measures Department