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Voluntary Respirator Use Agreement

By signing this document, I verify that I have received and have reviewed the following documents:

Respiratory Protection Program for Voluntary Use of Respirators
Appendix D of 1910.134: https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.134AppD
Oregon OSHA Voluntary Respirator Use Fact Sheet

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Signed by Charles Lewis
Signed On: August 9, 2019

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August 9, 2019 1:12 pm PDT

Voluntary Respirator Use Agreement Uploaded by Charles Lewis - info@nonprofithomeinspections.org IP 24.21.232.118, 192.88.134.11