Safety Binder
Radiation Binder
Waste Management Binder
HSE To-Do List
Acknowledgement Forms
100

This living log in the safety binder tracks all injuries that involved medical attention beyond first aid, days away from work, and/or restricted work activity and must be restarted at the start of each year.

OSHA 300 Log

100

What tab is the document that is reviewed and signed annually by all associates and contains the regulations around radiation safety in the state as well as training requirements.

Tab 4

100

With the exception of CA, hazardous waste is supposed to be picked up how many times per year? Hospitals are charged regardless if they have waste if they accepted the scheduled pickup date.

Twice per year

100

This quality assurance and quality control check on all x-ray equipment must be done how often?

Every fiscal quarter

100

This radiation acknowledgment must be signed annually by every associate confirming the review of the document.

The Radiation OSP acknowledgement

200

The most updated version of this document is from December 2021 and all hospitals must have this version in the binder.

The Injury and Illness Prevention Program Manual

200

These reports come to the hospital quarterly and for each individual associate annually and must initialed by the RSO.

Dosimetry Reports

200

This guide summarizes the waste management plan and is specific for each state. It is kept in tab 2.

The state specific quick reference guide.

200

This biannual check confirms that the safety equipment is in good condition.

The leaded PPE check

200

This acknowledgment in the safety binder lists the activity, possible hazard, and equipment needed to be safe and must be signed annually by each associate.

The PPE hazard assessment

300

This meeting must happen monthly and a suggested topic is sent out by HSE. A copy of the notes an attendance must be in the binder.

The Health and Safety Meeting

300

This receipt of installation must be kept in tab 9 of the binder.

FDA Forms

300

These two different documents represent a receipt of pickup of both types of waste and must be kept for a minimum of 3 years.

Hazardous waste manifests and Medical waste shipping documents

300

The HSC must be completed by each hospital practice manager how often?

Every fiscal quarter

300

This document must be signed annually by each associate and confirms review of the Banfield safety program.

IIPP acknowledgment

400

This document must be posted in the hospital as well as tab 10 of the binder.

The Emergency Evacuation Plan

400

This document in tab 10, although not required by all states, is created by a physicist and ensures the surrounding area is safe from radiation scatter.

Shielding Plan

400

With the exception of CA, this tab contains a list of hazardous substances that must be disposed of as hazardous waste.

Tab 3

400

This meeting should include a discussion on a safety topic or recent incident and occurs monthly.

The health and safety meeting

400

This document must be signed annually or when there is a change in the ACOS or lead doctor and kept in the radiation binder.

The RSO/ARSO acknowledgment

500

While not mentioned in the TOC of the safety binder, HSE recommends keeping this monthly log document in the back of the binder.

The monthly eyewash log

500

These logs are kept in tabs 6 and 7 of the binder.

Biannual PPE log and quarterly QAQC log

500

This log is completed monthly in most states but weekly in CA and MN.

The hazardous waste inspection log

500

This form must be posted in a common area of the hospital between Feb 1 – April 30

The OSHA 300A form

500

Each hospital should have an associate in charge of safety and they must sign this document annually or when there is a change in associate.

The safety officer acknowledgement and duties form

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