SCREENING REPORT

AUTHORITY: Not applicable.

POLICY: It is the policy of the Division of Occupational Safety and Health to report summary information about screening samples collected by compliance personnel on the Screening Report, OSHA Form 98.

PROCEDURES:

A. USE

1. The Screening Report is used to report summary information about screening samples to the IMIS. See Attachment A.

   ^{NOTE: Screening samples include any samples taken as input into the decision of whether or how to perform full shift or other sampling to document exposures.}

2. The primary purpose of the OSHA Forms 91, 92 and 93 is to provide a record of potential violations of health standards. The Screening Report summarizes the results of samples taken as input into decisions relating to the presence of a hazard, preliminary to the actual documentation of a violation, e.g., whether and how to perform full shift sampling or whether to make a referral.

3. Compliance personnel shall complete and submit an OSHA Form 98 to OMDS whenever screening samples are taken during an inspection by summarizing the results of all screening sampling for that inspection.

   ^{NOTE: Screening sampling can include noise screening, but excludes measurements of combustible gases, ventilation, or similar conditions.}

4. Original documentation of screening samples may be recorded in whatever manner compliance personnel find convenient, e.g., the Direct Reading Report, OSHA Form 93, on a field diagram or in field notes.

B. OFFICE PROCEDURES

1. Compliance personnel shall complete the OSHA Form 98 according to the instructions set forth in Section D.

   ^{NOTE: If more space is required, compliance personnel shall use additional OSHA Form 98s. On each additional OSHA Form 98, compliance personnel shall mark through the pre-printed Sampling Number and enter the Sampling Number from the first form used. Complete Items 6-11 as necessary, renumbering the line numbers in Item 6. Use as many OSHA Form 98s as are necessary and staple the forms together before submitting them to OMDS.}

2. After completion of the OSHA Form 98, compliance personnel shall give the Form 98 to Office Support Staff for submission to OMDS for data entry.

C. FORM DISTRIBUTION

1. Office Support Staff shall meet each Form 98 to OMDS when they receive the Form 98 from compliance personnel.

2. The original OSHA Form 98 shall be placed in the employer case file.

D. FORM COMPLETION

MOD/Date

Complete this item only when it is necessary to change an OSHA Form 98 previously submitted to OMDS. If modifications to the Form 91(S) are made, compliance personnel shall mark the modifications in red ink on the Form 91(S), enter "M" in the MOD box, enter the date of the modification in the "DATE" box and give the modified Form to Office Support Staff for submission to OMDS.

1. Reporting ID

   Enter the Reporting ID of the submitting office.

2. Inspection Number

   The Inspection Number from the related Cal/OSHA Form 1.

3. Sampling Number

   This is a preprinted number unique to each OSHA Form 98 which identifies each summary of screening data. This number must always be used when modifying the information on a sampling form.

4. Establishment Name

   Enter the name of the establishment as it appears on the Cal/OSHA Form 1.

5. Sampling Date

   Enter the month, day and year the screening samples were taken. If screening samples were taken on more than one day, enter the first day.

6. Line Number

   A sequential number used to identify individual groups of screening data in the computer record. Refer to this number to identify individual records for modifications or retrieval.

7. Substance Code

   Enter the appropriate hazardous substance code. See Attachment E of P&P C-170 & 170A.

8. Number Screens Taken

   Enter the total number of screening samples taken, e.g., the total number of detector tubes pulled, for the substance or agent identified in Item 7.

9. Highest Exposure Level

   Enter the "highest" level measured for the substance or agent identified in Item 7.

10. Units

    Enter the appropriate code from the following list to indicate the unit of measure in which the Highest Exposure Level is expressed for the substance identified in Item 9.

    ^{B=Decibels
    C=Picocuries per liter (radon)
    D=Milligrams per deciliter (blood)
    F=Fibers per cubic centimeter
    G=Million particles per cubic foot
    L=Milligrams per liter (urine)
    M=Milligrams per cubic meter
    P=Parts per million
    R=Millirems
    U=Milliwatts per square centimeter
    W=Milliwatts
    %=Percentage
    0=Specify Unit(s)}

    ^{NOTE: If the highest exposure level is expressed in micrograms, it must be converted to milligrams before submittal to OMDS.}

11. Total Number of Lines Used

    Enter the total number of line entries reported for this case. If multiple pages are used, enter on the FIRST page the total number of lines entered on all related pages of the OSHA Form 98, then leave this item blank on all the subsequent pages.

    Case File Page

    Enter the page number of this form after the case file has been organized.

Attachment: OSHA 98