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Guidelines for Selecting Reserve Trees
Book: Provides technical guidance on retaining reserve trees in concert with safe work practices and forest and wildlife management goals. Produced cooperatively by state and federal agencies and industry groups.

Publicación
F417-092-000
 
Competent Person Evaluation - Fall Restraint & Fall Arrest

The employer uses this checklist to determine the person they have designated as a competent person is competent within the description and intent of the fall restraint and fall arrest standard.



Formulario
F417-102-000
 
Competent Person Evaluation - Excavation & Trenching

The employer uses this checklist to determine the person they have designated as a competent person is competent within the description and intent of the excavation and trenching standards.



Checklist
F417-104-000
 
Workplace Violence: Awareness and Prevention for Employers and Employees
Book: Describes four types of workplace violence, outlines steps to minimize and prevent violent acts, and discusses potential risk factors and prevention techniques.

Publicación
F417-140-000
 
Safety and Health Discrimination in the Workplace / Discriminación de seguridad y salud en el lugar de trabajo (English/español)

Poster: Employees have the right to report concerns about safety and health in their workplace. This poster describes "protected activities" under the Washington Industrial Safety and Health Act (WISHA) and explains what an employee should do if he/she has been punished or fired for exercising these rights. Get poster printing tips.

Cartel:  Los empleadores tienen derecho a reportar las inquietudes relacionadas con la seguridad y la salud en el lugar de trabajo.  Este cartel describe  las "actividades protegidas" bajo la Ley de Salud y Seguridad Industrial de Washington (WISHA, por su sigla en inglés) y explica lo que debe hacer un empleado si él/ella ha sido castigado o despedido por ejercer sus derechos.  Obtenga consejos para imprimir carteles.



Cartel
F417-188-909
 
Forklift Safety: Training requirements and helpful tips

Fact sheet: Provides answers to the most-often asked questions about forklift training. Includes a checklist that employer may use to document that employees have been trained and/or evaluated in the required topics.



Publicación
F417-202-000
 
Borrower Agreement Form Safety and Health Video Library

Borrower Agreement Form - To open an account and borrow videos, please fill out this form.



Formulario
F417-205-000
 
Reservation Form Safety and Health Video Library

Use this form to make reservations of safety and health videos. There is both a fillable MS Word form that you can email in, and a fillable PDF that you can fill and print.



Formulario
F417-206-000
 
Personal Protective Equipment (PPE) Guide
Book: This guide helps employers comply with the WISHA Personal Protective Equipment rules. It covers general personal protective equipment and PPE requirements used to protect the head, eyes and face, hand and arm, foot and leg, and body (torso) in most work environments.

Publicación
F417-207-000
 
Fall Protection: Responding to Emergencies
Book: This guide is for employers and for employees who work from exposed, elevated surfaces. It covers the following: what to do to prevent fall-related emergencies and how to respond promptly if a fall-related emergency occurs. Includes illustrations of aided-rescue equipment systems.

Publicación
F417-208-000
 
Keep Your Employees Safe and Working

Pamphlet/booklet: Describes the benefits of free employer consultations offered by L&I's Division of Occupational Safety and Health (DOSH). These services include on-site safety and/or industrial hygiene consultations, ergonomics assistance and risk management advice.



Publicación
F417-209-000

Otro(s) idioma(s):
Español
 
Mantenga a sus empleados seguros y trabajando

Folleto:  Describe los beneficios de las consultas gratis para  empleadores que ofrece la División de Seguridad y Salud Ocupacional (DOSH, por su sigla en inglés) de L&I.  Estos servicios incluyen consultas de seguridad y/o higiene industrial, asistencia de ergonomía y recomendaciones sobre el manejo de riesgos en el sitio de trabajo.



Publicación
F417-209-999

Otro(s) idioma(s):
Inglés
 
A Safe and Healthy Workplace Begins with You
Pamphlet: Provides an overview of employers' responsibilities for workplace safety and health in Washington State. Covers free L&I services, including workplace consultations, online training and prevention resources and required posters. Intended for new businesses or businesses hiring employees for the first time.

Publicación
F417-210-000
 
Jorge's New Job: Cholinesterase Testing in Washington State / Un Nuevo Trabajo para Jorge(English/Spanish)

Pamphlet/booklet: Uses a story format with dialogue and photographs to explain the hazards of cholinesterase-inhibiting pesticides, the state's monitoring program and the importance of using proper safety equipment when working with pesticides.

Panfleto/folleto:  Utiliza un formato de cuento con diálogo y fotografías para explicar los peligros de la colinesterasa, el programa de monitoreo del estado y la importancia del uso adecuado del equipo de seguridad cuando se trabaja con pesticidas.



Publicación
F417-213-909
 
Protect Yourself and Your Family from Lead Poisoning
Pamphlet/booklet: Explains the risks of lead exposure for workers who work on outdoor steel structures, and harmful effects on workers and their families. It includes a poster about the importance of safe work practices and procedures.

Publicación
F417-214-000
 
Heat-related Illness Education Card/ Tarjeta de educación sobre enfermedades relacionadas con el calor (English/español)

Identifies the effects of heat exhaustion and heat stroke on the body and what to do if you observe symptoms. Reviews prevention steps. PDF file is set up for two copies to print at one time.

Tarjeta: Identifica los efectos del agotamiento por el calor y la insolación en el cuerpo y lo que puede hacer si observa estos síntomas. Revisa los pasos para la prevención.  El archivo en PDF está configurado para que se impriman dos copias al mismo tiempo.



Publicación
F417-218-909
 
Voluntary Protection Program (VPP)
Fact sheet: Provides an overview of the VPP, a program that recognizes occupational safety and health excellence. Identifies benefits and includes testimonials from companies awarded VPP status.

Publicación
F417-221-000
 
Safety and Health Investment Projects (SHIP) Grant Program

Booklet: Introduces the SHIP Grant Program and application process. SHIP awards grants for innovative projects that (1) prevent workplace injuries, illnesses and deaths and (2) encourage injured workers to return to work early and reduce long-term disability.



Publicación
F417-224-000
 
Safety for Commercial Dive Teams
Fact sheet: Provides an overview of safety for commercial dive teams, summarizes the key requirements of commercial diving regulations (WAC 296-37), and includes contact information.

Publicación
F417-226-000
 
Safety and Health Program Assessment Worksheet

Safety and Health Program Assessment Worksheet



Formulario
F417-227-000
 
Nail Gun Safety: A Guide for Construction Contractors

Booklet: Gives information needed to prevent nail gun injuries for construction employers.



Publicación
F417-232-000
 
Ergonomics Consultation: Free, Confidential, Powerful Impact on Your Bottom Line

Pamphlet: Provides information to employers interested in a free ergonomics consultation for their business. Explains the importance of workplace ergonomics and how L&I can help to assess injury-causing tasks, and help develop an ergonomics program.



Publicación
F417-233-000
 
Tractor Safety: Rollover Protection and Seatbelts

Pamphlet: Summarizes the safety rules for rollover protective structures (ROPS) and seatbelts on tractors. Also lists exemptions and provides other information about safe operation of tractors.



Publicación
F417-234-000

Otro(s) idioma(s):
Español
 
Seguridad con los tractores: protección contra vuelcos y los cinturones de seguridad

Folleto: Resumen de las reglas de seguridad para la barra protectora contra vuelcos (ROPS, por su sigla en inglés) y los cinturones de seguridad en los tractores. También lista las exenciones y proporciona otra información sobre la operación segura de tractores.



Publicación
F417-234-999

Otro(s) idioma(s):
Inglés
 
Demounting and Mounting Procedures for Tubeless Truck and Bus Tires

Poster for tire and rim servicing. To be displayed with F417-237-000-B Demounting and Mounting Procedures for Tube-type Truck and Bus Tires and F417-237-000-C Multi-piece Rim Matching Chart. This poster must be printed at least 2'x3' in size.



Cartel
F417-237-000-A
 
Multi-piece Rim Matching Chart

Poster for tire and rim servicing. To be displayed with  F417-237-000-A Demounting and Mounting Procedures for Tubeless Truck and Bus Tires and F417-237-000-B Demounting and Mounting Procedures for Tube-type Truck and Bus Tires. This poster must be printed at least 2'x3' in size.



Cartel
F417-237-000-C
 
When a Loved One Dies at Work

Brochure: Provides information to loved ones of workers who died from a job-related injury or illness, including how to apply for survivor benefits. Explains the L&I fatality investigation and how family members can stay informed of the investigation's status.



Publicación
F417-240-000

Otro(s) idioma(s):
Español
 
Cuando un ser querido fallece en el lugar de trabajo

Folleto: Proporciona información para los seres queridos de trabajadores que mueren de una lesión o enfermedad relacionada con el trabajo, incluyendo cómo solicitar beneficios de sobreviviente. Explica la investigación de L&I por una muerte y cómo los miembros de la familia pueden mantenerse informados sobre el estado de la investigación.



Publicación
F417-240-999

Otro(s) idioma(s):
Inglés
 
Workplace Safety and Health Pocket Guide

Pocket guide: Provides links to online information, including safety and health consultations, how to develop a safety program, reporting hazards and injuries, other safety training, and information for teen workers.



Publicación
F417-241-000
 
Preguntas y Respuestas:Comunicación sobre los riesgos químicos

Hoja de información: Proporciona información sobre cambios a los reglamentos federales de comunicación de la Administración de Seguridad y Salud Ocupacional (OSHA, por su sigla en inglés), los cuales causan la necesidad para cambios en la norma del estado de Washington.  Se proyecta que los cambios mejoren el entendimiento de la información de peligro que se encuentra en las etiquetas de los productos para prevenir más efectivamente las lesiones, enfermedades y muertes.



Publicación
F417-242-999

Otro(s) idioma(s):
Inglés
 
Safety and Health Discrimination in the Workplace

Brochure: Employees have the right to report concerns about safety and health in their workplace. This brochure describes "protected activities" under the Washington Industrial Safety and Health Act (WISHA) and explains what an employee should do if he/she has been punished or fired for exercising these rights.



Publicación
F417-244-000

Otro(s) idioma(s):
Español
 
Discriminación de seguridad y salud en el lugar de trabajo

Folleto: Los empleados tienen derecho a reportar sus inquietudes sobre seguridad y salud en sus lugares de trabajo.  Este folleto describe las “actividades protegidas": bajo la Ley de Seguridad y Salud Industrial de Washington (WISHA, por su sigla en inglés) y explica lo que debe hacer un empleado si él/ella es castigado o despedido por ejercer estos derechos.



Publicación
F417-244-999

Otro(s) idioma(s):
Inglés
 
Q&A: Cranes, Rigging and Personnel Lifting Rule, Chapter 296-155 WAC, Part L

Q&A Factsheet: Answers to questions crane or derrik operators/owners might have regarding vehicle/operator certification and training required for cranes and derriks based on possible construction site scenerios.



Publicación
F417-245-000
 
Risk Management Consultation

Pamphlet/booklet: Describes the benefits of free risk management consultations. L&I’s Risk Managers can provide: data and analysis specific to your business that shows how claims can affect the premiums you pay; show you the cost/benefit of claim management strategies; identify return-to-work options and resources; and review best practices in hiring strategies and procedures.



Publicación
F417-246-000
 
2014 Workplace Safety and Health Calendar: Top 12 Hazards that Cause Injuries and Deaths

Calendar: Features real Washington State businesses and employees handling typical workplace hazards and spotlighting the top 12 hazards that cause injuries and deaths. It includes suggested weekly safety and health tips for different hazards, including slips trips and falls, struck by falling objects, burns and more.



Publicación
F417-248-000
 
Logger Safety Initiative Jobsite Notification

Members of the Logger Safety Initiative and landowners use this form to report their jobsite to L&I.



Formulario
F417-249-000
 
Bicycle Safety: Delivery, couriers, and messengers

Fact Sheet: Provides a summary of requirements and tips to ensure the safety of bicycle couriers, bicycle messengers and bicycle delivery riders. Includes a safety checklist.



Publicación
F417-250-000
 
2015 Workplace Safety and Health Calendar: Preventing Sprains and Strains - Washington’s Leading Workplace Injury

Calendar: Features real Washington State businesses and employees in jobs where sprains and strains are most common. The calendar includes suggested weekly safety and health tips for preventing sprains and strains to the neck, shoulders, back, hands/wrists, knees, and elbows.



Publicación
F417-251-000
 
Fall Hazards: Standing Walls - Highlights of Fall Protection Requirements

Safety Topic fact sheet: Describes the fall hazards workers are exposed to while framing, erecting and raising walls without using fall protection. Includes photos, safety requirements and different methods of fall restraints and fall arrest systems.



Publicación
F417-252-000
 
Employee Misconduct: Information for Employers

Fact Sheet: This publication is intended to help employers understand how the Department of Labor & Industries (L&I) and Employment Security Department (ESD) take employee misconduct into account when making decisions about workplace safety and health violations or unemployment benefits.

Contact:
L&I: Terry Walley
360-902-4758, Terry.Walley@Lni.wa.gov
ESD: Unemployment Benefits Employer Hotline
1-877-504-5607



Publicación
F417-254-000
 
Agriculture Safety and Health Pocket Guide

This durable, compact pocket guide is an easy reference guide to safety and health hazards and accident prevention practices for many aspects of agricultural work. It is intended for use in the field by workers and employers in the state of Washington to help them work safely and be in compliance with state regulations.

This guide does not replace any of the requirements in the actual regulations and should only used as a companion to the actual regulations.



Publicación
F417-255-000
 
2016 Workplace Safety and Health Calendar: Safety and Health Never Goes Out of Style

Calendar: "Safety and Health Never Goes Out of Style," the Department of Labor & Industries' 2016 workplace safety and health calendar, is now available. This calendar features vintage posters created in the 1960s and 70s by graphic artists at L&I. The artists used humor and attention-grabbing illustrations to depict typical workplace hazards. The safety and health theme is "Focus on FACTS" to prevent the leading causes of worker fatalities, serious injuries and occupational disease. Each month features a vintage poster, a safety workplace message and five safety tips.



Publicación
F417-256-000
 
Q&A: Emergency Washing Requirements for Pesticide Handlers

Fact Sheet: Produced in collaboration with the Washington State Department of Agriculture, this fact sheet answers questions about emergency washing requirements for pesticide handlers. It includes information about when emergency washing is required, how much water is necessary, emergency eyewash, access to water in remote areas and more.



Publicación
F417-257-000

Otro(s) idioma(s):
Español
 
Preguntas y respuestas: Requisitos de lavado de emergencia para trabajadores agrícolas que aplican y manejan pesticidas

Hoja de información: Elaborada en colaboración con el Departamento Estatal de Agricultura del estado de Washington, responde a preguntas acerca de los requisitos de lavado de emergencia para trabajadores agrícolas que aplican pesticidas. Incluye información de cuando se requieren los lavados de emergencia, cuanta agua es necesaria, lavados para los ojos en casos de emergencia, acceso al agua en áreas remotas y más. 



Publicación
F417-257-999

Otro(s) idioma(s):
Inglés
 
Application for Copies of Citation and Notice

Used by an employee to apply for copies of citation and notices issued to their employer.



Formulario
F418-023-000
 
Alleged Safety Or Health Hazards (DOSH Complaint Form)

Employees use this form to report work place conditions which jeopardize workers safety and health.



Formulario
F418-052-000

Otro(s) idioma(s):
Español
 
Presuntos riesgos de Salud y Seguridad (Formulario de queja de la División de Seguridad y Salud Ocupacional)

Los empleados usan este formulario de queja para reportar las condiciones de trabajo que ponen en peligro la seguridad y salud de los trabajadores.



Formulario
F418-052-999

Otro(s) idioma(s):
Inglés
 
Construction Checklist - Safety

Safety checklist for fall protection, ramps, stairways, ladders, trenches, excavations, scaffolds, personal protective equipment (PPE), electrical and chemical.



Checklist
F418-055-000
 
Application for Amusement Ride or Air Supported Structure Operating Permit

To apply for a decal for an amusement ride or air supported structure.



Formulario
F500-010-000
 
Application for Electrical Contractors License

Application used to get an electrical contractors license



Formulario
F500-018-000
 
Electrical/Telecommunications Contractor's Bond to the State of WA

Used to show proof of a bond in the State of Washington.



Formulario
F500-019-000
 
Electrical/Telecommunications Contractor Assignment of Savings Account

This is used to assign ownership interest to a savings account that is held by L&I for one year after a contractor's license has expired or after the contractor ceases business in Washington State.



Formulario
F500-020-000
 
Request for Duplicate or Replacement License or Certificate

To request a duplicate or replacement of your Washington state electrical license or certificate.



Formulario
F500-032-000
 
Chapter 19.28 RCW - Electricians and Electrical Installations

Simplified version of the Chapter 19.28 RCW - Electricians and Electrical Installations Rules



Manual
F500-039-111
 
Electrical Safety Standards,Administration, and Installation WAC 296-46B

Electrical Safety Standards,Administration, and Installation WAC 296-46B



Manual
F500-039-222
 
Administrator / Electrician / Master Electrician Certificate Renewal

To renew your electrical certificate. Fee varies depending on renewal type.



Formulario
F500-045-000
 
Application to Establish an Account and Access to L&I's Electrical Permit & Inspection System (EPIS) with L&I's Miscellaneous Accounts

To request access to L&I's EPIS - Miscellaneous Accounts



Formulario
F500-054-000
 
Application to Access L&I's Electrical Permit and Inspection System (EPIS) from SecureAccess Washington and Utilize Contractor Deposit Account via the Internet

To establish a contractor deposit account by an electrical contactor or registered construction contractors who are legally required to purchase electrical work permits from L&I.



Formulario
F500-055-000
 
Electrical Installation Variance Application

To apply for a variance which is an allowable deviation from specific requirements of a National Electrical Code section, or the WAC 296-46B where the proposed alternate methods will maintain equivalent safety.



Formulario
F500-063-000
 
Application for Amusement Ride Inspector Certification

Application to be certified as an amusement ride inspector.



Formulario
F500-065-000
 
Electrical Education Course Application

Used to get approval of a course as an electrical continuing education class. This application must be received by L&I at least 30 days before the course is offered.



Formulario
F500-068-000
 
Reassignment of Savings Account or Time Deposit - Electrical Contractor

A reassignment is permitted only when (1) the Electrical Contractor (assignor) changes the name of the business; (2) the Electrical Contractor transfers the funds to a new account; or (3) the financial institution changes the account number.



Formulario
F500-072-000
 
Electrical / Telecommunication Contractor's License Renewal Notice

This form is used to notify you that your license will expire and for you to use to renew your license.



Formulario
F500-077-000
 
Electrical Work on Residential Property: What You Should Know Before Work Begins

Fact Sheet: Explains to property owners the importance of electrical permits, inspections and approvals. An electrical permit is required for most new, remodel and maintenance electrical work.



Publicación
F500-078-000
 
Account Deposit for Contractor's or Miscellaneous Account Holder's

Used to deposit money into your L&I account (Electrical).



Formulario
F500-080-000
 
Electrical Inspection Witness Statement

Used to gather information from a person who was a witness to electrical work that is being investigated by L&I.



Formulario
F500-087-000
 
Application for Master Electrician Certification Examination

Use this form to apply for the master electrician exam.



Formulario
F500-088-000
 
Electrical Continuing Education Instructor Application

An application to receive approval from L&I to instruct electrical continuing education courses.



Formulario
F500-090-000
 
Contractor Electrical Work Permit Application

This application is used to apply for a valid electrical permit from L&I. 4 pages.



Formulario
F500-093-000
 
Property Owner Electrical Work Permit Application

This application is used to apply for a valid electrical permit. 5 pages.



Formulario
F500-094-000
 
Application for a 0% Supervision Modified Electrical Training Certificate & Specialty Examination

Covers 03A, 06B, 07A, 07B, 07C, 07D, 07E, and 10 specialty licenses.



Formulario
F500-097-000
 
Application for Specialty Electrician Certificate

Application and instructions for the specialty electrician certificate for 03A, 06B, 07A, 07B, 07C, 07D, 07E and 10. Eligibility granted through modified supervision requirements of RCW 19.28.191(1)(g)(ii)



Formulario
F500-098-000
 
Application for Accreditation of Engineer to Approve Industrial Utilization Equipment

Used by an Engineer to apply for accreditation by L&I to approve unlisted equipment.



Formulario
F500-101-000
 
Application for Pump Installer Combination General Contractor Registration and Electrical Contractor License

Used for creating combination electrical and plumbing contractors license



Formulario
F500-104-000
 
Electrical Work on Commercial Property: What You Should Know Before Work Begins
Fact Sheet: Explains to commercial property owners the importance of electrical permits, inspections and approvals. An electrical permit is required for most new, remodel and maintenance electrical work.

Publicación
F500-109-000
 
Questions and Answers about Electrical Safety
Fact Sheet: Answers questions about training and certification/licensing requirements for those who perform electrical installations, and electrical work that requires a permit and inspection.

Publicación
F500-110-000
 
Before Electrical Sign Work Begins: What Electrical Sign Contractors and Electricians Should Know
Fact Sheet: Explains work that is allowed and not allowed under (04) Sign Scope of Work and what electrical sign contractors and electricians should know before doing sign work. Also covers electrical Class B labels and electrical permits, inspections and fees.

Publicación
F500-111-000
 
Class B Labels: What You Should Know

Fact Sheet: Explains Class B label electrical work, scope and limitations, and provides general instructions for using Class B labels.



Publicación
F500-112-000
 
Online Electrical Services: Tools for Property Owners, Contractors and Electricians
Fact Sheet: Describes the online services available from L&I's Electrical Program, including URLs for different topics covered on the Web, how to sign up for the Electrical listserv (to receive updates by e-mail), and how to sign up for the monthly e-newsletter, also provided by e-mail.

Publicación
F500-113-000
 
Electrical Program Contacts

Fact Sheet: Provides information for requesting electrical inspections, including telephone numbers and locations of L&I offices that handle electrical inspections.



Publicación
F500-114-000
 
Electrical Safety Tips for Your Home: Protect Your Family and Your Property

Brochure: Provides information to help consumers properly handle electrical equipment and appliances, know the required permits and inspections for electrical work, and verify licenses and certifications before having electrical work performed.



Publicación
F500-115-000
 
Green Power Generation System Installation: What You Should Know Before Doing Any Electrical Work
Fact sheet: Explains that an electrical permit and inspection are required for most new, remodel, and maintenance electrical work. Provides information specific to the installation of green power generation systems.

Publicación
F500-116-000
 
How to Become a Certified Electrician: What You Need to Know about Certification in Washington State
Fact sheet: Provides information about getting a trainee card and outlines the electrical training and experience required to be certified as an electrician in Washington State.

Publicación
F500-117-000
 
An Annual Electrical Permits Saves Time and Money. Would it Work for You?

Flier: Describes when facility operators/owners qualify for an annual electrical permit.



Publicación
F500-123-000
 
Electrical Telecommunication Principal Member Owner Update Request

Electrical Telecommunication Principal Member Owner Update Request



Formulario
F500-124-000
 
Request for Letter of Good Standing

This form is used by electricians to request the agency send a letter of good standing for all electrical hours/experience from Washington State.



Formulario
F500-128-000
 
Application for Telecommunications Contractor's License

Application used to get an telecommunications contractors license.



Formulario
F503-008-000
 
Non-Compliance Report - Boiler & Pressure Vessel Inspection

Used by L&I inspectors when a boiler or pressure vessel does not pass inspection. You can only mail or fax this form to L&I. E-mailed forms are NOT accepted.



Formulario
F620-012-000
 
Board of Boiler Rules Interpretation and Revision Request Form

Used to submit written requests for interpretations and revisions to the definitions, rules and regulations found in WAC 296-104. These must be submitted 45 days prior to the Board of Boiler Rules Meeting date. F620-056-000 Chief Inspector Clarification and Interpretation Request Form must be submitted before using this form.



Formulario
F620-017-000
 
Operating Boilers Safely
Fact sheet: Explains what you need to know to keep your boilers and pressure vessels operating safety. Provides an overview of inspection requirements, frequency and fees.

Publicación
F620-025-000
 
Shop and Field Inspection Report

Used by L&I inspectors when they inspect boilers.



Formulario
F620-027-000
 
Boiler / Pressure Vessel Water Heater Installation or Reinstallation Permit
This form is filled out by the installer, contractor and/or owner who wants to install or reinstall a boiler.

Formulario
F620-032-000
 
Application for Certificate of Competency as an Inspector of Pressure Retaining Items

To apply for a certificate of competency as an Inspector of Pressure Retaining items. You can only mail or fax this form to L&I. Emailed forms are not accepted. NOTE: Applications MUST be received no later than 30 days prior to the exam date. Incomplete applications WILL NOT be accepted.



Formulario
F620-040-000
 
Boiler/Pressure Vessel Clearance Variance Request

To request a clearance variance on a boiler or pressure vessel. You can only mail or fax this form to L&I. E-mailed forms are not accepted.



Formulario
F620-041-000
 
Rental Boiler Operating Permit - Good at this Location Only

To request a permit to use a rental boiler at one location only.

Allow 24 hours for a response. Accuracy and completeness speeds up the processing time.



Formulario
F620-042-000
 
Historical Boilers Inspection Guideline

Inspection sheet for boiler inspectors. 4 pages.



Formulario
F620-043-000
 
Incident Report Boiler or Pressure Vessel

Used for the reporting of incident with boilers or a pressure vessels.



Formulario
F620-044-000
 
Pre-Inspection Checklist for Hot Water Heating or Hot Water Supply Boilers

Checklist which reflects the most common violations encountered by Field Inspectors. This checklist should be gone through prior to requesting inspection of Hot Water Heating or Hot Water Supply Boilers



Checklist
F620-050-000
 
Pre-Inspection Checklist for Potable Water Heaters - ASME "HLW" Stamped Water Heaters

Checklist which reflects the most common violations found by Field Inspectors. This checklist should be gone through prior to calling for an inspection of Potable Water Heaters-HLW



Checklist
F620-051-000
 
Pre-Inspection Checklist for Low Pressure Steam Boilers

Checklist which reflects the most common violations found by Field Inspectors. This checklist should be gone through prior to calling for an inspection of Low Pressure Steam Boilers



Formulario
F620-052-000
 
Pre-Inspection Checklist for High Pressure Boilers

Checklist which reflects the most common violations found by Field Inspectors. This checklist should be gone through prior to calling for an inspection of High Pressure Boilers



Formulario
F620-053-000
 
Apprenticeship Applicant Register
Example: Used for tracking applicants for an apprenticeship program. Registered Apprenticeship Programs use their own forms.

Formulario
F100-045-000
 
Board of Boiler Rules Extension of Inspection Frequency Request Form

Board of Boiler Rules Extension of Inspection Frequency Request Form



Formulario
F620-055-000
 
Chief Inspector Clarification and Interpretation Request Form

Form is used to ask the Chief Inspector to consider written requests for clarification and interpretation to the definitions, rules and regulations in WAC 296-104. Thsi form must be completed before F620-017-000 Board of Boiler Rules Interpretation and Revision Request form can be submitted.



Formulario
F620-056-000
 
Claim for Pension by Spouse or Children
Used by a spouse or dependents of a deceased worker. The workers' fatal accident or occupational disease incurred in the course of their employment. This application is needed to determine if applicant(s) is/are entitled to a survivor benefit.

Formulario
F242-056-000

Otro(s) idioma(s):
Español
 
Board of Boiler Rules Washington State Specials Request Form

Board of Boiler Rules Washington State Specials Request Form



Formulario
F620-057-000
 
Faulty Water Heaters and Kids Don't Mix
Fact sheet: Designed for operators of childcare facilities, this fact sheet explains the importance of keeping boilers and pressure vessels operating safety. Provides an overview of inspection requirements, frequency, and fees.

Publicación
F620-059-000
 
Vocational Technical Stakeholder Group (VTSG) Application

This form is for recruiting private sector vocational counselors to be on the Vocational Technical Stakeholder Group (VTSG). The form is made available on the department’s vocational website when recruiting for new members to assist the department in addressing vocational issues and formulating policy. Prospective applicants are expected to download, sign, and return the form to PSRS for consideration.



Formulario
F280-049-000
 
Physical Exam - Charter Boat Operators License

This form is used by applicants applying for a charter boat operators license to have completed by a physician for an operators license



Formulario
F416-056-000
 
Inservice Inspection checklist

Inservice Inspection checklist for power boilers, low pressure boilers, pressure vessels, and hot water boilers.



Formulario
F620-060-000
 
Charter Vessel Inspection

Form used for the applicant to complete a Certification of Inspection of a charter boat.



Formulario
F416-058-000
 
Construction Elevator Installation Application and Inspection Data Report

Used by companies to apply for an Construction Elevator (Hoist) at a job site. One application per car and companies need to contact the Elevator Section for the appropriate installation and operating fee.

Allow two weeks for a response. Accuracy and completeness speeds up the processing time.



Formulario
F621-001-000
 
Application for Self-Insurance Certification

Used by employers to apply for self-insurance certification.



Formulario
F207-001-000
 
Elevator Permit Application

Used for installation application for elevators (new, renewals, and alterations).

For New Installations: Allow 30 business days for a response.

For Alterations: Allow 14 business days for a response.

Accuracy and completeness speeds up the processing time.

Residential Incline Chair Lifts: Allow one week for a response.



Formulario
F621-005-000
 
Construction Contractor's Application for Workers' Compensation Account with No Workers or Hours

Used by employers with no employees or worker hours to report but need an open account for contract bidding process.



Formulario
F625-077-000
 





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