Report Form

Labour and Immigration Workplace Safety and Health 200-401 York Avenue, Winnipeg, Manitoba, Canada R3C 0P8 T 204-945-1947 F 204-948-2209 daf.francisco@gov.mb.ca www.safemanitoba.com

Employer Site Name (or Person) Selkirk Chrysler Site Description MOTOR VEHICLE DEALERS

Employer Mailing Address 1011 Manitoba Ave City/Town/Municipality, Province Postal Code Selkirk, MB R1A 3T7 Country Canada Worksite Location (if different than above) 1011 Manitoba Ave Selkirk, MB Management WSH Committee/Rep Contact Carmen Walker Worksite Management Contact Tacy Smith Worker WSH Committee/Rep Contact

Safety & Health Committee

Yes

No

Phone Number: 482-5808 Fax Number: 785-2739 Worker Representative Number of Workers 22 Union or Association Name Yes No

Worksite Worker Contact Bob Kosc

On December 5th the undersigned Officer attended the above worksite location to inspect the indoor air quality of the workplace. Using a Drager XAM 7000 sn0570 gas monitor the following levels were detected: Area CO(Carbon Monoxide) NO2 Nitrogern Dioxide Sales (Front Office) 0 ppm 0 ppm Parts & Drive Through Garage 3 ppm 0 ppm Mechanical Garage 4 ppm 0 ppm The above indoor air quality were within the MB Workplace Safety & Health Regulation and Guideline for indoor air quality. There were 2 digital CO monitors interlocked with the ventilation system. Parts & Drive Through Garage will alarm at 12 ppm and ventilation will kick-in to minimize the CO exposure levels. Mechanical Garage will alarm at a 15 ppm and ventilation will kick-in to minimize the CO exposure levels. ----------------------------------------------------------------

Nitrogen Dioxide, a TLV-TWA of 0.2ppm for 8 hours is recommended standard for occupational exposure in Manitoba to minimize the potential for ocular, mucous membrane, and respiratory tract irritation. Carbon Monoxide, a TLV-TWA of 25ppm for 8 hours is recommended standard for occupational exposure in Manitoba to maintain blood carboxyhemoglobin(COHb) levels below 3.5%, to minimize the

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potential for nausea, headaches, and dizziness.

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Carbon Dioxide(CO2), outdoor exposure level range is 300ppm 400ppm. CO2 is the fresh air indicator, a TLV-TWA of 5000ppm for 8 hours, is the recommended standard for occupational exposure in Manitoba to minimize the potential for headaches, dizziness and restless.

This Report Form has been discussed with the undersigned, and a copy given to each on 05 December 2013 at 11:25 The following documents must be posted at the workplace: a copy of any report or document applicable to the workplace, as issued or recommended by a safety and health officer.

Signed: Employer's Representative and Title Workers Representative - Safety and Health

Daf Francisco

- Occupational Hygienist