NORTH CAROLINA
REGISTER
VOLUME 12 • ISSUE 5 • Pages 334 - 442
eptember 2, 1997
SEP 1997
i '^vv*"
i
fl
IN THIS ISSUE
Revenue - Tax Review Board '
l
Voting Rights Letters
Environment, Health, and Natural Resources
Human Resources
Labor
Nursing, Board of {t
Psychology Board '
*'
Public Education
Speech and Language Pathologists & Audiologists
Transportation
Rules Review Commission '
Contested Case Decisions
PUBLISHED BY
The Office ofAdministrative Hearings
Rules Division
PO Drawer 27447
Raleigh, NC 27611-7447
Telephone (919) 733-2678
Fax (919) 733-3462
This publication is printed on permanent, acid-free paper in compliance with G.S. 125-1 1.13
Digitized by the Internet Archive
in 2011 with funding from
University of North Carolina at Chapel Hill
http://www.archive.org/details/northcarolinareg125nort
NORTH CAROLINA IN THIS ISSUE
Volume 12, Issue 5
Pages 334 - 442
I. IN ADDITION
Voting Rights Letters 334-335
Revenue
Tax Review Board 336
n. RULE-MAKING PROCEEDINGS
Environment, Health, and Natural Resources
Wildlife Resources Commission 337
Human Resources
Medical Assistance 337
Licensing Boards
Nursing, Board of 338
Psychology Board 338
Transportation
Highways, Division of 337 - 338
September 2, 1997
This issue contains documents officially filed
through August 12, 1997.
in. PROPOSED RULES
Environment, Health, and Natural Resources
Environmental Management Commission 414-418
Marine Fisheries Commission 418 - 426
Human Resources
Medical Care Commission 339 - 354
Labor
Occupational Safety & Health, Division of 354 - 414
Licensing Boards
Speech and Language Pathologists and
Audiologists, Board of Examiners 427 - 430
Office of Administrative Hearings
Rules Division
424 North Blount Street (27601)
PO Drawer 27447
Raleigh, NC 27611-7447
(919) 733-2678
FAX (919) 733-3462
Julian Mann III, Director
James R. Scarcella Sr., Deputy Director
Molly Masich, Director of APA Services
Ruby Creech, Publications Coordinator
Jean Shirley, Editorial Assistant
Linda Richardson, Editorial Assistant
IV. TEMPORARY RULES
Environment, Health, and Natural Resources
Marine Fisheries Commission 431 - 433
Public Education
Elementary & Secondary Education 433 - 434
V. RULES REVIEW COMMISSION 435-437
VI. CONTESTED CASE DECISIONS
Index to ALJ Decisions 438 - 441
VII. CUMULATIVE INDEX 1-43
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IN ADDITION
This Section contains public notices that are required to be published in the Register or have been approved by the Codifier
of Rules for publication.
IKP:DHH:ALP:tlb
DJ 166-012-3
97-1496
U.S. Department of Justice
Civil Rights Division
Voting Section
P.O. Box 66128
Washington. D. C. 20035-6128
July 25, 1997
Jesse L. Warren, Esq.
City Attorney
P.O. Box 3136
Greensboro, North Carolina 27402-3136
Dear Mr. Warren:
This refers to four annexations (Ordinance Nos. 97-63, 97-65, 97-66 and 97-69) and their designation to districts of the
City of Greensboro in Guilford County, North Carolina, submitted to the Attorney General pursuant to Section 5 of the Voting
Rights Act, 42 U.S.C. 1973c. We received your submission on May 28, 1997.
The Attorney General does not interpose any objection to the specified changes. However, we note that Section 5 expressly
provides that the failure of the Attorney General to object does not bar subsequent litigation to enjoin the enforcement of the
changes. See the Procedures for the Administration of Section 5 (28 C.F.R. 51.41).
Please be advised that it is imnecessary to provide multiple copies of documents when making a Section 5 submission.
Sincerely,
Isabelle Katz Pinzler
Acting Assistant Attorney General
Civil Rights Division
By:
Elizabeth Johnson
for Chief, Voting Section
12:5 NORTH CAROLINA REGISTER September 2, 1997 334
IN ADDITION
U.S. Depanment of Justice
Civil Rights Division
IKP:DHH:NT:tlb Voting Section
DJ 166-012-3 P.O. Box 66128
97-1494 Washington. D.C. 20035-6128
97-2027
July 28, 1997
David A. Holec, Esq.
City Attorney
P.O. Box 7207
Greenville, North Carolina 27835-7207
Dear Mr. Holec:
This refers to ten annexations (Ordinance Nos. 97-25, 97-31, 97-33, 97-34, 97-45, and 97-52 through 97-56) and theii
designation to districts of the City of Greenville in Pitt County, North Carolina, submitted to the Attorney General pursuant to
Section 5 of the Voting Rights Act, 42 U.S.C. 1973c. We received your submissions on May 28 and July 14, 1997.
The Attorney General does not interpose any objection to the specified changes. However, we note that Section 5 expressly
provides that the failure of the Attorney General to object does not bar subsequent litigation to enjoin the enforcement of the
changes. In addition, as authorized by Section 5, we reserve the right to reexamine these submissions if additional information that
would otherwise require an objection comes to our attention during the remainder of the sixty-day review period. See the
Procedures for the Administration of Section 5 (28 C.F.R. 51.41 and 51.43).
Sincerely,
Isabelle Katz Pinzler
Acting Assistant Attorney General
Civil Rights Division
By:
Elizabeth Johnson
for Chief, Voting Section
335 NORTH CAROLINA REGISTER September 2, 1997 12:5
IN ADDITION
STATE OF NORTH CAROLINA
COUNTY OF WAKE
IN THE MATTER OF:
The Denial of Sales and Use Tax Claims for
Refund for the period of January 10, 1990 through
August 21, 1992, by the Secretary of Revenue against
Inacom Business Centers, Inc.
BEFORE THE
TAX REVIEW BOARD
ADMINISTRATIVE
DECISION NUMBER: 334
THIS MATTER was heard before the Tax Review Board (hereinafter "Board") on Tuesday, April 22, 1997, in the office
of the State Treasurer in the City of Raleigh, Wake County, North Carolina. It involved a Petition for administrative review filed by
Inacom Business Centers, Inc. (hereinafter "Taxpayer") from the Final Decision of Michael A. Hannah, Assistant Secretary for Legal
and Administrative Services for the Department of Revenue (hereinafter "Assistant Secretary") entered on August 23, 1996, denying
Taxpayer's request for refund of sales taxes collected upon the sales of computer software for the period of January 10, 1990 through
August 21, 1992.
Chairman Harlan E. Boyles, State Treasurer presided over the hearing with ex officio member, Jo Anne Sanford, Chairman,
Utilities Commission and duly appointed member, Noel L. Allen, attorney at law.
Gerald Johnson, Wilma Ross and Dell Evans appeared at the hearing on behalf of the Taxpayer; George W. Boylan, Special
Deputy Attorney General, appeared on behalf of the Department of Revenue. Pursuant to G.S. §1 05-24 1.2(bl), the Tax Review Board
conducted the hearing upon review of the petition, the final decision, the record, the brief and documents filed in this matter.
The scope of administrative review for petitions filed with the Tax Review Board is governed by G.S. §1 05-24 1.2(b2). After
conducting a hearing, G.S. §1 05-24 1.2(b2) states in pertinent part that:
(b2)... "the Board shall confirm, modify, reverse, reduce, or increase the assessment or decision
of the Secretary."
AND IT APPEARING TO THE BOARD: after review of the petition, the final decision, the record, the brief and documents
filed in this matter, and upon carefully considering the arguments presented that the findings of fact made by the Assistant Secretary
were fully supported by competent evidence in the record, that the conclusions of law made by the Assistant Secretary were fully
supported by the findings of fact, and that the decision by the Assistant Secretary was fully supported by the conclusions of law;
IT IS THEREFORE ORDERED that the Final Decision of the Assistant Secretary is CONFIRMED in every respect.
Entered this the 6th day of August, 1997.
TAX REVIEW BOARD
/s/Harlan E. Boyles, Chairman
State Treasurer
/s/Jo Aime Sanford
Chairman, Utilities Commission
/s/Noel L. Allen, member
a2:5 NORTH CAROLINA REGISTER September 2, 1997 336
RULE-MAKING PROCEEDINGS
A Nonce ofRule-making Proceedings is a staiement ofsubject matter of the agency 's proposed rule making. The agency must
publish a notice of the subject matter for public comment at least 60 days prior to publishing the proposed text of a rule.
Publication of a temporary rule ser\'es as a Notice of Rule-making Proceedings and can be found in the Register under the
section heading of Temporary Rules. A Rule-making Agenda published by an agency senses as Rule-making Proceedings and
can be found in the Register under the section heading of Rule-making Agendas. Statutory reference: G.S. 150B-2L2.
TITLE 10 - DEPARTMENT OF HUMAN
RESOURCES
CHAPTER 26 - MEDICAL ASSISTANCE
^^otice of Rule-making Proceedings is hereby given by the
DHR - Division of Medical Assistance in accordance wth
G.S. 150B-21.2. The agency shall subsequently publish in the
Register the text of the rule(s) it proposes to adopt as a result
of this notice of rule-making proceedings and any comments
received on this notice.
Citation to Existing Rules Affected by this Rule-Making:
15A NCAC 1OF. 0330 and .0339 - Other rules may be proposed
in the course of the rule-making process.
Authority for the rule-making: G.S. 75A-3; 75A-15
Statement of the Subject Matter:
15A NCAC lOF .0330 - Amendment to modify' provisions for
placement and maintenance of markers.
15.A NCAC lOF .0339 - Amend no wake zone at Lake Viev,
Pointe in McDowell Countw
Citation to Existing Rules Affected by this Rule-Making:
10 NCAC 26K .0006 - Other rules may be proposed in the
course of the rule-making process.
Authority for the rule-making:
42 C.F.R. 447.15
G.S. 108A-25(b): 108A-54;
Statement of the Subject Matter: Lists conditions for which
providers can bill Medicaid recipients. Clarifies patient
liability for the cost of care, when managed care patient
knowingly seeks out-of-network care.
Reason for Proposed Action: Providers have expressed
confusion about the apparem conflict in 10 NCAC 26M .0203
and 10 NCAC 26K .0006 regarding patient liability for the cost
of care.
Comment Procedures: Written comments concerning this
rule-making action must be submitted by November 3, 1997, to
Portia W. Rochelle, Rule-making Coordinator, Division of
Medical Assistance, 1995 Umstead Drive, Raleigh, NC 27603.
TITLE ISA - DEPARTMENT OF ENVIRONMENT,
HEALTH, AND NATURAL RESOURCES
CH.APTER 10 - WILDLIFE RESOLUCES
•ANT) W ATER SAFETY
SL^CHAPTER lOF - NIOTORBOATS AND
WATER SAFETY
A Jotice of Rule-making Proceedings is hereby given by the
1 y North Carolina Wildlife Resources Commission in
accordance with G.S. 150B-21.2. The agency shall
subsequently publish in the Register the text of the rule(s) it
proposes to adopt as a result of this notice of rule-making
proceedings and any comments received on this notice.
Reason for Proposed Action:
congested area.
To regulate boat speed in
Comment Procedures: The record will be open for receipt oj
written comments from September 2, 1997 through November
2, 1997. Such written comments nrnst be delivered or mailed
to the North Carolina Wildlife Resources Commission, 512 N.
Salisbury Street, Raleigh, NC 27604-1188.
TITLE 19A - DEPARTMENT OF
TRANSPORTATION
CHAPTER 2 - DIVISION OF HIGHWAYS
SUBCHAPTER 2E - MISCELLANEOUS
OPERATIONS
\ Jotice of Rule-making Proceedings is hereby given by the
1 V North Carolina Department of Transportation - Division oj
Highways in accordance with G.S. 150B-21.2. The agency
shall subsequently publish in the Register the text of the rule(s)
it proposes to adopt as a result of this notice of rule-making
proceedings and any comments received on this notice.
Citation to Existing Rules Affected by this Rule-Making
19A NCAC2E .0218 - .0222 - Other rules may be proposed in
the course of the rule-making process.
Authority for the rule-making: G.S. 136-13; 136-137; 136-
89.56: 143B-348; 143B-350(f); 23 C.F.R. 750 Subpart A; 23
U.S.C 131(f)
Statement of the Subject Matter: Rules set out parameters
and conditions for the Logo Signing Program.
Reason for Proposed Action: Rules are proposed for
atyiendmem to clarify existing language for legal interpretation
337 NORTH CAROLINA REGISTER September 2, 1997 12:5
change criteria for participation in program, and set
standardized fees for program signs.
Comment Procedures: Any interested person may submit
written comments on the proposed rules by mailing the
comments to Emily Lee, Department of Transportation, P.O.
Box 25201, Raleigh, NC 27611, within 30 days after the
proposed rules are published.
RULE-MAKING PROCEEDINGS
TITLE 21 - OCCUPATIONAL LICENSING
BOARDS
CHAPTER 36 - BOARD OF NURSING
SECTION .0200 - LICENSURE
"KTotice of Rule-making Proceedings is hereby given by the
1 yNorth Carolina Board of Nursing in accordance with G.S.
I50B-2I.2. The agency shall subsequently publish in the
Register the text of the rule(s) it proposes to adopt as a result
of this notice of rule-making proceedings and any comments
received on this notice.
Citation to Existing Rules Affected by this Rule-Making: 21
NCAC 36 .0227 - Other rules may be proposed in the course of
the rule-making process.
Authority for the rule-making: G.S. 90-6; 90-18(14); 90-
18.2; 90-171.20(4); 90-171.20(7); 90-171. 23(b); 90-171.36;
90-171.37; 90-171.42
Statement of the Subject Matter: Describes the nurse
practitioner qualifications for approval to practice and the
practice requirements. The physician supen'ision Paragraph
(h) to be changed will allow more flexibility.
Reason for Proposed Action: The Board of Nursing and the
N. C. Medical Board are recommending that a change be made
in the current rule to allow more flexibility in how physician
supervision of the nurse practitioner's performance of medical
acts is implemented and validated.
Comment Procedures: Comments regarding this action should
be directed to Jean H. Stanley. APA Coordinator, North
Carolina Board of Nursing, P.O. Box 2129, Raleigh, NC
27602-2129. Comments must be received in the Board of
Nursing office by 4:30 p.m. on November 3, 1997.
CHAPTER 54 - NORTH CAROLINA
PSYCHOLOGY BOARD
A Totice of Rule-making Proceedings is hereby given by the
1 y North Carolina Psychology Board in accordance with G.S.
150B-21.2. The agency shall subsequently publish in the
Register the text of the rule(s) it proposes to adopt as a result
of this notice of rule-making proceedings and any comments
received on this notice.
Citation to Existing Rules Affected by this Rule-Making:
21 NCAC 54 .1611 - .1613, .2006. .2010, .2104, .2301 -
.2314, .2401 - .2402, .2501 - .2505, .2601 - .2602, .2704 -
.2706 - Other rules may be proposed in the course of the rule-making
process.
Authority for the rule-making: G.S. 90-270. 4(d)(e); 90-
270.5(e); 90-270.9; 90-270. 13(c); 90-270. 14(a)(2); 90-
270.15(a)(3); 90-270. 15 (a) (22); 90-270. 20(b) (c)(d); 90-270.21;
150B-3; 150B-4; 150B-20; 150B-21.2; 150B-38; 150B-39;
150B-40
Statement of the Subject Matter: Ancillary Services;
Administrative Hearing Procedures; Rule-making Proceedings;
Rule-making Hearings; Declaratory Rulings; Continuing
Education; Psychological Associate Activities Requiring
Supervision; Health Services Provider Certification; Practice by
Other Professionals; Practice and Supervision of Students,
Interns, Fellows, and Trainees; Responding to Board Inquiries
Reason for Proposed Action: To more clearly and accurately
set the procedures for conducting administrative and rule-making
hearings, andfor issuing declaratory rulings; to define
ancillary services; to set continuing education requirements; to
clarify activities for which Psychological Associates require
supervision; to define academic requirements for health services
provider certification; to clarify exemption from the Psychology
Practice Actfor qualified members of other professional groups,
and for students, interns, fellows, or other trainees; to clarify
licensees ' responsibility to respond to Board inquiries.
Comment Procedures: Comments shall be submitted in
writing to Martha Storie. Executive Director, North Carolina
Psychology Board, 895 State Farm Road, Suite 102, Boone, NC
28607.
n:5 NORTH CAROLINA REGISTER September 2, 1997 338
PROPOSED RULES
Diis Section contains the text ofproposed rules. At least 60 days prior to the publication of text, the agency published a Notice
of Rule-making Proceedings. The agency must accept comments on the proposed rule for at least 30 days from the publication
date, or until the public hearing, or a later date if specified in the notice by the agency. The required comment period is 60
days for a rule that has a substantial economic impact of at least five million dollars ($5,000,000). Statutory reference: G.S.
150B-21.2.
TITLE 10 - DEPARTMENT OF HUMAN RESOURCES
Notice is hereby given in accordance with G.S. 150B-21.2
that the North Carolina Medical Care Commission intends
to amend 10 NCAC 3D .0801-. 0803. .0901. .0904. .0913,
.0915-. 0916, .0925. .1001-. 1004. .1103, .1202-. 1206. .1301-
.1302. .1401. .1403. and repeal rules cited as 10 NCAC 3D
.0806. .0902. .0905. .0907-.0909. .0911, .0917-.0924, .0926.
Notice of Rule-making Proceedings was published in the
Register on March 3. 1997.
Proposed Effective Date: August 1. 1998
A Public Hearing will be conducted at 9:30 a.m. on December
12, 1997 at the Weil-Spring Retirement Community Inc,
Auditorium, 4100 Well Spring Drive, Greensboro, NC 27410.
Reason for Proposed Action: Chapter 131E, Article 7
authorizes the Medical Care Commission to establish rules for
ambulance services including vehicles and personnel. This is
the first comprehensive review of these rules since 1989. These
ainendmerus are necessary to update the rules to reflect current
emergency medical practice.
Comment Procedures: Persons who wish to make written or
verbal comment regarding these proposed amendments should
contact: Mr. Ed Seagroves. Disaster & Special Projects
Coordinator. NC Office of Emergency Medical Services, PO
Box 29530, Raleigh, North Carolina 27626-0530, Tele: (919)
733-2285, Fax: (919) 733-7021. Verbal and written comments
will be received through the date of the public hearing. Persons
are encouraged to submit written comments by September 2.
1997 to allow adequate time for review and consideration by the
Commission.
Fiscal Note: These Rules do affect the e.xpenditures or
revenues of state and local government funds. These Rules do
not have a substantial economic impact of at least five million
dollars ($5,000,000) in a 12-month period.
CHAPTER 3 - FACILITY SERVICES
SUBCHAPTER 3D - RULES AND REGULATIONS
GOVERNING AMBULANCE SERVICE
.0801
SECTION .0800 - DEFINITIONS
AMBULANCE AND BASIC LIFE SUPPORT
(BLS) PROFESSIONAL
(a) Definitions used in this Subchapter will be in accordance
with those found in G.S. 131E-155. incorporated by rcfercBce
according to G.S. 1 500- 14(c) and as follow.
(b) An ambulance must have a permit issued by the
Department of Human Resources, Division of Facility Services,
Office of Emergency Medical Services in one of the following
categories:
(1) "Category I Ambulance" means an emergency
ambulance used to transport patients with emergency
traumatic or medical conditions or patients for which
the need for emergency medical care is anticipated
either at the scene of the emergency or enroute to a
medical facility. Category I ambulances may be used
to transport all tyf)es of patients.
(2) "Category II Ambulance" means an ambulance used
solely to transport sick or infirm patients, having a
known, non-emergency medical condition, on
scheduled basis between facilities or between
residence and a facility. Category II ambulances
must not be used to transport patients defined under
any other category of ambulance.
(3) "Category III Ambulance" means an emergency
ambulance specifically designed and equipped to
transfer critically ill patients from one medical
facility to another or as ground support to a permitted
air ambulance program. The patient care
compartment of Category III ambulances must be
staffed by appropriately certified or licensed
personnel approved for the mission by the program
medical director. Category III ambulances must be
utilized as part of an organized critical care transport
program and may not be used in place of any other
category of ambulance defined in this Subchapter.
(4) "Category IV Ambulance" means an ambulance
specifically designed and equipped to transport
patients by air. The patient care compartment of
Category IV ambulances must be staffed by
appropriately certified or licensed personnel
approved for the mission by the program medical
director. Category IV ambulances must be operated
as either:
(A) Part of an approved mobile intensive care
program and must comply with the criteria as
outlined in 21 NCAC 32H; or
(B) Part of an air ambulance program which
complies with 21 NCAC 32H .1004.
(5) "Category V Ambulance" means a watercraft
specifically designed and equipped to routinely
transport patients.
339 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
(c) The term "field technician" "Basic Life Support (BLS)
rnfessional" means a certified ambulance attendant or
mergency medical technician.
\uthority G.S. 131E-157(a); 131E- 159(b).
9802 CERTIFIED EMT INSTRUCTOR
The term "qualified "certified Emergency Medical Technician
EMT) instructor" means a person who instructs or coordinates
mergency medical services (EMS) training educational
rograms and continuing education programs who meets the
riteria defined in Rule . 1202 of this Subchapter.
[uthority G.S. 131E-159(b).
0803 APPROVED TEACHING INSTITUTION
The term "approved teaching institution" means any agency
nth a current memorandum of agreement contract with the
)ffice of Emergency Medical Services to provide emergency
nedical services training educational programs. Approved
caching instimtions must meet the criteria found in Rule .1201
if this Subchapter.
[uthority G.S. 131E- 159(b).
0806 MEDICAL CREW MEMBER
The te rm "medical c rew member " means a physician.
ntermediate, EMT-intermediatc. CMT-dcfibrillation technician
ce rtification and who has completed additional training in
Jtitudc—physiology. EMS—communications. in-flight
mcrgencies, and airc raft and flight safety conducted under the
lirect guidance of the medical director for the program in
egistcred nurse. EMT-paramedic, EMT-advanced
)r EMT who holds a current North Carolina license or
yhich he functions.
luthority G.S. 1 31E-l57(a).
SECTION .0900 - VEfflCLES
0901 INTERIOR DIMENSIONS
(a) Any vehicle issued a permit as a Category I Category L
ategory IL or Category III ambulance must have the following
ninimum patient compartment interior dimensions:
(1) The length, measured on the floor from the back of
the driver's compartment, driver's seat or partition to
the inside edge of the rear loading doors, must be at
least im 102 inches.
(2) The width of the compartment after cabinet and cot
installation must provide at least 1 1 inches of clear
aisle walkway between the primary cot and the squad
bench, a second cot or curbside wall of the vehicle.
(3) The height must be at least 52 48 inches over the
patient area, measured from the approximate center
of the floor, exclusive of cabinets or equipment.
(b) Any vcliiclL issued a permit as a Category II ambulance
to an ambulance provider must have the following minimum
patient compartment inte rior dimensions :
fij The length, measured on the floor from the back of
the drive r 's compartment, drive r 's seat, or partition
to the inside edge of the rear loading doors must be
at least 102 inches.
(2)
—
The width of the compartment afte r cabinet and cot
installation must provide for at least 1 1 inches of
clear aisle walkway between the cot and the squad
bench, a second cot or the curbside wall of the
vehicle.
iSr) The height must be at least 48 inches over the patient
area measured from the approximate center of the
floor , exclusive of cabinets or equipment.
(c) £b} Category IV ambulances must have:
(1) A patient care area sufficiently isolated from the
cockpit to minimize inflight distractions and
interference while providing sufficient working space
to render patient care; and
(2) Door openings of sufficient size to permit the safe
loading and unloading of a person occupying a litter.
(d)£c} Category V ambulances must have a patient care area
which:
(1) Provides access to the head, torso, and lower
extremities of the patient while providing sufficient
working space to render patient care;
(2) Is covered to protect the patient and the technician
from the elements; and
(3) Has an opening of sufficient size to permit the safe
loading and unloading of a person occupying a litter.
Authority G.S. 131E-157(a).
.0902 INSPECTION CERTIFICATE
Any vehicle issued a permit as a Category I. II. or III
ambulance must have a current safety equipment inspection
certificate issued by the North Carolina Division of Motor
Vehicles.
Authority G.S. 131E-157(a).
.0904 VEHICLE BODY
The ambulance vehicle body must be free from defects that
could adversely affect the safe ope ration of the vehicle. The
ambulance is not to have structural or functional defects which
may adversely affect the patient, the technicians, and/or the
safe operation of the vehicle.
Authority G.S. 131E-157(a).
.0905 OXYGEN CYLINDERS
Oxygen cylinder s used in ambulance vehicles must bear static
pressure date and must be replaced or refilled as soon as
possible afte r use.
Authority G.S. 131E-1 57(a).
2:5 NORTH CAROLINA REGISTER September 2, 1997 340
PROPOSED RULES
.0907 DOORS
All doors leading into passenger and patient compartment
must open prope rly and close securely with all hardware
working properly.
Authority G.S. 131E-157(a).
.0908 WINDOWS
Windows and windshield must be clear and free of c racks.
Authority G.S. 131E-157(a).
.0909 REAR-VIEW MIRROR
Rear-view mirror utilized in Category I, II, or III ambulances
must be free of c racks and blemishes.
Authority G.S. 131E-157(a).
.0911 SPARE TIRE
Ambulance vehicles issued permits as Category I, II. or III
must carry a se rviceable spare tire and equipment to change a
flat ti re or unserviceable tire. An acceptable alte rnative to this
requirement is an immediately available se rvice vehicle or a
plan for the immediate dispatch of anothe r ambulance.
Authority G.S. 131E-157(a).
.0913 PERMIT
(a) The ambulance permit must include the following
information:
(1) vehicle identification number;
permit number;
ambulance provider identification number;
identification of inspector; and
expiration date.
(b) No person shall display or cause to be displayed or
permit to be displayed or to knowingly possess, transfer,
remove, imitate, or reproduce an ambulance permit, except by
direction of the Office of Emergency Medical Services.
(c) An ambulance shall be permitted in only one category.
(d) Any vehicle permitted as a Category I Ambulance must
contain all equipment required in 10 NCAC 3D .1001(a),
. 1002, . 1003(a), and .1103. .1103 of this Subchapter.
(e) Any vehicle permitted as a Category I Ambulance which
operates as a Mobile Intensive Care Unit as defined in 10
NCAC 3M .0102, .0103. 70*05; or .0107 must contain all
equipment required in 10 NCAC 3M .0202, .0203, .0205, or
.0207.
(2)
(3)
(4)
(5)
NCAC 3M .0102. .0103. or .0107 must contain all equipment
required in 10 NCAC 3M .0202. .0203. or .0207.
(h) Each licensed ambulance provider planning to operate
permitted ambulances at an ALS level must first meet the
minimum permitting requirements for BLS operation for all
ambulances to be ALS permitted. The licensed ambulance
provider must provide for inspection the number of ALS
equipment/supplies/medications packages in accordance with
the approved protocols for that provider. The licensed
ambulance provider can not unless under disaster circumstances
operate more permined ambulances at an ALS level at any time
than the approved number of ALS packages.
Authority G.S. 1 3]E- 157(a).
.0915 AMBULANCE LETTERING: MARKINGS:
SYMBOLS AND EMBLEMS
(a) Each ambulance must have the name of the ambulance
provider permanently displayed on each side of the vehicle in
lette r s at least th ree inches high, vehicle.
(b) Category II ambulances must have the words
"CONVALESCENT AMBULANCE" permanently lettered on
both sides and on the rear of the vehicle body in at least five
inch lette rs, body.
(c) Category II ambulances may not use emergency medical
symbols, such as the Star of Life, block design cross, or any
other medical markings, symbols, or emblems, including the
word "EMERGENCY," on the vehicle or in any advertisement
publication, or literature pertaining to Category II ambulance
services.
Authority G.S. 131E-1 57(a).
.0916 GENERAL AMBULANCE REQUIREMENTS
The interior of the ambulance and the equipment within the
ambulance shall be free from dirt, contamination, or impurities
and shall work properly. The exterior of the ambulance and
tics
the
patient area of the ambulance, to include interior and equipment
surfaces is to be maintained in a clean manner and to bg
managed at all times in accordance with the locally approvec
infection control policy. Provisions are to be available for the
storage of both stocked medical supplies and bedding materials
as well as for soiled supplies. The base station(s)'s storage
facilities for items to be restocked on the ambulances are to be
kept clean and organized so as to permit effective cleaning.
Authority G.S. 131E-157(a).
(0 Each CMS provider must ensure that, at a minimum, .0917 EQUIPMENT
60% of the vehicles permitted as Category I Ambulances and
which may operate as a Mobile Intensive Care unit must
contain all appropriate equipment and supplies specified in 10
NCAC 3M .0202 - .0207. Any vehicle permined as a Category
V Ambulance must contain all equipment required in Rules
. 1001(h) and . 1003(e) of this Subchapter.
(g) Any vehicle permitted as a Category V Ambulance
which operates as a Mobile Intensive Care Unit as defmed in 10
Equipment shall be of smooth construction for case oi
cleaning.
Authority G.S. 131E-157(a).
.0918 LINEN
(a) Freshly laundered linen or disposable linen
shall be used I oisposapie on cots and pillows and linen shall be changed after each patient
341 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
, tiaiisported.
(b) Clean linen storage shall be provided on each ambulance.
uthority G.S. 131E-157(a).
)919 MEDICAL SUPPLIES
Closed conipartmcnts shall be provided within the ambulance
K medical supplies.
uthority G.S. 131E-157(a).
)920 PILLOWS AND MATTRESSES
Pillows and mattresses shall be kept clean and in good repair .
uthority G.S. 131E-157(a).
)921 SOILED SUPPLIES
Closed containers shall be provided for soiled supplies.
luthority G.S. 131E-157(a).
9922 SURFACES
Exterior and interior surfaces of ambulance shall be cleaned
ally.
[uthority G.S. 131E-157(a).
9923 BLANKETS AND HAND TOWELS
Blankets and hand towels used in any ambulance shall be
lean.
[uthority G.S. 131E-157(a).
}924 IMPLEMENTS INSERTED IN NOSE OR
MOUTH
(a) Implements inserted into the patient's nose or mouth shall
c single-se rvice, wrapped and properly stored and handled.
(b)
—
When multi-use items are used, the local health care
acilities or County Health Department shall be consulted for
istructions in sanitation and handling of such items.
[uthority G.S. 131E-157(a).
0925 INFECTIOUS DISEASE
When an ambulance has been utilized to transport a patient
nown to the licensed ambulance providers to have a
ommunicable disease as defined in G.S. 130A- 133(1), it is the
esponsibility of the licensed ambulance provider to ensure that
le ambulance, including its equipment and supplies, is taken
ut of service until appropriately cleansed and disinfected
ccording to local infection control policy.
[uthority G.S. 131E-157(a).
0926 STORAGE
(a) All stUMgL spaces used for storage of linens, equipment.
medical supplies and other supplies at base stations shall be kept
clean.
(b) The contents shall be arranged so as to pe rmit diorough
cleaning.
Authority G.S. 131E-157(a).
SECTION .1000 - AMBULANCE EQUIPMENT
. 1001 MEDICAL AND RELATED EQUIPMENT
(a) Except as allowed by .0913(e) and tf) (hj of these Rules,
category I ambulances for which permits are issued shall
contain at least the following operational and functional
equipment exclusive of personal equipment carried by
emergency medical technicians and ambulance attendants:
(1) One portable aspirator capable of a minimum
vacuum of 300 millimeters of mercury and a
minimum air flow rate of 16 liters per minute with
rapid drawdown time. A minimum of three, single
use, non-opaque, one piece, rigid suction instruments
or appropriate replacement containers for manually
operated devices and a suction rinsing water bottle
must be supplied with this either unit;
(2) One each portable squeeze bag ventilation unit (bag
and mask) in adult and child adult, child, and infant
sizes with transparent face mask capable of operation
down to zero degrees fahrenheit and an attachment
for oxygen hookup. A minimum of two one
transparent, flexible, disposable oxygen supply tubes
tube must be supplied with each unit;
(3) Six nonmetallic, oropharyngeal airways sanitarily
stored together in separate sizes ranging from 55
millimeters through 115 millimeters;
(4) One bite stick cithe r commercially manufactured or
made of three tongue blades taped together and
padded ;
<^(4) One portable oxygen imit consisting of the following
components: 360 liter (D size) or larger oxygen
cylinder; yoke regulator with cylinder contents gauge
(2000 pounds per square inch) and gravity or non-gravity
dependent flow gauge (0-12 liters per minute
minimum); a minimum of three transparent, nasal
cannulas in adult and child sizes; and a minimum of
three each, adult and child, disposable, transparent,
oxygen masks with delivery tubes and headband. A
full spare cylinder (D size) or larger of oxygen for
this unit shall be furnished and stored on the
ambulance vehicle; oxygen tanks must show date of
last static test;
f6)(5} One Two small, one two medium, and one two large
size adult extrication collar collars and one two
pediatric size extrication collar ; collars;
fB(6) One rigid short backboard. The minimum size must
be 14 inches wide by 32 inches long. A stabilization
device which is of the design to allow horizontal
flexibility and vertical rigidity, equipped with chest
2:5 NORTH CAROLINA REGISTER September!, 1997 342
PROPOSED RULES
i^m
W(8}
tWOD
(20)08}
t22)(2m
e»>(21)
f25)!22J
(26)123}
and leg straps and accessories for stabilization of the
head and neck may be substituted for the rigid short
backboard;
©ne Two rigid long backboard backboards a
minimum of 16 inches wide by 72 inches long with
two straps each for patient stabilization and other
accessories for stabilization of the head and neck;
Two sets of each rigid padded board splints in the
following sizes; 3 inches wide by 15 inches long, 3
inches wide by 3 feet long, and 3 inches wide by 4-
1/2 feet long. Other splints, in kit form, of inflatable
design or rigid laminated and high density
polyurethane foam construction are acceptable. A kit
must contain at least two full leg and two full arm
splints;
One child and one adult size lower extremity traction
splint with appropriate attachments;
Two sandbags constructed of a nonporous mate rial
Minimum size must be
12 inches. A head
for immobilization purposes.
2 inches by 4 inches by
immobilizer may be substituted for sandbags ;
Twelve 4 inch by 4 inch sterile gauze pads
individually packaged;
Six sterile 5 inch by 9 inch or larger absorbent
dressings individually wrapped;
Twelve rolls of roller gauze;
Four rolls of adhesive tape;
Four Two sterile nonadhering, nonporous dressings
for an open chest wound. Minimum size shall be 3
inches by 8 inches;
Six triangular bandages;
Two pairs One pair of 5-1/2 inches bandage shears;
Two sterile bum sheets, minimum size of 40 inches
by 72 inches;
A total of 2606 1000 cubic centimeters of sterile
irrigating solution in plastic containers in addition to
the fluids carried for intravenous use;
One emesis basin; basin, or scalable emesis
container;
One obstetrical kit containing gloves, scissors or
surgical blades, umbilical cord clamps or tapes,
dressings, towels, perinatal pad, a bulb syringe, and
a receiving blanket;
Onc-poison antidote kit contammg syrup ot ipecac,
activated charcoal and a means of administe ring the
prope r dosage:
One each small, regular and large size aneroid or
electronic blood pressure cuff and adult and pediatric
stethoscopes. One stethoscope with adult and
pediatric attachments is acceptable;
One sheet of rubbe r or heavy plastic, minimum size
of 30 inches by 72 inches, or one body bag;
One four wheeled, elevating cot with a minimum
three inch thick mattress pad with a nonporous cover.
The cot must be equipped with restraining straps
(chest and thigh area) of at least two inches in width.
(chest and thigh area). A crash stable fastener
installed per the cot manufacturer's instructions and
compatible with the model cot furnished must secure
the specified cot to the floor or side wall;
-(2?) One additional st retche r with patient restraining
(26)124
(29)125}
(36)126}
(3+)t27}
straps and capable of being secured inside the paticiii
compartment;
Two sets of clean cot linen constructed of washable
or disposable material in addition to a set on the cot
(a set equals two sheets and one pillowcase);
Two pillows covered with a nonporous material;
Two blankets constructed of washable material; and
One child restraint device to safely transport
pediatric patients in the patient compartment of the
ambulance.
(b) Category II ambulances for which permits are issuec
shall contain at least the following operational and ftmctiona
equipment exclusive of personal equipment carried by
personnel:
(1) One portable aspirator capable of a minimun
vacuum of 300 millimeters of mercury and
minimum air flow rate of 16 liters per minute wit!
rapid drawdown time. A minimum of three, single
use, non-opaque, one piece, rigid suction instrument"
or appropriate replacement collection containers foi
manually operated devices and a suction rinsinj
water bottle must be supplied with this either unit;
One each portable squeeze bag ventilation imit (ba]
and mask) in adult and child adult, child, and infan
(2)
(3)
(4)
(5)14}
sizes with transparent face mask capable of operatioi
down to zero degrees fahrenheit and an attachmen
for oxygen hookup. A minimum of two om
transparent, flexible, disposable oxygen supply ttibej
mbe must be supplied with each imit;
Six nonmetallic, oropharyngeal airways sanitaril)
stored together in separate sizes ranging from 5!
millimeters through 1 15 millimeters;
One bite stick eithe r commercially manufactured oi
(6)15}
(^16}
(8)17}
made of three tongue blades taped together an(
padded:
One portable oxygen unit consisting of the followin|
components: 360 liter (D size) or larger oxygei
cylinder; yoke regulator with cylinder contents gaug<
(2000 poimds per square inch) and gravity
non-gravity dependent flow gauge (0-12 liters pei
minute); a minimum of three transparent, nasa
canniJas in adult and child sizes; and a minimum o
three each, adult and child, disposable, transparent
oxygen masks with delivery tubes and headband,
full spare cylinder (D size) or larger of oxygen fo:
this imit shall be furnished and stored on thf
ambulance vehicle; oxygen tanks must show date o
last static test;
Twelve four Six 4 inch by ferar 4 inch sterile gauzf
pads individually packaged;
Six Three sterile five 5 inch by nine 9 inch absorben
dressings individually wrapped;
Six rolls of roller gauze;
343 NORTH CAROLINA REGISTER September 2, 1997 12:1
PROPOSED RULES
tTtJT
mm
WIO)
'nim
^(16)
{¥^
Two rolls of adhesive tape;
Three triangular bandages;
Two pairs One pair of five and one-half inches
bandage shears;
One emesis basin; basin, or sealable emesis
container;
One each small, regular and large size aneroid or
electronic blood pressure cuff and adult and pediatric
stethoscopes. One stethoscope with adult and
pediatric attachments is acceptable;
One four wheeled, elevating cot widi a minimum
three inch thick manress pad with a nonporous cover.
The cot must be equipped with restraining straps
(chest and thigh area) of at least two inches in width.
(chest and thigh area). A crash stable fastener
installed per the cot manufacturer's instructions and
compatible with the model cot furnished must secure
the specified cot to the floor or side wall;
Two sets of clean cot linen constructed of washable
or disposable material in addition to a set on the cot
(a set equals two sheets and one pillowcase);
Two pillows covered with a nonporous material;
Two blankets constructed of washable material; and
A firm board of minimum size 14 inches by 32
inches to support the back during manual heart
compressions; and compressions.
One—ehrW
—
rest raint device—to
—
safely—transport
pediatric patients in the patient compartment of the
ambulance.
(c) Category III ambulances for which permits are issued
lust have the following operational and functional medical
quipment immediately available to be plac ed loaded within
ive minutes on the vehicle:
(1) One portable aspirator capable of a minimum
vacuum of 300 millimeters of mercury and a
minimum air flow rate of 16 liters per minute with
rapid drawdown time. A minimum of three, single
use, non-opaque, one piece, rigid suction instruments
or appropriate collection containers for manuallv
operated devices and a suction rinsing water bottle
must be supplied with this either unit;
(2) One each portable squeeze bag ventilation unit (bag
and mask) in adult and child adult, child, and infant
sizes with transparent face mask capable of operation
down to zero degrees fahrenheit and an attachment
for oxygen hookup. A minimum of two one
transparent, flexible, disposable oxygen supply tttbes
mbe must be supplied with each unit;
(3) Six nonmetallic, oropharyngeal airways sanitarily
stored together in separate sizes ranging from 55
millimeters through 115 millimeters; W One bite stick cithe r commercially manufactured or
made of three tongue blades taped together and
padded;
(5){4} One portable oxygen unit consisting of the following
components: 360 liter (D size) or larger oxygen
(6)15}
mm
f9)£81
/ 1 r\\
fi^(lO)
t«)Lm
t+6)
t+^a6i
e-BH?)
(22)081
cylinder; yoke regulator with cylinder contents gauge
(2000 pounds per square inch) and gravity or
non-gravity dependent flow gauge (0-12 liters per
minute); a minimum of three transparent, nasal
cannulas in adult and child sizes; and a minimum of
three each, adult and child, disposable, transparent,
oxygen masks with delivery tubes and headband. A
full spare cylinder (D size) or larger of oxygen for
this unit shall be furnished and stored on the
ambulance vehicle; oxygen tanks must show date of
last static test;
Twelve fbor 4 inch by foor 4 inch sterile gauze pads
individually packaged;
Six sterile frre 5 inch by nine 9 inch absorbent
dressings individually wrapped;
Six rolls of roller gauze;
Two rolls of adhesive tape;
Three t riangular bandages;
Two pairs One pair of five and one-half inches
bandage shears;
One emesis basin ; basin, or sealable emesis
container:
Two ste rile bum sheets, minimum size of 40 inches
by 72 inches;
A total of 2986 1000 cubic centimeters of sterile
irrigating solution in plastic containers in addition to
the fluids carried for intravenous use;
One obstetrical kit containing gloves, scissors or
surgical blades, umbilical cord clamps or tapes,
dressings, towels, perinatal pad, a bulb syringe, and
a receiving blanket;
Gne-poison antidote kit containing syrup oi ipecac,
activated charcoal and a means of administering the
proper dosage;
One each small, regular and large size aneroid or
electronic blood pressure cuff and adult and pediatric
stethoscopes. One stethoscope with adult and
pediatric attachments is acceptable;
One four wheeled, elevating cot with a minimum
three inch thick mattress pad with a nonporous cover.
The cot must be equipped with restraining straps
(chest and thigh area) of at least two inches in width.
(chest and thigh area). A crash stable fastener
installed per the cot manufacmrer's instructions and
compatible with the model cot furnished must secure
the specified cot to the floor or side wall. A self
contained transport incubator with stand and capable
of being secured in the ambulance may be
substituted;
Two sets of clean cot linen constructed of washable
or disposable material in addition to a set on the cot
(a set equals two sheets and one pillowcase);
Two pillows covered with a nonporous material :
Two blankets constructed of washable material; and
A firm board of minimum size 14 inches by 32
inches to support the back during manual heart
2:5 NORTH CAROLINA REGISTER September!, 1997 344
PROPOSED RULES
compressions ; and compressions.
f23) ©nt
—
child—
r
est raint—device—to
—
safely—transport
pediat r ic patients in the patient compartment of the
ambulance.
(d) Category IV ambulances for which permits are issued
must have the following medical equipment immediately
available to be plaeeti loaded within five minutes on the
aircraft:
(1) One vehicular mounted and one portable aspirator
with rapid drawdown time capable of providing a
minimum vacuum of 300 millimeters of mercury and
a minimum air flow rate of 16 liters per minute up to
the maximum operating altitude of the aircraft. A
minimum of three, single use, non-opaque, one
piece, rigid suction instruments or appropriate
collection containers for manually operated devices
and a suction rinsing water bottle must be supplied
with this either unit;
(2) One each ponable squeeze bag ventilation unit (bag
and mask) in adult and child adult, child, and infant
sizes with transparent face mask capable of operation
down to zero degrees fahrenheit and an attachment
for oxygen hookup. A minimum of two one
transparent, disposable oxygen supply tubes tube
must be supplied with each unit;
(3) Six nonmetallic, oropharyngeal airways sanitarily
stored together in separate sizes ranging from 55
millimeters through 1 15 millimeters;
f4) One bite stick cithe r commercially manufactured or
made of three tongue blades taped togethe r and
padded;
t5)£4] Oxygen unit containing a quantity of oxygen
sufficient to supply an appropriate flow rate for the
period of time it is anticipated oxygen will be
needed, but not less than ten liters per minute for 30
minutes. The oxygen shall be carried in two separate
containers, one of which must be portable. The
portable oxygen unit shall have a yoke regulator with
cylinder contents gauge, flow gauge, and DISS
outlets;
ffi>(5) Twelve ftmr 4 inch by fotir 4 inch sterile gauze pads
individually packaged;
fJH(6) Six sterile five 5 inch by nine 9 inch absorbent
dressings individually wrapped;
ffr>(7) Twelve rolls of roller gauze;
^(8) Four rolls of adhesive tape;
H#i(9) Tour Two sterile nonadhering, nonporous dressings
for an of)en chest wound. Minimum size shall be 3
inches by 8 inches;
H-HUO] Six triangular bandages;
H^(l 1) Two ste r ile bum sheets, minimum size of 40 inches
by 72 inches;
(4^021 A total of 2eee lOOO cubic centimeters of sterile
irrigating solution in plastic containers in addition to
the fluids carried for intravenous use;
<+^(13) One emesis basin; basin, or scalable emesis
container;
©ne Two IV pressure bagr bags;
An electronic means of measuring blood pressur(
while in flight;
One stethoscope and manual blood pressure cuff;
One ECG monito r /defib r illatoi
mam
(23)1211
monitor/defibrillator/pacer;
One complete kit for endotracheal intubation;
One litter and attachment for securing the liner to th(
airframe inside the cabin of the aircraft. The litte:
must allow for elevation of the patient's head;
One blanket constructed of washable material; and
Four air sick bags; and
Four Three IV hooks.
(e) The medical director shall decide the combination o
medical equipment specified in Paragraph (d) of this Rule tha
is carried on a mission based on what is in the best interest o
patient care.
(f) All rotary wing aircraft permitted as a Category IN
ambulance must have the following flight equipment operationa
in the aircraft:
(1) Two 360 channel VHF aircraft frequenc;
transceivers;
(2) One VHF omnidirectional ranging (VOR) receiver;
(3) Attitude indicators;
(4) One nondirectional beacon (NDB) receiver;
(5) One glide scope receiver;
(6) One transponder with 4097 code. Mode C;
(7) Turn and slip indicator in the absence of thre(
attitude indicators;
(8) Current FAA approved navigational aids and chart
for the area of operations;
(9) Radar altimeter; and
(10) Loran navigational system. LORAN-C or Satellitt
Global Navigational system.
(g) Any fixed wing aircraft issued a permit as a Category I\
ambulance must have a current "Instrument Flight Rules
certification.
(h) Category V ambulances for which permits are issuet
shall contain at least the following operational and functiona
equipment exclusive of personal equipment carried bj
personnel:
(1) One portable aspirator capable of a minimim
vacuum of 300 millimeters of mercury and
minimum air flow rate of 16 liters per minute witl
rapid drawdown time. A minimum of three, singlf
use, non-opaque, one piece, rigid suction instrument!
or appropriate collection containers for manualh
(2)
(3)
operated devices and a suction rinsing water bottk
must be supplied with this either unit;
One each portable squeeze bag ventilation unit (baj
and mask) in adult and child adult, child, and infan
sizes with transparent face mask capable of operatioi
down to zero degrees fahrenheit and an attachmen
for oxygen hookup. A minimum of two oni
transparent, flexible, disposable oxygen supply ttibci
tube must be supplied with each unit;
Six nonmetallic, oropharyngeal airways sanitaril)
345 NORTH CAROLINA REGISTER September 2, 1997 12:t
PROPOSED RULES
stored together in separate sizes ranging from 55
millimeters through 115 millimeters;
f4) One bite stick cithe r commercially manufactured or
made of three tongue blades taped together and
padded;
f5){4} One portable oxygen unit consisting of the following
components: 360 liter (D size) or larger oxygen
cylinder; yoke regulator with cylinder contents gauge
(2000 pounds per square inch) and gravity or
non-gravity dependent flow gauge (0-12 liters per
minute); a minimum of three transparent, nasal
cannulas in adult and child sizes; and a minimum of
three each, adult and child, disposable, transparent,
oxygen masks with delivery tubes and headband. A
full spare cylinder (D size) or larger of oxygen for
this unit shall be furnished and stored on the
ambulance vehicle; oxygen tanks must show date of
last static test;
t6)£5] ©nc Two small, one two medium, and one two large
size adult extrication collar collars and one two
pediatric size extrication collar ; collars:
ffl(6) One rigid short backboard. The minimum size must
be 14 inches wide by 32 inches long. A stabilization
device which is of the design to allow horizontal
flexibility and vertical rigidity, equipped with chest
and leg straps and accessories for stabilization of the
head and neck may be substituted for the rigid short
backboard;
f6)(7) One Two floatable rigid long backboard backboards
a minimum of 16 inches wide by 72 inches long with
two straps each for patient stabilization and other
accessories for stabilization of the head and neck;
f9)£8} Two sets of each rigid padded board splints in the
following sizes; three inches wide by 15 inches long,
three inches wide by three feet long, and three inches
wide by four and one-half feet long. Other splints,
in kit form, of inflatable design or rigid laminated
and high density polyurethane foam construction are
acceptable. A kit must contain at least two full leg
and two full arm splints;
One child and one adult size lower extremity traction
splint with appropriate attachments;
Two sandbags constructed of a nonporous material
for immobilization purposes. Minimum size must be
two inches by four inches by 12 inches.—A head
immobilizer may be substituted for sandbags ;
Twelve fbor 4 inch by fbor 4 inch sterile gauze pads
individually packaged;
Six sterile five 5 inch by nine 9 inch or larger
absorbent dressings individually wrapped;
Twelve rolls of roller gauze;
Four rolls of adhesive tape;
Four Two sterile nonadhering, nonporous dressings
for an open chest wound. Minimum size shall be
three inches by eight inches;
Six triangular bandages;
fW)(16) Two pairs One pair of Five and one-half inches
bandage shears;
(+9)£17} Two sterile burn sheets, minimum size of 40 inches
by 72 inches;
(20)08} A total of 2060 1000 cubic centimeters of sterile
irrigating solution in plastic containers in addition to
the fluids carried for intravenous use;
(2t->(19) One emesis basm; basin, or scalable emesis
container:
(22)(20) One obstetrical kit containing gloves, scissors or
surgical blades, umbilical cord clamps or tapes,
dressings, towels, perinatal pad, a bulb syringe, and
a receiving blanket;
f23) One poison antidote kit containing syrup of ipecac,
activated charcoal and a means of administering the
prope r dosage;
t24)t21i One each small, regular and large size aneroid or
electronic blood pressure cuff and adult and pediatric
stethoscopes. One stethoscope with adult and
pediatric attachments is acceptable;
f25)£2Z) One sheet of rubber or heavy plastic, minimum size
of 36 inches by 72 inches, or one body bag;
f26)(23) One additional floatable litter with patient restraining
straps and capable of being secured to the watercraft;
and
f2y>(24) Two blankets constructed of washable material.
Authority G.S. 131E-157(a).
.1002 EXTRICATION AND ACCESS EQUIPMENT
Category I ambulances for which permits are issued must
contain at least the following equipment:
(+^ One ten-inch adjustable open end wrench;
(2) One sc rewdrive r with flat blade;
(3) One sc rewdrive r with Phillips blade ;
t4) One hacksaw with a minimum of six blades ;
(5) One four-pound hammer with 15-ineh handle;
i€) One pai r of plie rs, ten-inch vise-grip;
(?) One 24-inch wrecking bar ;
(S) One 48-inch c rowbar with pinch point;
(^(1) Two pair heavy duty work gloves;
H%^{2) Two pair OSIIA approved safety glasses; and
(ii->(3) Two OSIIA approved safety helmets.
Authority G.S. 131E-157(a).
.1003 OTHER EQUIPMENT
(a) Ambulances for which permits are issued as Category I,
II, or III must have at least the following:
(1) One Two operational flashlight: flashlights:
(2) A two and one -half five pound fire extinguisher
which must be a dry chemical or halogen,
all-purpose type with a pressure gauge and approved
by Underwriters Laboratories and U.S. Department
of Transportation and must be mounted in a
quick-release bracket;
NORTH CAROLINA REGISTER September 2, 1997 346
PROPOSED RULES
(3) "No Smoking" signs placed in cab or cabin and
patient compartments; and
(4) Electric lights to illuminate the patient compartment
which are designed and located so that no glare is
reflected into the driver's eyes or line of vision.
(b) Institutions or organizations which ope rate Category I\^ ambulances with the State of North Carolina must comply wit
Navigational system, navigational radar, or othe
comparable radio equipment suited for wate
navigation; and
(5) Marine radio.
if) Institutions or organizations which operate Catcgoiy -
all provisions of Chapter 75A Article 1 (Boating Safety Act)
the
—
North Carolina General Statutes including all rule
Commission under the author ity of these statutes.
Authority G.S. 131E-157(a).
.1004 WEAPONS AND EXPLOSIVES FORBroDEN
(a) Weapons as defmed by the local county district attorney'
office and explosives shall not be worn or carried aboard a
ambulance vehicle within the State of North Carolina whei
such ambulance vehicle is operating in any patient transpoi
capacity or is available for such transport fimction.
(b) This Rule shall apply whether or not such weapons an(
explosives are concealed or visible.
(c) This Rule shall not apply to duly appointed lav
enforcement office r s who are serving in an authorized lav
enforcement capacity while a passenger , occupant or attendan
on an ambulance vehicle, officers.
(d) Safety flares are authorized for use on ambulanc'
vehicles with the following restrictions:
(1) These devices are not stored inside the
compartment of the ambulance vehicle:
(2) These devices must be packaged and stored so as t(
patien
ambulances within the State of North Carolina shall be defmed
as Ai r Taxi Ope rators unde r Part 135 of Title XIV or Part 91
of the fede ral Aviation Administration's Rules gove rning ai r established—by—the
—
North—Carolina—Wildlife—Resource
operations and as such must hold a current ce rtificate unde r
these rules. In addition to the equipment required under this
certification:
(1) All Category IV ambulances must be equipped with
an internal voice communication system to allow for
commimication between the medical crew and the
flight crew; and
(2) All rotary wing Category IV ambulances must be
equipped with:
(A) An external public address system;
(B) A remote control external search light; and
(C) A light which illuminates the tail rotor.
(c) Institutions or organizations which operate Category IV
ambulances must submit to the Division of Facility Services,
Office of Emergency Medical Se rvices : Services documentation
that operation is coordinated with the local EMS svstem. ^ Copy of current fede ral Aviation Administration
Part 135 or 9 1 Certificate. A copy of this document
is available for review at the Division of facility
Services. Office of Emergency Medical Services,
located at 701—Barbour Drive.—Raleigh,—North
Carolina or copies may be obtained by contacting the
Supe rintendent of Documents. U.S. Government
Printing Office, Washington, D.C. 20402; and
(2) Documentation that operation is coordinated with the
local EMS system.
(d) In addition to that required in Paragraph fb) of this Rule,
Category IV ambulances approved under Rule .0801(b)(4)(B)
of these rules must be equipped with: A two-way voice radio
licensed by the Federal Commimications Commission capable
of operation on any frequency required in the Public Safety
Radio Service or Special Emergency Radio Service to allow
communications on an as needed basis with public safety
agencies such as fire departments, police departments,
ambulance and rescue units, hospitals and local government
agencies.
(e) In addition to that required in Paragraph (a) of this Rule,
Category V ambulances must be equipped with : with the
following operational and functional equipment.
(1) Two floatable ope rational flashlights;
(2) Two five pound fire extinguishers which must be a
dry chemical, all-purpose type with a pressure gauge
and approved by Underwriters Laboratories and U.S.
Department of Transportation and must be mounted
in a quick-release bracket;
(3) Lighted compass;
(4) Radio navigational aids as ADF (automatic
directional finder) or LORAN-C, Satellite Global
prevent accidental discharge or ignition.
Authority G.S. 131E-157(a).
SECTION .1100 - COMMUNICATIONS
.1103 EQUIPMENT
Each ambulance shall be equipped with a two-way radi(
capable of establishing radio communications from within th(
ambulance service area of the coimty in which the ambulanc(
is based to the county designated dispatch coordination cente;
in that county and to the emergency department of th(
hospital(s) to which patients are routinely transported. Th(
radio shall be licensed by the Federal Communicationi
Commission (FCC).
(1) For an ambulance permitted as a Category
ambulance as defined in Rule .0801(b)(1) or i
Category 111 ambulance as defined in Rul
.0801(b)(3) of this Subchapter, a radio telephone typt
device such as a cellular telephone cannot be the soh
ai
source of two way voice communication.
A communication instrument such as a cellulai
telephone capable of rapidly establishing two waj
voice communication mounted within the driver'!
compartment or patient treatment compartment usee
to summon emergencv assistance is acceptable as thj
sole communications device for an ambulance that i;
347 NORTH CAROLINA REGISTER September!, 1997 12:t
PROPOSED RULES
permitted as a Category U ambulance, as defined in
Rule .08QHb)(2) of this Subchapter.
ulhority G.S. 131E-157(a); 143-509(4).
SECTION .1200 - TRAINING AND
PERFORMANCE OF PERSONNEL
1202 CRITERIA FOR CERTIHED EMT
INSTRUCTOR
A qualified certified EMT Instructor as defmed in Rule .0802
f this Subchapter shall meet the following criteria:
(1)
(2)
£3}
Recognition from the Office of Emergency Medical
Services that he meets the following Standards of the
Certified EMT Instructor/ Coordinator Recognition
Program:
(a) Current North Carolina certification as an
EMT, EMT-defibrillation technician,
EMT-intermediate, CMT-advanccd
intermediate, or EMT-paramedic;
(b) Two Three years experience within the last
five years of direct clinical patient contact in
critical or emergency care;
(c) Current ce rtification as an American Heart
Association—or
—
American—Red
—
-or- Cross
cardiopulmonary resuscitation (CPR)
(d)
(e)
(f)
(g)
£4} lo be
instructor; Documentation of JOO hours of
formal, classroom teaching experience:
Successful completion of the U.S. Department
of Transportation's, EMT Instructor Course or
equivalent;
High school diploma or General Education
Development certificate;
A lead or assistant instructor for six basic
rescuer CPR courses within the last three
ycarx—and Current affiliation with an
approved teaching institution: and
Expe rience as an instructor for at least three
basic EMT courses or complete practice
teaching in one basic EMT course under the
supervision of an experienced EMT instructor .
Be recommended for certification by the
approved teaching institution with which the
person is affiliated.
Annually attends an EMT Evaluator and
Instructor/Coordinator Workshop offered by the
Office of Emergency Medical Services.
Certification shall be valid for a period not to exceed
four years.
To recertified as an EMT Instructor, a person
shall meet the following criteria:
(a) Current North Carolina certification as an
EMT. EMT-defibrillation technician. EMT-intermediate.
or EMT-paramedic:
Current direct clinical patient care experience
in critical or emergency care:
M
(c) Current affiliation with an approved teaching
institution: and
(d) Be recommended for recertification by the
approved teaching institution with which the
person is affiliated. The recommendation
must address the instructional performance of
the candidate as well as the number of courses
taught during the previous certification period.
Authority G.S. 131E-159(b).
.1203 EDUCATIONAL PROGRAMS
A training An educational program intended to qualify
personnel as Ambulance Attendants or Emergency Medical
Technicians must be approved by the Office of Emergency
Medical Services following guidelines established by the
Commission and offered by an approved teaching institution.
Authority G.S. 131E-1 59(b).
.1204 AEROMEDICAL FLIGHT CREW MEMBERS
(a) All flight crew members who operate as the pilot in
command and who fly rotary wing aircraft as air ambulances
must meet, at a minimum, the following criteria:
(1) 2,000 hours helicopter flight time;
Commercial rotocraft certificate;
Instrument helicopter rating;
Ten hours additional flight training when making a
transition from single to twin engine aircraft;
Five hours additional flight training when making a
transition from one model aircraft to another;
Ten Four hours flight time orientation of which two
should be day time and two should be night time for
new pilots if unfamiliar with the program service
area including night flights; and area; and
Ftve Two hours flight time orientation for new pilots
if familiar with the program service area including
night flights.
(b) All flight crew members and medical crew members,
including specialty teams must meet, at a minimum, the
following criteria:
(1) Fly an average of at least five missions per month
per six month period or complete refresher training
in aircraft safety every six months; and
(2) Complete refresher training in aircraft safety on an
annual basis.
(c) Relief pilots utilized by the program may assume
operational duties at the discretion of the Lead Pilot/Aviation
Site Manager.
Authority G.S. 131E-1 59(b).
.1205 AMBULANCE ATTENDANT PERFORMANCE
Ambulance attendants trained educated in approved t raining
programs and certified by the Office of Emergency Medical
Services may assist the emergency medical technician in
(2)
(3)
(4)
(5)
(6)
(7)
2:5 NORTH CAROLINA REGISTER September 2, 1997 348
PROPOSED RULES
performing any of the following procedures if allowed by the
County Emergency Medical Services System in which they
function:
(1) Patient assessment;
(2) Basic life support techniques in accordance with the
American Heart Association or American Red Cross
including airway management and cardiopulmonary
resuscitation;
(3) Hemorrhage control;
(4) Oxygen administration;
(5) Treatment for shock;
(6) Bandaging and dressing soft tissue injuries;
(7) Splinting fractures and dislocations;
(8) Treatment of injuries to the skull, spine, and chest;
(9) Assisting in normal and abnormal childbirth;
(10) Lifting and moving patients for transfer to a medical
facility;
(11) Treatment of injuries as a result of exposure to heat
and cold;
(12) Treatment of bums; and
(13) Providing of basic life support for medical
emergencies, emergencies; and
(14) Use of an automated external defibrillator.
Authority G.S. 131E-159(b).
.1206 EMERGENCY MEDICAL TECHNICIAN
PERFORMANCE
Emergency Medical Technicians trained educated in
approved t raining programs and certified by the Office of
Emergency Medical Services may perform any of the following
procedures if allowed by the County Emergency Medical
Services System in which they function:
(1) Patient assessment;
(2) Basic life support techniques in accordance with the
American Heart Association or American Red Cross
including airway management and cardiopulmonary
resuscitation;
(3) Oxygen administration;
(4) Hemorrhage control;
(5) Treatment for shock;
(6) Bandaging and dressing soft tissue injuries;
(7) Application of military anti-shock trousers;
(8) Splinting fractures and dislocations;
(9) Treatment of injuries to the head, face, eye, neck,
and spine;
(10) Treatment of injuries to the chest, abdomen and
genitalia;
(11) Provision of basic life support for medical injuries;
(12) Assisting in normal and abnormal childbirths;
(13) Treatment of injuries as a result of exposure to heat
and cold;
(14) Treatment of bums;
(15) Lifting and moving patients for transfer to a medical
facility; and
(16) Extrication of patients from confined areas, areas;
and
(17) Use of an automated extemal defibrillator.
Authority G.S. 131E-159(b).
SECTION .1300 - CERTIFICATION REQUIREMENTS
FOR BASIC LIFE SUPPORT PERSONNEL
.1301 CERTIFICATION REQUIREMENTS:
AMBULANCE ATTENDANT
(a) To become certified as an Ambulance Attendant, J
person shall successfully complete either of the followin]
options : options within one year of the approved educational
program course completion date:
(1) OPTION I
(A)
(B)
Be at least 18 years of age;
Successfully complete, within one year prioi
to
—
application, complete an Ambulance
Attendant training approved program meetin:
the requirements of the "North Carolina
Ambulance Attendant Curriculum Outline"
Outline." dated February \994—and
incorporated he rein by refe rence including
subsequent amendments and editions.—This
document may be obtained free of charge
from—the
—
Office—of Emergency—Medical
Services, P.O. Box 29530, Raleigh, NC
27626-0530. When training the approved
(2)
educational program was completed over one
year prior to application, a person shall submit
evidence of completion of continuing
education in emergency medicine taken in the
past year to the Office of Emergency Medical
Services;
(C) Pass a basic life suppon practical examination
administered by the Office of Emergency
Medical Services; and
(D) Pass either an Ambulance Attendant written
examination or an oral examination, at the
option of the applicant, administered by the
Office of Emergency Medical Services; or
OPTION II
(A)
(B)
Be at least 18 years of age;
Successfully complete, within one year prior
to
—
application, complete an approved
Emergency Medical Technician training
program meeting the requirements of the
"North Carolina Emergency Medical
Technician Curriculum Outline" Outline
dated February 1 994 and incorporated herein
by refe rence including subsequent amendments
and editions. This document may be obtained
free of charge from the Office of Emergency
Medical Services, P.O. Dux 29530, Raleigh;
NC 27620-0530. When training the approved
educational program was completed over one
year prior to application, a person shall submit
evidence of completion of continuing
349 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
education in emergency medicine taken in the
past year to the Office of Emergency Medical
Services;
(C) Pass a basic life support practical examination
administered by the Office of Emergency
Medical Services; and
(D) Complete an Emergency Medical Technician
written examination administered by the
Office of Emergency Medical Services and
achieve a minimum score of 55%. 70% on the
Ambulance Attendant Subset contained within
the Emergencv Medical Technician written
examination.
(b) Persons holding current certification equivalent to an
Ambulance Attendant with the National Registry of Emergency
/ledical Technicians or in another state where the training
ducation and certification requirements have been approved for
egal recognition by the Office of Emergency Medical Services
nay become certified by:
(1) Presenting evidence of such certification for
verification by the Office of Emergency Medical
Services; and
(2) Be at least 18 years of age.
(c) Certification obtained through legal recognition shall be
'alid for a period not to exceed the length of the current
lertification or a period not to exceed four years whichever is
hotter. No certification shall be valid for a period exceeding
our years. Persons who live in a state that borders North
Carolina and are currently affiliated with an ambulance
)rovider in North Carolina may continue to obtain a North
Carolina certification through legal recognition if they continue
meet the recertification requirements in the state in which
hey reside. Persons who live in North Carolina and are
:urrently certified in another state that borders North Carolina
nay continue to obtain a North Carolina certification through
egal recognition if they continue to meet the recertification
equirements in the state in which they are certified. Persons
vho were previously certified in North Carolina and are
urrently certified in another state or with the National Registry
)f Emergency Medical Technicians, shall present evidence of
:ontinuing education and skill evaluation prior to becoming
:ertified through legal recognition.
(d) To become recertified as an Ambulance Attendant a
)erson must successfully complete either of the following
)ptions:
(1) OPTION I
(A) A continuing education program consisting of
a minimum of 48 hours during each two year
period of the person's four year certification
period taught or coordinated by a Qualified
conducted under the direction of a Certified
EMT Instructor. The continuing education
program shall meet the requirements set forth
in the "Guidelines for Initial Education,
Refresher Education, Continuing Education
and Performance Evaluation of Emergency
Medical Services Basic Life Support
Personnel" dated February 1 994 Personnel":
or and
—
incorporated—he rein—by—
r
eference
including—subsequent—amendments—and
editions. This document may be obtained free
of charge from the Office of Emergency
Medical Se rvices, P.O. Box 29530, Raleigh,
NC 27626-0530;
(B) A continuing education program consisting of
a minimum of 48 hours during each two year
period of the person's four year certification
period conducted under the direction of a
Medical Director as defined in 21 NCAC 32H
.0102(8). The continuing education program
shall meet the requirements set forth in the
"Guidelines for Continuing Education and
Performance Evaluation of Emergency
Medical Services Advanced Life Support
Personnel" i and
tB)£Q A basic life support skill evaluation(s)
approved by the Office of Emergency Medical
Services conducted under the direction of a
Qualified Certified EMT Instructor or Medical
Director as defmed in 21 NCAC 32H .0102(8)
assessing the ability to perform the skills of an
Ambulance Attendant; or
(2) OPTION II
(A) A continuing education program consisting of
a minimum of 96 hours during the person's
four year certification period. The continuing
education program shall meet the requirements
set forth in the "Guidelines for Initial
Education, Refresher Education, Continuing
Education and Performance Evaluation of
Emergency Medical Services Basic Life
Support Pe rsonnel"—dated February—^994
Personnel " ; and and incorporated he rein by
reference including subsequent amendments
and editions. This document may be obtained
free of charge from the Office of Emergency
Medical Services, P.O. Box 29530, Raleigh,
NC 27626-0530 ;
(B) A basic life support practical examination
administered by the Office of Emergency
Medical Services; or
(3) OPTION III
(A) An approved Ambulance Attendant refresher
course consisting of a minimum of 48 hours
during the person's last year of certification.
This refresher course shall meet the
"Guidelines for Initial Education, Refresher
Education, Continuing Education and
Performance Evaluation of Emergency
Medical Services Basic Life Support
Pe rsonnel" dated February 1 994 Personnel":
and incorporated herein by refe rence including
(2:5 NORTH CAROLINA REGISTER September 2, 1997 350
PROPOSED RULES
subsequent amendments and editions.—This
doeument may be obtained free of charge
from—the
—
Office—of Emergency—Medical
Sci' viccs, P.O. Box 29530. Raleigh, NC
27626-0530 :
(B) A basic life suppon practical examination
administered by the Office of Emergency
Medical Services; and
(C) Afte r Septembe r 30, 1 996, an Ambulance
Attendant A written examination or an oral
examination, at the option of the applicant,
administered by the Office of Emergency
Medical Services.
Authority G.S. 131E-I59(aj: 1984 S.L., c. 1034.
.1302 CERTIFICATION REQUIREMENTS:
EMERGENCY MEDICAL TECHNICIAN
(a) To become certified as an Emergency Medical
Technician, a person shall meet the following c r ite r ia ; criteria
within one year of the approved educational program course
completion date:
(1) Be at least 18 years of age;
(2) Successfully complete, within one year prior to
application, complete an approved Emergency
Medical Technician training program meeting the
requirements of the "North Carolina Emergency
Medical Technician Curriculum Outline"—dated
Tcbruary 1994 Outline." and incorporated he rein by
refe rence including subsequent amendments and
editions.—This document may be obtained free of
charge from the Office of Emergency Medical
Se rvices, P.O. Box 29530. Raleigh, NC 27626-0530.
When training the approved educational program was
completed over one year prior to application, a
person shall submit evidence of completion of
continuing education in emergency medicine taken in
the past year to the Office of Emergency Medical
Services;
(3) Pass a basic life support practical examination
administered by the Office of Emergency Medical
Services; and
(4) Pass an Emergency Medical Technician written
examination administered by the Office of
Emergency Medical Services.
(b) Persons holding current certification equivalent to an
Emergency Medical Technician with the National Registry of
Emergency Medical Technicians or in another state where the
t raining educational and certification requirements have been
approved for legal recognition by the Office of Emergency
Medical Services may become certified by;
(1) Presenting evidence of such certification for
verification by the Office of Emergency Medical
Services; and
(2) Be at least 18 years of age.
(c) Certification obtained through legal recognition shall be
valid for a period not to exceed the length of the current
certification or a period not to exceed four years whichever i;
shorter. No certification shall be valid for a period exceeding
four years. Persons who live in a state that borders Nortl
Carolina and are currently affiliated with an ambulancf
provider in North Carolina may continue to obtain a Nortl
Carolina certification through legal recognition if they continu(
to meet the recertification requirements in the state in whicl
they reside. Persons who live in North Carolina and ar(
currently certified in another state that borders North Carolini
may continue to obtain a North Carolina certification througl
legal recognition if they continue to meet the recertificatioi
requirements in the state in which they are certified. Person
who were previously certified in North Carolina and ar(
currently certified in another state or with the National Registr;
of Emergency Medical Technicians, shall present evidence o
continuing education and skill evaluation prior to becominj
certified through legal recognition.
(d) To become recertified as an Emergency Medica
Technician a person shall successfully complete either of thi
following options:
(1) OPTION I
(A) A continuing education program consisting o
a minimum of 48 hours during each two yea
period of the person's four year certificatioi
period taught or coordinated by a Qualifiei
conducted under the direction of a Certifiei
EMT Instructor. The continuing educatio:
program shall meet the requirements set fort
in the "Guidelines for Initial Education
Refresher Education, Continuing Educatio
and Performance Evaluation of Emergenc
Medical Services Basic Life Suppoi
Pe rsonnel" dated February 1 994 Personnel"
or and
—
incorporated herein by—
r
cferenci
including—subsequent—amendments—an
editions. This document may be obtained fre
of charge from the Office of Emergenc;
m
Medical Services. P.O. Box 29530. Raleigh
NC 27626-0530.
A continuing education program consisting o
a minimum of 48 hours during each two yea
period of the person's four year certificatio
period conducted under the direction of
Medical Director as defined in 2\ NCAC 321
.0102(8). The continuing education prograr
tfi)iCl
shall meet the requirements set forth in th
"Guidelines for Continuing Education an
Performance Evaluation of Emergenc
Medical Services Advanced Life Suppoi
Personnel"; and
A basic life support skill evaluation(s|
approved by the Office of Emergency Medic;
Services conducted under the direction of
Qualified Certified EMT Instructor or Medic
Director as defmed in 21 NCAC 32H .0102(J
assessing the ability to perform the skills of a
Emergency Medical Technician; or
(
351 NORTH CAROLINA REGISTER September!, 1997 12:
PROPOSED RULES
(2) OPTION II
(A) A continuing education program consisting of
a minimum of 96 hours during the person's
four year certification period. The continuing
education program shall meet the requirements
set forth in the "Guidelines for Initial
Education, Refresher Education, Continuing
Education and Performance Evaluation of
Emergency Medical Services Basic Life
Support Personnel
"
—dated Tcbruary—W94
Personnel"; and and incorporated herein by
reference including subsequent amendments
and editiom. This document may be obtained
free of charge from the Office of Emergency
Medical Services, P.O. Box 29530. Raleigh,
NC 27626-0530;
(B) A basic life support practical examination
administered by the Office of Emergency
Medical Services; or
(3) OPTION III
(A) An approved Emergency Medical Technician
refresher course consisting of a minimum of
48 hours during the person's last year of
certification. This refresher course shall meet
the "Guidelines for Initial Education,
Refresher Education, Continuing Education
and Performance Evaluation of Emergency
Medical Services Basic Life Support
Pe rsonnel" dated February 1 994 Personnel";
and incorporated herein by refe rence including
subsequent amendments and editions.—This
document may be obtained free of charge
from—the
—
Office—of Emergency—Medical
Services, P.O. Box 29530, Raleigh, NC
27626-0530;
(B) A basic life support practical examination
administered by the Office of Emergency
Medical Services; and
(C) After September 30, 1 996, an An Emergency
Medical Technician written examination
administered by the Office of Emergency
Medical Services.
[uthority G.S. 131E-159(b): 1984 S.L., c. 1034.
SECTION .1400 - ADMINISTRATION
1401 LICENSE, PERMIT OR CERTIFICATION
DENIAL, SUSPENSION, AMENDMENT OR
REVOCATION
(a) The Department may deny, suspend, or revoke the
lermit of a specific vehicle for any of the following reasons:
(1) Failure to substantially comply with the requirements
of Section .0900 of this Subchapter;
(2) Obtaining a permit through fraud or
misrepresentation; or
(3) Failure to provide emergency medical care to the
defmed ambulance service area in a timely and
professional manner.
(b) The Department may issue a temporary permit for a
specific vehicle whenever the Department finds that:
(1) the ambulance provider to which that vehicle is
assigned has substantially failed to comply with the
provisions of G.S. 13 IE, Article 7 and the rules
adopted imder that article; and
(2) there is a reasonable probability that the ambulance
provider can remedy the permit deficiencies within a
reasonable length of time; and
(3) there is a reasonable probability that the ambulance
provider will be able thereafter to remain in
compliance with the rules regarding ambulance
permits for the foreseeable future.
(c) The Department shall give the ambulance provider
written notice of the temporary ambulance permit. This notice
shall be given personally or by certified mail and shall set forth:
( 1
)
the length of the temporary ambulance permit not to
exceed 60 days;
(2) a copy of the ambulance inspection form;
(3) the statutes or rules alleged to be violated; and
(4) notice to the ambulance provider's right to a
contested case hearing on the temporary ambulance
permit.
(d) The temporary ambulance permit shall be effective
immediately upon its receipt by the ambulance provider. The
temporary ambulance permit shall remain in effect imtil:
(1) the Department restores the vehicle to full permitted
status; or
(2) the Department revokes the vehicle's ambulance
permit.
(e) The Department may deny, suspend, or revoke the
certification of a field technician BLS professional or certified
EMT instructor for any of the following reasons:
(1) Failure to comply with the applicable performance
and certification requirements as found in Sections
.1200 and .1300 of this Subchapter;
(2) Obtaining or attempting to obtain certification or
rccertification through fraud or misrepresentation;
Immoral or dishonorable conduct;
(3) Aiding a person in obtaining or attempting to obtain
certification or rccertification through fraud or
misrepresentation; Making false statements or
representations to the Office of Emergency Medical
Services or willfully concealing of material
information in connection with an application for
certification:
(4) Failure—to
—
competently—perform—the
—
skills—or
procedures enumerated in Section .1200 of this
Subchapte r; Being unable to perform as a BLS
professional with reasonable skill and safety to
patients and the public by reason of illness.
drunkenness, excessive use of alcohol, drugs,
chemicals, or ajiy other type of material or by reason
2:5 NORTH CAROLINA REGISTER September 2, 1997 352
PROPOSED RULES
of any physical or mental abnormality:
(5) Performance of a skill or procedure which is not
within the scope and responsibility of the certificate
holder; Unprofessional conduct, including but not
limited to a failure to comply with the rules relatin g
to the proper function of a BLS professional or
certified EMT instructor contained in this Subchapter
or the performance of or attempt to perform a
procedure which is detrimental to the health and
safety of a patient or which is beyond the scope and
responsibility of the BLS professional or certified
EMT instructor;
(6) Pe r fo rmance—of—a—skiti—or—procedure—that—is
detr imental to the health and safety of a patient ;
Conviction in any court of a crime inyolving moral
turpitude, a conviction of a felony, or conviction of
a crime involving the function of a BLS professional:
(7) Any felony conviction: By false representations
obtaining or attempting to obtain money or anything
of value from a patient:
(8) A misdemeanor conviction of the use, possession, or
distribution of illegal drugs within the past five years ;
or Adjudication of mental incompetence:
(9) Conviction of driving while impaired within the past
five years. Lack of professional competence to
practice with a reasonable degree of skill and safety
for patients including but not limited to a failure to
perform a prescribed procedure, failure to perform
a prescribed procedure competently or performance
of a procedure which is not within the scope of the
official duties of the BLS professional:
(10) Failure to respond within a reasonable period of time
and in a reasonable maimer to inquires from the
Office of Emergency Medical Services concerning
any matter relating to the practice of a BLS
professional or certified EMT instructor:
(11) Testing positive for substance abuse by blood, urine
or breath testing while on duty as a BLS professional
or certified EMT instructor: or
(12) Representing or allowing others to represent that the
BLS professional or certified EMT instructor has a
certification that the BLS professional or certified
EMT instructor does not in fact have.
(f) The Department shall deny any application for an
Ambulance Provider License upon becoming aware that the
applicant is not in substantial compliance with G.S. 13 IE,
Article 7 and the rules adopted under that article.
(g) The Department may amend any Ambulance Provider
License by reducing it from a full license to a provisional
license whenever the Department finds that:
(1) the licensee has substantially failed to comply with
the provisions of G.S. 131E, Article 7 and the rules
adopted under that article; and
(2) there is a reasonable probability that the licensee can
remedy the licensure deficiencies within a reasonable
length of time; and
(3) there is a reasonable probability that the licensee will
be able thereafter to remain in compliance with the
licensure rules for the foreseeable future.
(h) The Department shall give the licensee written notice of
the amendment to the Ambulance Provider License. This
notice shall be given personally or by certified mail and shall
set forth:
(1) the length of the provisional Ambulance Provider
License;
(2) the facmal allegations;
(3) the statutes or rules alleged to be violated; and
(4) notice to the ambulance provider's right to a
contested case hearing on the amendment of the
Ambulance Provider License.
(i) The provisional Ambulance Provider License shall be
effective immediately upon its receipt by the licensee and shall
be posted in a prominent location at the primary business
location of the ambulance provider, accessible to public view,
in lieu of the full license. The provisional license shall remain
in effect until:
(1) the Department restores the licensee to full licensure
status; or
(2) the Department revokes the licensee's license.
(j) The Department may revoke or suspend an Ambulance
Provider License whenever:
(1) the Department finds that:
(A) the licensee has substantially failed to comply
with the provisions of G.S. 131E, Article 7
and the rules adopted imder that article; and
(B) it is not reasonably probable that the licensee
can remedy the licensure deficiencies within a
reasonable length of time; or
(2) the Department finds that:
(A) the licensee has substantially failed to comply
with the provisions of G.S. 13 IE, Article 7
and the rules adopted under that article; and
(B) although the licensee may be able to remedy
the deficiencies within a reasonable period of
time, it is not reasonably probable that the
licensee will be able to remain in compliance
with licensure rules for the foreseeable future;
or
(3) the Department finds that there has been any failure
to comply with the provision of G.S. 131E, Article
7 and the rules adopted under that article that
endanger the health, safety or welfare of the patients
cared for and transported by the licensee.
(k) The issuance of a provisional Ambulance Provider
License is not a procedural prerequisite to the revocation or
suspension of a license pursuant to Paragraph (j) of this Rule.
Authority G.S. 13IE- 155.1; 131E-156; 131E-157(a);
131E-159(b).
.1403 APPLICATION PROCEDURES, REQUIRED
FORMS
(a) All applications for licensure, certification, or
recertification must be filed with the Office of Emergency
353 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
Medical Services on the appropriate forms.
(b) At a minimum, the following forms are required for
application:
(1) Certification Application Form for certification of
persoimel; and
(2) Certified Instructor Application Form: and
i^Q} Ambulance Provider License Application Form for
issuance of licenses.
(c) The following documents are required for educational
and evaluation programs incorporated herein by reference
including subsequent amendments and editions. Copies of these
documents are available free of charge from the Office of
Emergencv Medical Services. PO Box 29530. Raleigh. NC
27626-0530.
(1) "North Carolina Ambulance Attendant Curriculum
Outline":
(2) "North Carolina Emergency Medical Technician
Curriculum Outline":
(3) "Guidelines for the Initial Education. Refresher
Education. Continuing Education and Performance
Evaluation of Emergency Medical Services Basic
Life Support Personnel "
:
(4) "Guidelines for Continuing Education and
Performance Evaluation of Emergency Medical
Services Advanced Life Support Personnel"
fe)(d} EMS providers shall complete all forms, surveys, and
requests for data, as required by these Rules.
Authority G.S. 131E-155.1; 131E-157(a); 131E-159(b).
TITLE 13 - DEPARTMENT OF LABOR
Notice is hereby given in accordance with G.S. 150B-21.2 that the Department of Labor, Division of Occupational Safety and
Health intends to amend rule cited as 13 NCAC 7F .OWL Notice of Rule-making Proceedings was published in the Register
on March 14, 1997.
Proposed Effective Date: July 1, 1998
A Public Hearing will be conducted at 10:00 a.m. on September 17, 1997 at the NCDOL:
Health, 319 Chapanoke Road, Suite 105, Conference Room A, Raleigh, NC.
Division of Occupational Safety and
Reason for Proposed Action: This amendment to 13 NCAC 07F .0101 (1) reformats portions of the rule to make it easier to
correlate the State requirements with the previously adopted requirements of 29 CFR 1910. 1000 and other related standards, (2)
removes information related to interim requirements that have expired, (3) corrects errors in computational formulas, units of
measure, and other entries, (4) adopts the existing federal standardfor silica, and (5) removes information that repeats the content
offederal standards fRef: G.S. 1508-19(4)].
Note: The attached edited pages also reflect a Notice of Text & Hearing submittal published in the August I, 1997 NC Register.
Comment Procedures: The purpose of this anrwuncement is to encourage all interested and potentially affected persons or parties
to make their views known to the Division of Occupational Safety and Health (OSH) whether in favor of or opposed to any and all
provisions of the proposal being noticed. Written comments, data, or other information relevant to this proposal must be submitted
within 30 days (October 3, 1997). Written comments may be submitted to: Peggy D. Morris, Division of Occupatiorml Safety and
Health at NCDOL: Division of Occupational Safety and Health, 319 Chapanoke Road, Suite 105, Raleigh. NC 27603-3432, Phone:
(919) 662-4581 or 1-800-LABORNC, FAX: (919) 662-4582.
Fiscal Note: This Rule does not affect the expenditures or revenues of state or local government funds,
a substantial economic impact of at least five million dollars ($5,000,000) in a 12-month period.
This Rule does not have
CHAPTER 7 - OFFICE OF OCCUPATIONAL SAFETY AND HEALTH
SUBCHAPTER 7F - STANDARDS
SECTION .0100 - GENERAL INDUSTRY STANDARDS
.0101 GENERAL INDUSTRY
fa) The provisions for the Occupational Safety and Health Standards for General Industry, Title 29 of the Code of Federal
Regulations Part 1910 promulgated as of February 28,1 997, August 4, 1997. and exclusive of subsequent amendments, are
incorporated by reference except as follows:
12:5 NORTH CAROLINA REGISTER September 2, 1997 354
PROPOSED RULES
(1) Subpart H - Hazardous Materials, 29 CFR 1910.120, Hazardous waste operations and emergency response,
§1910. 120(q)(6) is amended by adding a new level of training:
"(vi) First responder operations plus level. First responders at operations plus level are individuals who respond to
hydrocarbon fuel tank leaks where the leaking tanks contain a hydrocarbon fuel which is used to propel the vehicle on
which the tank is located. Only those vehicles designed for highway use or those used for industrial, agricultural or
construction purposes are covered. First responders at the operations plus level shall have received at least training equal
to first responder operations level and, in addition, shall receive training or have had sufficient experience to objectively
demonstrate competency in the following areas and the employer shall so certify:
(A) Know how to select and use proper specialized personal protective equipment provided to the first responder at
operations plus level;
(B) Understand basic hazardous materials terms as they pertain to hydrocarbon fuels;
(C) Understand hazard and risk assessment techniques that pertain to gasoline, diesel fuel, propane and other
hydrocarbon fuels;
(D) Be able to perform control, containment, or confinement operations for gasoline, diesel fuel, propane and other
hydrocarbon fuels within the capabilities of the available resources and personal protective equipment; and
(E) Understand and know how to implement decontamination procedures for hydrocarbon fuels."
(2) Subpart I -- Personal Protective Equipment -- 29 CFR 1910.132, General requirements, is amended at 29 CFR
1910.132(b) to read:
"(b) Equipment. (1) Employer-provided equipment. It is the responsibility of the employer to provide, at no cost to
the employee, all personal protective equipment which the employee does not wear off the jobsite for use off the job.
(2) Employee-owned equipment. Where employees provide their own protective equipment, the employer shall be
responsible to assure its adequacy, including proper maintenance, and sanitation of such equipment."
(3) Subpart R -- Special Industries - incorporation by reference of final rule for 29 CFR 1910.269, Electric Power
Generation, Transmission, and Distribution, including Appendices A through E, published in 59 FR (January 31, 1994)
pages 4437 - 4475, all typographical and grammatical corrections to 1910.269 as published in 59 FR (June 30, 1994)
pages 33660 - 33664, and the amendment to 1910.269(g)(2)(i) as published in 59 FR (August 9, 1994) page 40729, except
that 29 CFR 1910.269(g)(2)(v) is amended to read:
"(v) Fall arrest equipment, work positioning equipment, or travel restricting equipment shall be used by employees
working at elevated locations more than 4 feet (1.2 m) above the ground on poles, towers or similar structures if
other fall protection has not been provided. A fall protection system as defined in 29 CFR 1926, Subpart M - Fall
Protection, is required to be used by all employees when ascending, descending or changing locations on poles,
towers or similar structures. However, the use of non-locking snap hooks with any fall protection system is
prohibited as of July 1, 1995. Qualified employees may free climb wood poles if the employer can ensure (1) that
the employee is able to comfortably and safely grip the pole with both hands while climbing, (2) that the pole is
free from attachments or any configurations of attachments that will materially impair the ability of a qualified
employee to safely free climb the pole, (3) that the pole is otherwise free from impediments, contaminants or
conditions of any type, including but not limited to ice, high winds or chemical treatments which materially impair
the ability of a qualified employee to safely free climb the pole, and (4) that the employee is able to climb such
structures without material physical impairments including over-exertion, lack of sleep or other physical stresses."
29 CFR 1910.269 as amended above is effective January 1, 1995, except that employers have until July 1, 1995,
to implement the use of locking snap hooks, and employers have until January 1, 1996, to design and implement
a system of fall protection for use by employees while ascending, descending or changing locations on towers.
Also, 29 CFR 1910.269(a)(2) Training is effective January 31, 1995, and 29 CFR 1910.269(v)(ll)(xii) is effective
February 1, 1996.
(4) Subpart Z - Toxic and Hazardous Substances:
tal (t4c) 29 CFR 1910.1000 Air Contaminants:
Revision of 1 9 10.1000 (a) and (f), removal of Table Z-2 and Table Z-3 and re-adoption of revised permissible
exposure limits as Table Z-1 as or iginally published in 54 FR (January 1 9 , 1 989) pages 2923 - 2958 as follows:
"§1 9 10.1000 Air contaminants.
An employee's exposure to any substance listed in Table Z-1 of this section shall be limited in accordance with
the requirements of the following paragraphs and sections.
(a) Table Z- l.(l) Substances with limits designated by "C" - Ceiling Limits. An employee's exposure to any
substance in Table Z-1. the exposure limit of which is followed by a "C". shall at no time exceed the exposure limit
given for that substance in Table Z- 1
.
(2) Current peivtissible e.vposure limits. An employee's exposure to any substance listed in Table Z-1 shall not
exceed the Time Weighted Average (TWA), Short Term Exposure Limit (STEL) and Ceiling Limit specified for
that substance in Table Z-1 under the Current PEL column.
355 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
(3) Skin Desigtiation. To prevent or reduce skin absorption, an employee's skin exposure to substances listed in
Table Z-1 with an "X" in the Skin Designation column following the substance name shall be prevented or reduced
to the extent necessary in the ci rcumstances through the use of gloves, coveralls, goggles, or other appropriate
personal protective equipment, engineering controls or work practices.
(4) Definitions. The following definitions arc applicable to the Current PEL column of Table Z-1 :
(i) Time weighted average (TWA) is the employee's average airborne exposure in any 8-hour work shift
of a 40-hour work week which shall not be exceeded.
(ii) Short term exposure limit (STCL) is the employee's 15-minute time weighted average exposure which
shall not be exceeded at any time during a work day unless another time limit is specified in a parenthetical
notation below the limit. If another time period is specified, the time weighted average exposure over that
time period shall not be exceed at any time during the working day.
(iii) Ceiling is the employee's exposure which shall not be exceeded during any part of the work day. If
instantaneous monitoring is not feasible, then the ceiling shall be assessed as a I5-minuic time weighted
ave rage exposure which shall not be exceeded at any time over a working day.
(5)
—
Additional Definitions. The terms "substance," "air contaminant, ' and "material" arc equivalent in
meaning for 29 CFR 1 9 10.1000.
(b) and (c) are resen'ed.
(d) and (e) are not amended.
if) Effective dates. (1) The effective date for the pe rmissible exposure limits specified in the following
Current PCL column of Table Z-1 is March 7, 1 997.
iii The equation in 29 CFR 1910.1000(d)(l)(i) is clarified to read as follows:
E ^ icx, ± Cbib ± . . . cj:^
(iil The equation in 29 CFR 1910. 1000(d)(2)(i) is clarified to read as follows:
E, = (C,/L,} + tC,/L,l + . . AC^^i
(iii) The permissible exposure limits as originally published in 54 PR (January 19. 1989) pages 2331-2983 are
incorporated except as otherwise specified or noted in this Rule,
(iv) Employee exposure to the toxic and hazardous substances listed in the following tables shall be limited to
the specified values.
PERMISSIBLE EXPOSURE LIMITS FOR AIR CONTAMINANTS
NOTE: Because of the length of the table, explanatory Footnotes applicable to all substances are given below.
Footnote (1) The PELs are 8-hour TWAs unless otherwise noted; a (C) designation denotes a ceiling limit.—They are to be
detci'mined from breathing-zone air samples.
Footnote (2) Parts of vapor or gas pe r million parts of contaminated ai r by volume at 25 degrees C and 760 tor r.
Footnote (3) Milligrams of substance pe r cubic meter of air . When entry is in this column only, the value is exact; when listed
with a ppm entry, it is approximate.
Footnote (4) The CAS number is for information only. Enforcement is based on the substance name.
Footnote f^ £11 Regarding Styrene Only: OSHNC recognizes that the permissible exposure limits for styrene may not be
achievable solely through engineering and work practice controls for boat-building and operations comparable to boat building.
Comparable of)erations are those that (1) employ the manual layup and sprayup process, (2) the manufactured items that utilize the
same equipment and technology as that found in boat building, and (3) the same considerations of large part size, configuration
interfering with air-flow control techniques, and resin usage apply. Examples of operations comparable to boat building would
include the manufacture of large above-ground or below-ground storage tanks, large parts for recreational vehicles, and large duct
work. Because it is impossible to define in advance every manual layup and sprayup process for which compliance may not be
feasible solely through engineering and work practice controls, some guidelines concerning part size and configuration issues are
necessary. The primary question for manual layup and sprayup operations is whether the part's size and configuration interfere
with normal air-flow techniques. For operations making parts (such as tubs and vanities) that do not meet the guidelines described,
beginning April 1, 1996, the hierarchy of controls specified in 29 CFR 1910.10(X)(e) will apply to reduce styrene exposures to the
new 50 ppm TWA and 100 ppm STEL. In consequence, the burden of proof will be on the employer to show that engineering and
work practice controls are not feasible for specific operations. However, with respect to boat-building operations the burden of
proof would be on OSHNC to prove that the level could be attained solely through engineering and work practice controls.
Footnote f6) {21 Regarding Acrylamide. Carbon Dioxide and Silica only: no change was made to the PEL. The federal standards
at 29 CFR 1910.1000 are adopted.
Footnote irf) £31 Regarding Subtilisins only: PELs for this substance is are not included in Table Z-1 below, adopted.
12:5 NORTH CAROLINA REGISTER September 2, 1997 356
PROPOSED RULES
TABLE Z- 1. LIMITS FOR AIR CONTAMINANTS
SUBSTANCE
NCnVIBER
FORMER PEL CURRENT PEL
Acetaldch^ dc 75-07-0 200 ppm TWA 100 ppm TWA
150 ppm STEL
Acetic acid 64-1 9 -7 10 ppm TWA 10 ppm TWA
Aceiic anhydride 108-24-7 5 ppm TWA 5 ppm TWA (C)
Acetone €Mr^ 1000 ppm TWA 750 ppm TWA
1000 ppm STEL
75-05-8 40 ppm TWA 40 ppm TWA
60 ppm STEL
!-Aceiylaminofluorene —see 1 9 10.1014 53- 96-3
Acetylene dichlor idc —!^ee 1.2-Dichloroeihylenc
Ac^rteTtc-frfrabromide 79-27-6 ppm TWA ppm TWA
Acetylsalicylic acid —(Aspi rin)
50-70-2 5 mg/m^ TWA
Acrolein 107-02-0 0.1 ppm TWA 0.1 ppm TWA
0.3 ppm STEL
Acrv' lamide 79 -06-1 0.3 mg/m^^FWA 0.3 mg/m' TWA
Acrv
' lic acid 79-10-7 No former PEL 10 ppm TWA X
Ac rs'lonitriic:
see 1 9 10.1045. 107-13-1
Aldr in 309-00-2 0.25 mg/m^ TWA 0.25 mg/m^ TWA
Allyl alcohol 107-18-6 2 ppm TWA 2 ppm TWA
4 ppm STEL
Allvl chloride 107-05-1 1 ppm TWA 1 ppm TWA
2 ppm STEL
Allyl glycidyl ethe r (AGE) 106- 92-3 10 ppm (C) 5 ppm TWA
10 ppm STEL
Allyl propyl disulFidc 2179 -5 9-1 2 ppm TWA 2 ppm TWA
3 ppm STEL
alpha-Alumina
Total Dust —Rcspi r able fraction
1344-28-1
15 mg/m'"-TWA 4e-^ng/ffl'^FWA
5 mg''m*^FWA
357 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
Aluminum (as Al)
Metal
Total dust
Rcspirablc fraction
—Welding fumes
Alkyls
7429-90-5
7429-90-5
45-mg/ffl''-TWA
5-^Hg/iR'-TWA
45-^fif/ffi'-^FWA
J nig/m 1 w/\
5-^ng/fH'-TWA
5 mg/m*-^FWA
^ /..-^ T^H r A X—Ills/ in I vv /\
Aluminum (soluble salts) 7429-90-5 mg/m*-^FWA
4-Aminodiphenyl ;
see 1 9 10.1011 92-67-1
2-Aminoethanol ; —sec Ethanolamine
2-Aminopyridine 504-29-0 0.5 ppm TWA
Amitrol 61-82-5 No fo rmer PEL 0.2 mg/m^^FWA
Ammonia 7664-41-7 50 ppm TWA 35 ppm STCL
Ammonium ehloride fume 12125-02-9 No former PEL 10 mg/m^ TWA
20 mg/m^ STEL
Ammonium sulfamate —Total dust —Rcspirable fraction
7773-06-0
15 mg/m^ TWA
5 mg/m^ TWA
10 mg/m^ TWA
5 mg/m^ TWA
'i-Amyl acetate 620-63-7 100 ppm TWA 100 ppm TWA
jec-Amyl acetate 626-30-0 125 ppm TWA 125 ppm TWA
Aniline and homologs 62-53-3 5 ppm TWA 2 ppm TWA X
Anisidinc (i?-. /^-isomers). 29 1 9 1-52-4 0.5 mg/m^ TWA 0.5 mg/m^ TWA
Antimony and compounds
(as Sb)
7440-36-0 0.5 mg/m^ TWA 0.5 mg/m^ TWA
ANTU (Alpha
naphthylthiourea)
86-88-4 0.3 mg/m» TWA 0.3 mg/m^ TWA
Arsenic, inorganic—
compounds (as As) ;
see 1 9 10.1018
Varies with
compound
Arsenic, organic
compounds (as As)
0.5 mg/m^ TWA 0.5 mg/m^ TWA
Arsine 7784-42-1 0.05 mg/m^ TWA 0.05 ppm TWA
Asbestos; sec 1 9 10.1001
Atrazine 1 9 12-24-9 No former PEL 5 mg/m^ TWA
Azinphos-mcthyl 86-50-0 0.2 mg/m^ TWA 0.2 mg/m^ TWA
Barium, soluble compounds
(as Da)
7440-39-3 0.5 mg/m» TWA 0.5 mg/m» TWA
12:5 NORTH CAROLINA REGISTER September 2, 1997 358
PROPOSED RULES
Barium sulfate —Total dust —Rcspi rablc fraction
7727-43-7
15 mgfm^ TWA
5 mg/m' TWA
10 mg/m^ TWA
5 mg/m^ TWA
Dcnomyl —Total dust —Rcspi rablc fraction
17004-35-
15 mg/m^ TWA
5 mg/m^ TWA
10 mg/m^ TWA
5 mg/m^ TWA
Benzene: Sec 1 9 10.1028
See Table Z-2 for the
limits applicable in the
ope rations or sectors
excluded in 1 9 10.1028(d)
71-43-2
Be nzidme : Sec 1910.1010 92-07-5
p-Bcnzoquinone ;—scc-
Quinone.
Bcnzo(a)py rcnc: see—
Coal tar pitch volatilcs
Benzoyl pe roxide 94-36-0 5 mg/m^ TWA 5 mg/m=
' TWA
Benzyl chloride 100-44-7 5 mg/m^
' TWA 5 mg/m^ TWA
Beryllium and
bciyllium compounds
(as Be)
7440-41-7 Table Z-2
0.002 ppm TWA
0.005 ppm STEL
(30 minute)—
0.025 ppm (C)
Biphenyl; see Diphenyl.
Bismuth telluridc,
Total dust
Rcspi rablc fraction
1304-02-1
15 mg/m^ TWA
5 mg/m^ TWA
15 mg/m' TWA
5 mg/m' TWA
Bismuth telluridc, Se-doped
1304-82-1 No forme r PCL 5 mg/m^ TWA
Borates, tet ra (anhydr ) 1330-43-4 No former PEL 10 mg/m^ TWA
Borates, tetra (decahyd) 1303-96-43 No former PEL 10 mg/m^ TWA
Borates, tetra (pentahyd) 12179-04-3 No former PEL 10 mg/m^ TWA
Boron oxide —Total dust —Rcspi rablc fraction
1303-06-2
15 mg/m^ TWA
5 mg/m^ TWA
10 mg/m^ TWA
5 mg/m^ TWA
Boron t ribromidc 10294-33-4 No former PEL 1 ppm (C)
Boron trifluoride 7637-07-2 1 ppm TWA (C) 1 ppm TWA (C)
Bromacil 314-40-9 No forme r PEL 1 ppm TWA
Bromine 7726-95-6 0.
1
ppm TWA 0.1 ppm TWA
0.3 ppm STEL
Bromine pcntafluor idc 7789-30-2 0.
1
ppm TWA
359 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
Di'omoform 75-25-2 0.5 ppm TWA 0.5 ppm TWA ^
Butadiene—(1.3-Dutadicne)
Sec 29 CrR 1 9 10.1051;
29 CrR 1910.1 9(1)
106-99-0
Butane 106-97-8 No former PEL 800 ppm TWA
Dutanethiol; See Butyl
mcrcaptan
2-Butanone (Methyl ethyl
ketone)
78-93-3 200 ppm TWA 200 ppm TWA
300 ppm STEL
-Buioxyethanol 111-76-2 50 ppm TWA 25 ppm TWA
/ i-Butyl-acetatc 123-06-4 150 ppm TWA 150 ppm TWA
200 ppm STEL
5fi."-Butyl acetate 105-46-4 200 ppm TWA 200 ppm TWA
fgrf-Butyl aeetate 540-00-5 200 ppm TWA 200 ppm TWA
>i-Butyl aerylate 141-32-2 No forme r PEL 10 ppm TWA
»-Butyl alcohol 71-36-3 100 ppm TWA 50 ppm (C)
5ei-"-Butyl alcohol 78-92 150 ppm TWA 100 ppm TWA
/i?;T-Butyl alcohol 75-65-0 100 ppm TWA 100 ppm TWA
150 ppm STEL
Butylamine 109-73-9 5 ppm (C) 5 ppm (C)
/g/-f-Butyl ehromate
(as CrO(3))
1189-85-1 0.1 mg/m^C) 0.1 mg/mMC)
«-Butyl glycidyl ether
(DGE)
2426-00-6 50 ppm TWA 25 ppm TWA
H-Butyl lactate 138-22-7 5 ppm TWA
; i-Butyl mcrcaptan 109-79-5 0.5 ppm TWA
Butyl mcrcaptan 109-79-5 10 ppm TWA 0.5 ppm TWA
o-sec-Butylphcnol 89-72-5 No former PEL 5 ppm TWA
/> -tert-Butyltoluenc 98-51-1 10 ppm TWA 10 ppm TWA
20 ppm STEL
Cadmium (as Cd);
sec 1 9 10.1027
7440-43-9
Calcium Carbonate
Total dust
Respirablc fraction
1317-65-3
15 mg/m'' TWA
5 mg/m' TWA
15 mg/m^ TWA
5 mg/m^ TWA
Calcium cyanamidc 156-62-7 No former PEL 0.5 mg/m^ TWA
Calcium hydroxide 1305-62-0 No former PEL 5 mg/m^ TWA
12:5 NORTH CAROLINA REGISTER September!, 1997 360
PROPOSED RULES
Calcium oxide 1305-76-8 5 mg/m^ TWA 5 mg/m^ TWA
Calcium silicate —Total dust —Respi rablc fraction
1344-95-2
15 mg/m' TWA
5 mg/m^ TWA
15 mg/m^ TWA
5 mg/m^ TWA
Calcium sulfate —Total dust —Rcspirablc fraetiion
7776-18-9
15 mg/m-' TWA
5 mg/m^ TWA
15 mg/m^ TWA
5 mg/m^ TWA
Camphor , synthetic 76-22-2 2 mg/m^ TWA 2 mg/m^ TWA
Caprolaetam (dust) 105-60-2 No forme r PEL 1 mg/m' TWA
3 mg/m^ STEL
Caprolaetam (vapor) 105-60-2 No former PEL 5 ppm TWA
10 ppm STEL
Captafol (Difolatan) 2425-06-1 No former PEL 0.1 mg/m-'TWA
Captan 133-06-2 No forme r PEL 5 mg/m^ TWA
Carbaryl (Sevin) 63-25-2 5 mg/m^ TWA 5 mg/m^ TWA
Carbofuran 1563-66-2 No former PEL 0. 1 mg/m^ TWA
Carbon black 1333-06-4 3.5 mg/m^ TWA 3.5 mg/m^TWA
Carbon dioxide 124-30-9 5000 ppm TWA 5000 ppm TWA
Carbon disulfide 75-15-0 Table Z-2 20 ppm TWA
30 ppm (O*
100 ppm Peak*
*Maximum duration is
30 min. for 8-hr . shift.
Carbon monoxide 630-00-0 50 ppm TWA 35 ppm TWA
200 ppm (C)
Carbon tctrabromidc 558-13-4 No former PEL 0.
1
ppm TWA
0.3 ppm STEL
Carbon tetrachloride 56-23-5 Table Z-2 2 ppm TWA
Carbonyl fluoride 353-50-4 No former PEL 2 ppm TWA
5 ppm STEL
Catechol (Pyrocatcchol) 120-00-9 No forme r PEL 5 ppm TWA ^
Cellulose —Total dust —Rcspirablc fractic
9004-34-6
15 mg/m^ TWA
5 mg/m-' TWA
15 mg/m^ TWA
5 mg/m^ TWA
Cesium hydroxide 21351-79-1 No former PEL 2 mg/m^ TWA
Chlordane 57-74-9 0.5 mg/m^ TWA 0.5 mg/m^ TWA
Chlorinated camphene 8001-35-2 0.5 mg/m' TWA 0.5 mg/m' TWA
1 mg/m^ STEL
Chlorinated diphcnyl oxide 557J0-99-5 0.5 mg/m^ TWA 0.5 mg/m^ TWA
361 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
n ^ nnm TU/
A
Chlorine 1 ppili i^>
•
Chlorine dioxide
U.J ppm 3 1 iiL
Chlorine trinuoride 7790-91-2
fcnteroacetaldehyac 107-20-0 1 ppm ti^; 1 ppm {K^}
ct-Chloroacetophc none
(1 ncnacyi cnioriue)
Chloroac-etyl chloride /7-U4 y
Chlorobenzenc
T/TOP ^ 1 I o-Chlorobenzyhdene X
maiononitriie
Chterobromomethane Tl 07 ^ 200 ppm TWA
z-L.nioro-1 ,j-outauicnc;
3CC pffu-cnioroprcnc
Chlorodifluoromethane
CT ,1iiO "^ 1 '^ Lhlorodipneny1 ?f
t 1 riH"' '''^ " Lhlorodiphcnyl X
1 /^i_l_ „ T
Ltnyicnc cnioronyurin
^,^r*
cnioroiorni
^ 1 T oo 1
i_nioromctnyi mcinyi 107-30-2
cincr; sec i^iu.iuuo
i-cnioro-i nitropropanc OUU z5-7 ^u ppm I 2 ppm TWA WA
/-•Ul . CT .1 "7/^ 1 ^ T 1 r\Ar\ rk«at> X^l^A
/ni-i 7G-06-2 U. 1 ppm 1 WA 0. 1 ppm 1 WA
lZO-'7T?-C5 ?t
iNo lormcr r'LL 5U ppm 1 WA
12:5 NORTH CAROLINA REGISTER September 2, 1997 362
PROPOSED RULES
t?-Cholorotolucne 95 -49-8 No fonnc r PEL 50 ppm TWA
2-Chloro-6
(trichlo romcthyl) pyr idine —Total dust —Respi rablc fraction
1 929-82-4
15 mg/m^ TWA
5 mg/m^ TWA
15 mg/m^ TWA
5 mg/m^ TWA
Chlorpyrifos 2921-88-2 No fo rmer PEL 0.2 mg/m^ TWA X
Chromic acid and—
chromates (as CrO(3))
Var ies with
compound
Tabl e Z-2 0.1 ppm (C)
Chromium (II) compounds
(as Cr )
7440-47-3 0.5 mg/m^ TWA 0.5 mg/m^ TWA
Chromium (III)—
compounds (as Cr )
7440-47-3 0.5 mg/m^ TWA 0.5 mg/m^ TWA
Chromium metal and insol.
salts (as Cr )
7440-47-3 mg/m^ TWA mg/m^ TWA
ChPi'senc: sec Coal tar
pitch volatilcs
Clopidol —Total dust —Rcspi rable fraction
2971-90-0
15 mg/m^ TWA
5 mg/m^ TWA
15 mg/m^ TWA
5 mg/m^ TWA
Coal dust (less than—
5% SiO(2)). respi rable
fraction Table Z-3 2 mg/m^ TWA
Coal dust (greate r than or
equal to 5% SiO(2)).
respi rable fraction Table Z-3 0.1 mg/m^ TWA
Coal tar pitch
volatilcs (benzene
soluble fraction),
anthracene. DaP,—
phenanthrene.
ac r idinc, ehryscnc,
pyrene.
65966-93-2 0.2 mg/m^ TWA 0.2 mg/m^ TWA
Cobalt, metal; dust
and fume (as Co)
7440-48-4 0. 1 mg/m-^ TWA 0.05 mg/m^ TWA
Cobalt earbonyl (as Co) 10210-68-1 No former PEL 0.1 mg/m^TWA
Cobalt hydrocarbonyl (as
Co)
16842-03-0 No former PEL 0.1 mg/m^ TWA
Coke oven emissions; see
1 9 10.1029
Coppe r —Fume (as Cu) —Dusts and mists (as Cu)
7440-50-0
0.1 mg/m-^TWA
1 mg/m^ TWA
0.1 mg/m^TWA
1 mg/m^ TWA
363 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
Cotton dust, raw, (c); See
1910.104-3
of waste recycling recycling (blending.
(blending, sorting. sorting, cleaning and
Cleaning ana wiiiowmg) ana
garnetling
1 1/^1 7fi 7
Total dust
Rcspirabie fraction. 5 mg/m-^ TWA
,, X Crcsol, all isomers
123-73-9
4170-30-3
Crotonaldehydc
299-86-5 C M*.•/•! X^l^ A Crufomate
Cumene X
Cyanamidc
Cyanides (as Cn) vanes witn
compounu
Cyanogen 4ou ly-s INO roi'incr i LL lu ppm 1 WA
. Cyanogen chloride 3Uo / / 4 iNO rormcr I'LL U.J ppm (L
)
1 lU-OZ-/ juu ppm 1 WA juu ppm 1 WA
iCiQ Q1 n X
1 no o.-! 1 Cyclohexanonc 25 ppm TWA
Cyclohexene 110-83-8 jOU ppm 1 WA
lUO *7l INO rormcr I'LL lu ppni 1 WA
cyeionitc 121-02-4 [NO rormcr i'll 1 .zf mg/m*' 1 X WA
^ , .J-DHZ-
y^- f /5 ppm i WA
TOT riT T
1 JlZl- /U-5 pjo lormcr r'LL 5 mg/m*^ 1 WA
fi-l "7^ "7 \C\ aM.a /.M^ TAl r A 1 (T «.«/ '^ XAl^ A lU mg/m-^ 1 WA
1 TTfi"^ '' ^ '^ C\ (\^ r-i»Ma XAlf li X
QA/^ r ^ n 1 r\ 1 M* ra /ii 1 ^ TW I \ ?€
i2;5 NORTH CAROLINA REGISTER September 2, 1997 364
PROPOSED RULES
Diacetonc alcohol
(4-nydroxy-4-methyl- —2-pcntanone)
123-42-2 50 ppm TWA 50 ppm TWA
1,2-Diaminocthanc :
sec Cthvlcncdiamine
Diazinon 333-41-5 No fo rme r PEL 0.1 mg/m^TWA
Diazomcthanc 334-88-3 0.2 ppm TWA 0.2 ppm TWA
Diboranc 1 9287-45-7 0.1 ppm TWA 0.
1
ppm TWA
1.2-Dibromo-3-
chloropropanc (DDCP)
sec 1 9 10.1044
96-12-8
1.2-Dibromoethane: sec
ethylene dibromidc
2-N-Dibutvlaminoethanol 102-81-8 No forme r PEL 2 ppm TWA
Dibutyl phosphate 107-66-4 ppm TWA 1 ppm TWA
2 ppm STEL
Dibutyl phthalatc 84-74-2 5 mg/m^ TWA 5 mg/m' TWA
Dichloroacctvlenc 7572-29-4 No fo rme r PEL 0.1 ppm (C)
i?-Dichlorobcnzene 95-50-1 50 ppm (C) 50 ppm (C)
/7-DichloTObcnzcnc 106-46-7 75 ppm TWA 75 ppm TWA
110 ppm STEL
3.3' -Dichlorobenzidinc ;
sec 1 9 10.1007
9 1-94-1
Dichlorodifluoromcthanc 75-71-8 1000 ppm TWA 1000 ppm TWA
l,3-Dichloro-5.5-
dimcthvl hvdantoin
118-52-5 0.2 mg/m^ TWA 0.2 mg/m^ TWA
0.4 mg/m^ STEL
Dichlorodiphcnyltri-—
chlorocthanc (DDT)
50-29-3 1 mg/m-'
' TWA 1 mg/m^ TWA
75-34-3 100 ppm TWA 100 ppm TWA
1.2-Dichlorocthane: sec
Ethylene dichloridc
1.2-Dichloroethylene 540-5 9-0 200 ppm TWA 200 ppm TWA
Dichlorocthyl ethe r 111-44-4 15 ppm (C) 5 ppm TWA
10 ppm STEL
Dichloromcthane: see
Methylene chloride
Dichloromonofluoro-me
thane
75-43-4 1000 ppm TWA 10 ppm TWA
365 NORTH CAROLINA REGISTER September!, 1997 12:5
PROPOSED RULES
T7T-l-''Cnloro -1- 2 ppm TWA
1,3 Dichloropropene 54Z-/5-0 X
2 , 2-Dichloropropionic
acid
Dichlorotctrafluoro-
Dichlorvos (UDVP) ^T TT 1 X
Dicrotopnos No former PCL X
.
Bicyclopentadienc t I- fj-u
Dicyclopcntadienyl iron
lotal dust
Rcspirable fraction 3 mg/m-^ 1 w/\
Dieldrin uU 5 / 1 X
• Diethanolaminc 111-42-2 iNo lornicr 1 i^l J ppm 1 \VA
.
Diethylamine
zs ppm 3 1 cu
2 Diethylaminocthanol 1 r\r\ T7 Q X
uictnyi ctncr; sec litnyi
ether
r\r; Tin Uiethyl Ketone
a A r r ^
Uiethyl phtnalate o4 oo I 5 mg/m-* 1 WA
uictnyicnc tnaminc 1 1 1 -4U-U nJo lorincr 1 ul 1 ppm 1 WA
r^n j-1 .1 -7 c /: 1 r. 1 An T->,MIM XMf A
ITTP '^'^ ^ iiJo-U/-3 U.5 ppm (L) U. 1 ppm 1 WA
1 rvo OT CA •»»«> xnr A TC M-iiii-i T^^^ i\
^.. 1 r\o 1 n
10o-tS-9 J ppm-T-WA 5 ppm TWA X
4-Dimcthylaminoazo-
—
benzene;
sec i7iu. 1U13 wJ 1 1 /
sec Mctnyiai
127-19-5 10 ppm X 1 WA lO ppm-l-WA
i2;5 NORTH CAROLINA REGISTER September 2, 1997 366
PROPOSED RULES
Dimcthylaminc 124-40-3 10 ppm TWA 10 ppm TWA
Dimethylaminobcnzcnc :
sec Xylidinc
Dimcthylanilinc
(N.N-Dimcthylaniline)
121-09-7 5 ppm TWA 5 ppm TWA
10 ppm STEL
^^
Dimcthylbcnzcnc :
sec Xylene
Dimethyl- 1 .2-dibromo-2
2-dichloroethyl
phosphate 300-76- 5 3 mg/m^ TWA 3 mg/m^ TWA
Dimcthylformamidc 60-12-2 10 ppm TWA 10 ppm TWA
i!.6-Dimethyl-4-
heptanone ; see
Diisobutvl ketone
1 . 1 -Dimethy Ihydrazine
.
57-14-7 0.5 ppm TWA 0.5 ppm TWA
Dimcthylphthalate 131-11-3 5 mg/m^ TWA 5 mg/m^ TWA
77-78-1 1 ppm TWA 0.1 ppm TWA X
Dinitolmidc
(3.5-dinit ro-—
o-toluamide) 148-01-6 No forme r PEL 5 mg/m^ TWA
Dinitrobcnzene
(all isomers)—
(ortho)
(mcta)
( para)
528-29-0
99-65-0
100-25-4
1 mg/m^ TWA 1 mg/m-' TWA
534-52-1 0.2 mg/m^TWA 0.2 mg/m^'TWA
25321-14-6 1.5 mg/m^TWA 1.5 mg/m^TWA
Dioxane—
(Diethylcne dioxide)
123-9 1-1 100 ppm TWA 25 ppm TWA X
Dioxathion 78-34-2 No forme r PEL 0.2 mg/m^ TWA
Diphcnyl (Diphenyl) 92-52-4 0.2 ppm TWA 0.2 ppm TWA
Diphenylamine 122-39-4 No forme r PEL 10 mg/m^ TWA
Diphenylmethane
diisocyanatc; sec—
Methylene bisphenyl
isocyanate
Dipropyl ketone 123-1 9-3 No forme r PEL 50 ppm TWA
methyl ethe r
34590-94-8 100 ppm TWA 100 ppm TWA
150 ppm STEL
X
Diquat 85-00-7 No former PEL 0.5 mg/m^ TWA
367 NORTH CAROLINA REGISTER September 2, 1997 12:5
PROPOSED RULES
Ui-sec octyl phthalate
(Di-(2-cthylhcxyl)
phthalate)
117-81-7 5 mg/m^ TWA 5 mg/m^ TWA
10 mg/m^ STEL
Disulfiram (Antabuse) 97-77-8 No forme r PEL 2 mg/m-^ TWA
Disulfoton 298-04-4 No former PEL 0.1 mg/m^ TWA
2,6-Di-fe>?-butyl-p-
crcsol
128-37- No former PEL 10 mg/m^TWA
©Toron 330-54-1 No former PEL 10 mg/m^ TWA
Divinyl benzene 100-57-6 No former PEL 10 ppm TWA
Emery
Total dust
Rcspi rable fracttorr
12415-34-8
15 mg/m^ TWA
5 mg/m^ TWA
10 mg/m'' TWA
5 mg/m^ TWA
Endosulfan 115-29-7 No former PEL 0.1 mg/m^ TWA
linurin 72-20-8 0.1 mg/m^TWA 0.1 mg/m^TWA
Epichlorohydrin 106-09-0 5 ppm TWA 2 ppm TWA X
TTTTT 2104-64-5 0.5 mg/m^ TWA 0.5 mg/m=
' TWA
1,2-Epoxypropanc ; see
Propylene oxide
2,3-Epoxy-l-propanol;
see Glycidol
Ethanethiol; see—
Ethyl mercaptan
Ethanolaminc 141-43-5 3 ppm TWA 3 ppm TWA
6 ppm STEL
Ethion 563-12-2 No former PEL 0.4 mg/m^ TWA
2-Ethoxyethanol
(Cellosolvc) 110-00-5 200 ppm TWA 200 ppm TWA
2-Ethoxyethyl acetate
(Cellosolve aeetate) 111-15-9 100 ppm TWA 100 ppm TWA
Ethyl acetate 141-70-6 400 ppm TWA 400 ppm TWA
Ethyl ac rylate 140-88-5 25 ppm TWA 5 ppm TWA
25 ppm STEL
X
Ethyl alcohol (Ethanol) 64-17-5 1000 ppm TWA 1000 ppm TWA
Ethylamine 75-04-7 10 ppm TWA 10 ppm TWA
Ethyl amyl ketone
(5-Methyl-3-—
hcptanone) 106-68-3 25 ppm TWA 25 ppm TWA
12:5 NORTH CAROLINA REGISTER September!, 1997 368
PROPOSED RULES
Ethyl benzene 100-41-4 100 ppm TWA 100 ppm TWA
125 ppm STCL
Ethyl bromide 74-96-4 200 ppm TWA 200 ppm TWA
250 ppm STEL
Ethyl butyl ketone
(3-Heptanone)
106-35-4 50 ppm TWA
Ethyl chloride 75-00-3 1000 ppm TWA 1000 ppm TWA
Ethyl ether 60-29-7 400 ppm TWA 400 ppm TWA
500 ppm STEL
Ethyl formate 109-94-4 100 ppm TWA 100 ppm TWA
Ethyl mereaptan 75-08-1 10 ppm (C) 0.5 ppm TWA
Ethyl silicate 78-10-4 10 ppm TWA
Ethylene chlorohydrin 107-07-3 5 ppm TWA 1 ppm (C>
Ethylcnediaminc 107-15-3 10 ppm TWA 10 ppm TWA
Ethylene dibromide 106-93-4 20 ppm TWA 20 ppm TWA
Ethylene dichloride—
(1.2-Dichl