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PPE Inspection Checklist - SafetyCulture

This document is a PPE inspection checklist that contains sections to check the condition of various types of personal protective equipment (PPE), including high visibility clothing, head protection, eye and face protection, hearing protection, safety footwear, rain gear, work clothing, gloves, and other equipment. For each item, the checklist allows marking it as "Safe", "At Risk", or "N/A". The checklist also includes signature lines for the employee and supervisor to sign, agreeing to use the appropriate PPE.

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419 views6 pages

PPE Inspection Checklist - SafetyCulture

This document is a PPE inspection checklist that contains sections to check the condition of various types of personal protective equipment (PPE), including high visibility clothing, head protection, eye and face protection, hearing protection, safety footwear, rain gear, work clothing, gloves, and other equipment. For each item, the checklist allows marking it as "Safe", "At Risk", or "N/A". The checklist also includes signature lines for the employee and supervisor to sign, agreeing to use the appropriate PPE.

Uploaded by

jitsss
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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10/13/2020 PPE Inspection Checklist - SafetyCulture

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Audit

High Visibility Clothing

High Visibility clothing must be in good condition with at least 775 square cm of
reflective trim.

Saf At N/A
e Risk

High Visibility clothing must be a color that contrasts with the environment.

Saf At N/A
e Risk

Head Protection

Hard hat must be High Visibility and Side Impact

Saf At N/A
e Risk

Hard Hat must be cleaned regularly and stored appropriately

Saf At N/A
e Risk

Hard hat must be free of cracks, dents or other damage.

Saf At N/A
e Risk

Chin strap must be used when working around helicopters


https://public-library.safetyculture.io/products/ppe-inspection 1/
10/13/2020 PPE Inspection Checklist - SafetyCulture

Saf At N/A
e Risk

https://public-library.safetyculture.io/products/ppe-inspection 2/
Eye and Face Protection

Safety Eyewear must fit properly and include side shields when necessary for
worker safety.

Saf At N/A
e Risk

Hearing Protection

Hearing protection must be worn when working in noisy conditions for


prolonged periods of time or in posted noise hazard areas. WorkSafe BC's
regulations
regarding noise exposure are: 85dBA Lex daily noise exposure level and 140
DBC peak sounds level.

Saf At N/A
e Risk

Safety Footwear

Must be of a design, construction and material appropriate to the protection


required for the work environment. Caulk boots must be worn when working
in the woods.

Saf At N/A
e Risk

Rain Gear

Rain Gear must be adequate for conditions likely to occur throughout the
day when working in the woods.

Saf At N/A
e Risk

PPE supplied by Employee

Safety Footwear
Must be of design, construction and material appropriate to the protection
required for the work environment.

Saf At N/A
e Risk

Work Clothing

Work Clothing, needed for protection against the natural elements, must be adequate
for conditions likely to occur throughout the day when working in the woods.

Saf At N/A
e Risk

Work gloves must be adequate to protect your hands and must be born when
required.

Saf At N/A
e Risk

Other

Additional Comments:

Enter text

I have read the PPE Policy of my company and accept the policy as outlined. By signing this
form, I agree to use the appropriate PPE in the situations described above, and report any
deficiencies to my supervisor.

Employee Signature: 
Supervisor Signature: 

Select date 

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things,
workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional
advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.

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