Title Page

  • Conducted on

  • Prepared by

  • Site location

  • Please check the items below that you require. Please note that you must give as much notice as possible (minimum of 3 days) At all times it is the employees responsibility to contact the office to order replenished PPE after the initial distribution within the specified order lead times.

  • Disposable nitrile gloves

  • Hand sanitiser

  • Face mask

  • Van cleaning materials

  • Employee Signature

  • When you have received your items of PPE please add the date and time below

  • Date items received

  • Employee signature upon receipt of items

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.