D003 - PPE Issue Sheet

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Employee & Labour only sub contractors acknowledgement of the following items:

• I confirm I have seen, read & understood the detail within the company’s Health & Safety Policy & Arrangements & I agree to comply with the rules & procedures contained within it, in the interests of health & safety

  Yes

  No

  N/A

• I confirm I have seen, read & understood the detail of the method statements in respect of my work & they have been explained to me & discussed with me

  Yes

  No

  N/A

• I confirm I agree with & understand the detail of the risk assessments in respect of my work & they have been explained to me & discussed with me

  Yes

  No

  N/A

• I recognize and understand my personal responsibility to avoid/minimize my exposure to the risks identified by adhering to and safe working processes and procedures developed and implemented by the management and using the protective equipment with which CMR Brickwork Specialists Ltd have provided

  Yes

  No

  N/A

• I confirm I have the following PPE (complete attached grid) It Is Instructed that upon the issue of any PPE equipment it is the responsibility of the Employee to make sure that it, or they, are fit for purpose at all times. I confirm I understand that my PPE should be checked on a daily basis and any items damaged, lost, or stolen should be reported to the management immediately. I understand I must not undertake any works without the correct PPE for the job

  Yes

  No

  N/A

I Have the following quantity of items

• HIGH VIZ VEST

• GLOVES

• EAR PLUGS

• SAFETY GLASSES

• FPP3 DUST MASK

• Other

Signed off by:

• Signed:

  Sign

• Date:

  Date