Demo One DOA-03 Daily RPE-PPE Checks

• Project Name

• Job Number

• Date

  Date

• Demo One Site Supervisor

Employee 1

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 2

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 3

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 4

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 5

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 6

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 7

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 8

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 9

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 10

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign

Employee 11

• Name of Operative/Supervisor including full face model type and serial number

  Select

• Does the Operative/Supervisor have all the required mandatory site safety and asbestos PPE i.e. transit shoes, safety boots, enclosure boots (no laces) etc.

• Are the face fits for both masks and the RPE service certificates in date and for the correct make and model?

  Yes

  No

  N/A

• AM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• Half mask

• Make and model

  Sundstrom SR100

  JSP Force 8

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Is mask fit for work?

  Yes

  No

  N/A

• PM RPE CHECKS

• Full face

• Items which MUST be checked: Head harness, facepiece (seal & visor), inhalation/exhalation valves, threaded connectors & seals, battery charge/condition, airflow rate and condition of filter.

• Half mask

• Items which MUST be checked: head harness, facepiece (seal), inhalation/exhalation valves and condition of filter.

• Employee's Name and Signature

  Sign