Phillip Sparks

Face fit Certificate

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Title Page

Site conducted
Conducted on
Location

Untitled page

Mask details
Company
Type: FFP3
HBCL Coldstores LTD
Make: Climax
Unit 9 G.B. Business Park
Model: 755
Cutler Heights Lane
Bradford
Size: Medium
BD4 9HZ
Condition: New
Chris Webb
Employee name:
Assessor name: Phillip Sparks
Other PPE worn during test:
Sensitivity Score:
Retest frequency:
Annual
Date test taken
Details of results
Exercise
Normal breathing
Number of repeat tests:
Deep breathing
Reason for retest:
Turning head side to side
Moving head up & down
Bending at waist
Did wearer need assistance to wear the
Talking out loud
mask:
Normal breathing
OVERALL RESULT
Face fit tester signature:
Wearer signature:

Phillip Sparks

Face fit Certificate

Use this Template

Print as PDF

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