Face fit test record

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Add location
  Address

• Select date

  Date

Employees Signature

• Add signature

  Sign

• Smoker?

  Yes

  No

  N/A

Record of Face Fit test, Qualitative test.

• Mask type

• Ownership. Is the mask New and owned by operative?

TEST

• Test using Bitter or Sweet?

  Bitter

  Sweet

• Bending?

• Looking upward, side to side and downward.

• Talking, repeating excercise.

• Did candidate fit mask without assistance?

  Yes

  No

  N/A

• Is the face fit a 100% pass?

  Yes

  No

  N/A

Health & Safety, Officer / Trainers Signature

• Add signature

  Sign