FMSO PPE Audit

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Personnel

PPE

• Flame retardant clothing (shirt and pants)

  Yes

  No

  N/A

• Safety Glasses

  Yes

  No

  N/A

• Hard Hat

  Yes

  No

  N/A

• Steel toe safety shoes

  Yes

  No

  N/A

• Hearing protection

  Yes

  No

  N/A

• Protective Gloves

  Yes

  No

  N/A

• Reflective vest

  Yes

  No

  N/A

Additional specialized PPE

• Arc rated hearing protection

  Yes

  No

  N/A

• Class zero rubber gloves with leather protectors

  Yes

  No

  N/A

• UV face shield

  Yes

  No

  N/A

• Nomex sock hood

  Yes

  No

  N/A

• Arc rated flash suit

  Yes

  No

  N/A

• Hot Stick

  Yes

  No

  N/A

• Auditor(s) Signature

  Sign

• Revision 1.0 iCloud posted document is the controlled copy. 06/18/13