FMTs Core Kit Monthly Inspection - TC

• Inspection Completed By:

• Confirm Site

  Select
Asset

Kit Bag Condition

• Is the Kit Bag in good condition externally & internally?

  Yes

  No

Nitrile Flock Lined Gloves

• Are the gloves in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the gloves require replacement?

  Yes - Order Replacement

  No - No Action Required

Sandy Nitrile Gloves

• Are the gloves in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the gloves require replacement?

  Yes - Order Replacement

  No - No Action Required

Dusk Mask P2 - Box of 10

• Do you have 5 or more masks in new condition?

  No - Order Replacement

  Yes - No Action Required

• How many masks do you have in new condition?

Cut Resistant Gloves

• 

• Are the gloves in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the gloves require replacement?

  Yes - Order Replacement

  No - No Action Required

Vented Hard Hat

• Is the Hard Hat in the kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Hard Hat require replacement?

  Yes - Order Replacement

  No - No Action Required

Safety Specs - Clear

• Are the specs in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the specs require replacement?

  Yes - Order Replacement

  No - No Action Required

Safety Specs - Smoke

• Are the specs in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the specs require replacement?

  Yes - Order Replacement

  No - No Action Required

Sunscreen

• Is there Sunscreen in the kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Sunscreen require replenishment?

  Yes - Order Replacement

  No - No Action Required

Slouch Hat

• Is the Hat in the kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Hat require replacement?

  Yes - Order Replacement

  No - No Action Required

Earmuffs

• 

• Are the Earmuffs in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the Earmuffs require replacement?

  Yes - Order Replacement

  No - No Action Required

First Aid Kit

• Is the First Aid Kit in the PPE kit or in the vehicle?

  No - Order Replacement

  Yes - No Action Required

• Does the First Aid Kit require replacement?

  Yes - Order Replacement

  No - No Action Required

• What items have been used, need replacement or are missing from the First Aid Kit?

Basic Harness

• Is the Basic Harness in the Kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Basic Harness require replacement?

  Yes - Order Replacement

  No - No Action Required

Adjustable Lanyard

• Is the Adjustable Lanyard in the Kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Lanyard require replacement?

  Yes - Order Replacement

  No - No Action Required

Safety Boots

• Are the Boots in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the Boots require replacement?

  Yes - Order Replacement

  No - No Action Required

Barricade Tape

• Is the Barricade Tape in the Kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Tape require replacement?

  Yes - Order Replacement

  No - No Action Required

Spectacle Pouch

• Is the Spectacle Pouch in the Kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Pouch require replacement?

  Yes - Order Replacement

  No - No Action Required

Spectacle Cord

• Is the Spectacle Cord in the Kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Cord require replacement?

  Yes - Order Replacement

  No - No Action Required

Half Face Respirator

• 

• Is the Half Face Respirator in the kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Half Face Respirator require replacement?

  Yes - Order Replacement

  No - No Action Required

• Are you confident that the respirator is the correct fit for you?

  Yes

  No

Full Face Respirator

• 

• Is the Full Face Respirator in the kit?

  No - Order Replacement

  Yes - No Action Required

• Does the Full Face Respirator require replacement?

  Yes - Order Replacement

  No - No Action Required

• Are you confident that the respirator is the correct fit for you?

  Yes

  No

Filters

• 

• Are the replacement filters in the kit?

  No - Order Replacement

  Yes - No Action Required

• Do the Filters require replacement?

  Yes - Order Replacement

  No - No Action Required

Fire Extinguisher

• 

• Is the Fire Extinguisher fixed appropriately and within the vehicle?

  No - Order Replacement

  Yes - No Action Required

• Does the Fire Extinguisher require replacement?

  Yes - Order Replacement

  No - No Action Required

• Does the First Extinguisher have more than 3 months left before requiring servicing?

  No - Order Replacement

  Yes - No Action Required

• I confirm that I have inspected and provided an accurate response to all questions and according to policies & guidelines.

  Sign