HSF5.2 -3 Individual PPE kit list. ADT / JCI / TYCO

Individual PPE Kit List

• Engineer

• Department

• Conducted on

  Date

• HSF5.2 Issue 3 (July 2016)

EQUIPMENT - You may not necessarily be issued with all this kit

• Asbestos Emergency Kit

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Cut 5 Gloves

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Cut 3 Gloves

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Personal First Aid Kit

  issued

  currently have

  returned

• Best before date

  Date

• Quantity & Comments

• Best before date

  Date

• Quantity & Return condition

• PPE Holdall

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Safety signage - specify what is held

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Safety harness kit (working at heights)

  issued

  currently have

  returned

• Harness ID

• Harness 1.3m Lanyard ID

• Harness Cowstail ID

• Harness Bag ID

• Quantity & Comments

• Harness ID

• Harness 1.3m Lanyard ID

• Harness Cowstail ID

• Harness Bag ID

• Quantity & Comments - Disposal date

• Safety footwear

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Overall -Fire resistant

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Overall - Disposable

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Plastic overshoes

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hand wipes - Scrubs

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hand wipes - Workforce

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Knee pads

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Tool belt

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hi-Viz -Trousers (Orange)

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hi-Viz -Coat

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hi-Viz -Vest/Jacket -Orange

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hi-Viz -Vest

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Dust mask

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Eye protection -Over spectacles

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Eye protection -Glasses

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Eye protection -Goggles

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Ear plugs

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Ear defenders - Separate

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Ear defenders - Clip-on

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Hard hat, (including chinstrap)

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Bump cap

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

• Other (please specify)

  issued

  currently have

  returned

• Quantity & Comments

• Quantity & Return condition

Declaration

• This is to confirm I has received / returned / currently have as stated and have been briefed on, the equipment as listed above

• Signed

  Sign

• Audited by:

  Sign