JOHNNA NUNEMAKER

Linn County REC Personal Protective Equipment

Quarterly Inspection

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Title Page

Inspector
Date of Inspection

Linn County REC Personal Protetive Equipment

Hard Hat

Shell Condition
Suspension
Crown Strap
Chin/Nape Strap
Accessories
Cleanliness
Storage

Rubber Gloves

Protector
Test Date
Rubber Condition
Cleanliness

Sleeves

Collar
Grommets
Test Date
Cleanliness
Storage

Eye/Face Protection

Ansi Design
Bow/Frame
Lens/Shield
Storage
Cleanliness

Foot Protection

Leather/Rubber
Laces/Eyelets
Sole/Heal
Hard Toe

Hand Protection

Leather/Fabric
Chemical Resistant

General Comments

Comments

Signature

Please Sign

JOHNNA NUNEMAKER

Linn County REC Personal Protective Equipment

Quarterly Inspection

Use this Template

Print as PDF

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