Title Page
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Conducted on
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Prepared by
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Name:
INSPECTION RECORD
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PLEASE ENSURE TO ADD PHOTO OF ITEM AND ANY ACTIONS ON THE 'EQUIPMENT/PPE/KITS DESCRIPTION' QUESTION:
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Please select Inspection Required:
Operator PPE Inspection:
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PLEASE ENSURE THE FOLLOWING RULES ARE UNDERTAKEN WHEN INSPECTING PPE:
1. Take a photo of PPE
3. set action if needing replacement/cleaning
a. Assign to 'Operator'
b. Note comments - Start with Operators Name
c. Images to clarify requirements -
Select PPE to be inspected:
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PLEASE ENSURE PPE COMPLIES WITH THE BELOW:
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SAFETY HELMET – CONFORMING TO EN 397
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EYE PROTECTION – EITHER A MESH VISOR COMPLYING WITH EN 1731 OR SAFETY GLASSES CONFORMING TO EN 166
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HEARING PROTECTION – CONFORMING TO EN 352
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LEG PROTECTION – CONFORMING TO EN 381-5
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PROTECTIVE BOOTS – CONFORMING TO EN 345-2
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SAFETY HELMET – CONFORMING TO EN 397
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HIGH VISIBILITY CLOTHING – CONFORMING TO EN471
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SAFETY FOOTWEAR – CONFORMING TO EN345-1
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PLEASE ENSURE THE FOLLOWING RULES ARE UNDERTAKEN WHEN INSPECTING COSHH CONTROLS:
1. Take a photo of COSHH CONTROL
3. set action if needing replacement/cleaning
a. Assign to 'CONTRACTOR'
b. Note comments
c. Images to clarify requirements
COSHH Controls Inspection:
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COSHH Control to be inspected:
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SPILL KIT:
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Spill Pads (Minimum of 12 Pads)
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Socks (Minimum of 2)
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1 Disposable bag
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1 Zip Tie
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not contaminated?
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adequate gloves
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goggles
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not contaminated?
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PLEASE ENSURE THE FOLLOWING RULES ARE UNDERTAKEN WHEN INSPECTING FIRST AID KITS:
1. Take a photo of FIRST AID KITS
3. set action if needing replacement
a. Assign to 'CONTRACTOR'
b. Note comments
c. Images to clarify requirements
First Aid Kit Inspections:
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First Aid Kit Type:
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Machine / Operation:
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Equipment Description:
- Pulley
- Wedge Eye Socket
- Wedge Socket
- Shackle
- Choker Chain
- Choker Chain Slider
- Web Sling
- Round Sling
- Wire Rope
- Wire Rope - Grip
- Wire Rope - Terminator
- Snatch Block
- Wire Strop
- Web Strop
- Towing Chain
- Towing Strop
- Main Line Brake
- Shotgun Carriage
- Skyline Carriage
- Tower
- OTHER:
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Name:
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Assessment:
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DO NOT USE EQUIPMENT - Please Mark up and inform operators not to be used in operations
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Please note reason for Failure:
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Equipment Description:
- Spade
- Sledge Hammer
- Vice
- Site Safe
- Fuel Bowser
- Fuel Tank
- Wire Cutters
- OTHER:
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Name of item:
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Assessment:
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DO NOT USE EQUIPMENT - Please Mark up and inform operators not to be used in operations
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Please note reason for Failure:
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Equipment Description:
- Felling Wedge
- Felling Bar
- Hammer
- Hand Winch
- Chainsaw Winch
- Mechanical Winch
- OTHER:
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Name:
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Assessment:
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DO NOT USE EQUIPMENT - Please Mark up and inform operators not to be used in operations
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Please note reason for Failure:
APPROVAL
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Inspections added and completed to the requirements:
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Signature of designated person:
