Information
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Monthly RPE Inspection
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Conducted on
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Conducted by
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Operative Name
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RPE Make Model
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Type of RPE
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Have you been Face Fit Tested to this make and model?
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Please check the mask and complete ALL questions below.
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Is the mask clean?
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Is the storage box clean and in good order?
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Are the straps in good working order and damage free?
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Are the buckles working and allow adjustment of straps?
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Are air seals (inlet/outlet) and face seal satisfactory?
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Is the filters within the expiry date, in good order and do not need changing
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What is the expiry date
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Statement: I have inspected the above RPE and ticked to indicate that the RPE was found to be in good order and have commented on work need to bring the item up to the required standard and inform my supervisor immediately.
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Supervisor's name
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Signature to acknowledge above statement
