Title Page
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Client / Site
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Conducted on (Date and Time)
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Inspected by
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Location
Box Number 1 - Engineering Office
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6 Bandages, Triangular
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4 Dressings, Eye Pad
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3 Dressings, HSE Large
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9 Dressings, HSE Medium
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2 Gloves, Pairs
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1 Guidance Leaflet
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40 Plasters Waterproof
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12 Safety Pins
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10 Wipes Cleansing
Box Number 2 - Workshop
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HypaCool Instant Cold Pack
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Sterile Dressing Large
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Sterile Dressing Medium
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Sterile Eye Dressing 10 x 8
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Sterile Eye Dressing
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Triangular Bandages
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Conforming Bandage
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Sterile Moist Wipes
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Foil Blanket
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Biohazard Bags
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HypaPlast
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Burn Gel Large
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Burn Gel Satchets
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Nitrile Gloves
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Scissors
Box Number 3 - Office
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1 Conforming bandage
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2 Triangular bandages
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1 Burn Dressing
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2 Eye pad dressings
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2 Finger Dressings
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2 HSE Medium Dressing
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2 HSE Large Dressing
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1 Foil Blanket
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6 Gloves, Pairs
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1 Guidance Leaflet
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40 Plasters, Washproof Assorted
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1 Resuscitation Face Shield
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1 Shears
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1 Tape, Microporous
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20 Wipes, Cleansing
Completion
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Recommendations
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Inspector (Name and Signature)