Personal Protective Equipment Hazard Assessment

ADRIAN COLLEGE 110 South Madison Ave Adrian, Michigan 49221 PPE Hazard Assessment

• Document No.

• Conducted on

  Date

• Prepared by

• Signiture

  Sign

• Department(s) impacted by assessment

• Workplace/area or Job being assessed:

EYE HAZARDS

• Flying Particles

  No

  Yes

• Chemical Splash

  No

  Yes

• Molten Metal

  No

  Yes

• Dust and Dirt

  No

  Yes

• Sparks

  No

  Yes

• Weld Flash

  No

  Yes

• Electrical

  No

  Yes

• Other:

HAND HAZARDS

• Skin absorption

  No

  Yes

• Chemical or thermal burns

  No

  Yes

• Severe cut or laceration hazard

  No

  Yes

• Punctures

  No

  Yes

• Other:

HEAD HAZARDS

• Falling objects

  No

  Yes

• Flying objects

  No

  Yes

• Electrical

  No

  Yes

• Hair entanglement

  No

  Yes

• Hot surfaces

  No

  Yes

• Chemicals

  No

  Yes

• Other:

FOOT HAZARDS

• Flying Objects

  No

  Yes

• Rolling Objects

  No

  Yes

• Powered Lawn Equipment

  No

  Yes

• Wet Process Areas

  No

  Yes

• Logging Areas

  No

  Yes

• Other:

FACE HAZARDS

• Impact Hazards

  No

  Yes

• Chemical

  No

  Yes

• Heat

  No

  Yes

• Torch Cutting

  No

  Yes

• Welding

  No

  Yes

• Casting

  No

  Yes

• High Temperature Exposures

  No

  Yes

• Other:

BODY HAZARDS

• Wet Process Areas

  No

  Yes

• Chemical

  No

  Yes

• Buffing

  No

  Yes

• Sand Blasting

  No

  Yes

• Polishing

  No

  Yes

• Hot Liquids (water, grease, acids, etc.)

  No

  Yes

• Other:

HEARING HAZARDS

• Loud Process and or Equipment

  No

  Yes

• Air and Electrical Impact Tools

  No

  Yes

• Forging

  No

  Yes

• Logging

  No

  Yes

• Tree Trimming

  No

  Yes

• Decibel Reading

• Other:

BREATHING HAZARDS

• Spray Finishing

  No

  Yes

• Fumes

  No

  Yes

• Vapors

  No

  Yes

• Dust

  No

  Yes

• Welding

  No

  Yes

• Foundries

  No

  Yes

• Permit Required Confined Space

  No

  Yes

• Other: