• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

A. Personal Protective Equipment (PPE) Program

  • 1. Hazard Assessment complete and documented

  • 2. PPE selection based upon Hazard Assessment

  • 4. Defective or damaged PPE not used

  • 5. Training complete and documented

B. Eye and Face Protection

  • 1. Eye and Face Protection appropriate to the hazard used

  • 2. Side Protectors used where flying objects hazards are found

  • 3. Eye protection incorporates prescription or can be worn without disturbing proper position of prescription lenses

  • 5. Maintained per manufacturers recommendations

C. Head Protection

  • 1. Hard hats used where there is the potential for head injury from falling objects

  • 4. Maintained per manufacturers recommendations

D. Foot Protection

  • 1. Appropriate for protection from falling or rolling objects

  • 2. Appropriate for protection from objects piercing the sole

  • 4. Maintained per manufacturers recommendations

E. Hand Protection

  • 1. Hand protection appropriate to the hazard

  • 2. Maintained per manufacturers recommendations

F. Other Related Issues

  • 1. Appropriate PPE available for hot work (e.g., cutting, welding, brazing)

  • 2. Clothing and shoes worn appropriate for tasks being performed

  • 3. Reflective vests used when working near vehicles

  • 4. Barricades used where appropriate

  • Summary of Findings

  • Please sign upon audit completion

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