Information

  • Document No.

  • Station

  • Conducted on

  • Prepared by

  • PPE User

  • Gear Type

  • Issue Date

  • Serial #

  • Chest

  • Length

  • Sleeve Lenght

Coat

Coat Outershell

  • Cleanliness?

  • Rips, tears, holes?

  • Thermal damage – charring, burn holes, melting, discoloration?

  • Fabric integrity – UV damage, chemical damage?

  • Seams – open or broken stitching?

  • Stitching – broken or missing stitches?

  • Excessive wear?

  • Closure system books/D's, snaps, Velcro, zipper – intact and functional?

  • Velcro – cleanliness, damage, stitching?

  • Hardware – missing, damaged, functional?

  • Trim – intact and functional?

  • Wristlets-elastic, damage, thumbhole?

  • Pockets – usable, intact?

  • Reinforcing material – intact and functional?

  • Cuffs – intact?

  • Fit – correct overlap?

  • Add-ons – approved?

  • NFPA Labels - Intact & Legible

Pant

Pants Outer Shell

  • Cleanliness?

  • Rips, tears, holes?

  • Thermal damage – charring, burn holes, melting, discoloration?

  • Fabric integrity – UV damage, chemical damage?

  • Seams – open or broken stitching?

  • Stitching – broken or missing stitches?

  • Excessive wear?

  • Closure system books/D's, snaps, Velcro, zipper – intact and functional?

  • Velcro – cleanliness, damage, stitching?

  • Hardware – missing, damaged, functional?

  • Trim – intact and functional?

  • Pockets – usable, intact?

  • Reinforcing material – intact and functional?

  • Suspenders-Functional?

  • Suspenders Buttons-Intact?

  • Fit – correct overlap?

  • Add Ons Approved?

  • NFPA Label-Intact&Legible?

Coat Liner

Coat Liner

  • Cleanliness ?

  • Liner Attachment System-Snaps, Zipper, Velcro-Intact&Functional

  • Fit of Liner in Shell-correct?

  • Pants Crotch -Intact

  • NFPA Label - Intact & Legible?

Moisture Barrier

Moisture Barrier

  • Rips, Tears, Holes?

  • Thermal Damage - Charring, Burns, Holes, Melting, Discoloratiom?

  • Seams-Intact?

  • Puddle Test-Pass

  • Seam Tape - Intact?

Thermal Liner

Thermal Liner

  • rips, Tears, Holes?

  • Thermal Damage-Charring, Burn Holes, Melting, Discoloration?

  • UV Damage- Face Cloth Faded

  • Quilt Stitching- Frayed, Broken?

  • Insulation-intact?

  • Excessive Wear?

Pants Liner

Pants Liner

  • Cleanliness

  • Liner Attachment System- Snaps, Zipper, Velcro-Intact & Functional?

  • Fit of Liner In Shell- Correct

  • Pants Crotch-Intact?

  • NFPA Label Intact & Legible

Moisture Barrier

  • Rips,Tears, and Holes

  • Thermal Damage-Charring, Burn Holes, Melting, Discoloration?

  • Seams - Intact?

  • Seam Tape- Intact?

  • Puddle Test - Pass?

Thermal Liner

  • Rips, Tears, and Holes?

  • Thermal Damage-Charring, Burn Holes, Melting, Discoloration?

  • UV Damage - Face Cloth Faded?

  • Quilt Stitching - Frayed Broken

  • Insulation - Intact

  • Excessive Wear?

Helmet

Shell

  • Cleanliness

  • Thermal Damage - Bubbling, Soft Spots, Warping, and Discoloration

  • Delamination

  • Dents, Nicks, Cracks, Gouges, Flaking?

  • Reflective Trim - Functional and in Place?

  • Add Ons - Approved

  • NFPA Label - Intact & Legible

Face shield/Goggles

  • Functional?

  • Scratches or Discoloration

Ear Flaps

  • Rips, Cuts, Tears?

  • Charring, Burn Holes, Melting?

  • Cuffs - Intact?

  • Attachment System - Intact & Functional

Impact Cap

  • Damage-Cracking or Thermal Damage

  • Components-Functional?

  • Suspension System - Functional?

  • Retention System

  • Chin Strap - Intact & Functional?

  • Leather Shield Correct Station

Hoods, gloves, boots

Hood

  • Cleanliness?

  • Rips, Tears, Holes?

  • Stretch

  • Excessive Wear?

  • Face Opening Elasticity?

  • Seams-Intact?

  • NFPA Label - Intact & Legible!

Gloves

  • Cleanliness?

  • Rips, Tears, Cuts?

  • Charring, Burn Holes!

  • Liner Intact?

  • Seams Intact?

  • Pliability?

  • NFPA Labels - Intact & Legible?

Boots

  • Cleanliness ?

  • Cuts, tears, punctures, Cracks, splits, delamination?

  • Charring, Burn Holes, Melting?

  • Exposed/Deformed Steel Toe, Shank or Midsole?

  • Tread-Intact

  • Seams-Intact?

  • Water Resistance?

  • Closure - Functional?

  • NFPA Label - Intact & Legible?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.