Select date

Name of Staff Member

Region/ Area Staff Member is Based

Please mark PPE issued to staff member


Safety Wellingtons

Size of Wellingtons

Ear Defenders

Safety Footwear

Size of Footwear

Ear Plugs

Safety Glasses

Helmet/ Visor/ Ear Muffs (complete unit)

Spray Suit

Dust Masks

Face Visor

Safety Helmet

Balistic Trousers

Size of Balistic trousers

Waterproof Jacket

Size of Jacket

Waterproof Trousers

Size of Waterproof trousers

Gloves- please state type

First Aid Kit

Hand Wipes

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.