Plant PPE Survey and Observations

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Station 1

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand Protection Recommendations

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Station 2

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand Protection Recommendations

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Station 3

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand Protection Recommendations

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Station 4

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Station 5

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand Protection Reccomendations

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Station 6

• Hand protection being worn is acceptable?

  Yes

  No

  N/A

• Hand Protection Recommendations

  Yes

  No

  N/A

• Eye Protection being Worn?

  Yes

  No

  N/A

• Eye Protection Recommendations<br>

  Yes

  No

  N/A

• Hearing Protection

  Yes

  No

  N/A

• Respiratory Protection

  Yes

  No

  N/A

• Respiratory Recommendations

  Yes

  No

  N/A

Spill/Absorbents

• Applications in which Absorbents are being used:<br>

  Yes

  No

  N/A

• Leaks

  Yes

  No

  N/A

• General Housekeeping

  Yes

  No

  N/A

• Emergency Spill Response

  Yes

  No

  N/A

• Overspray

  Yes

  No

  N/A

• Current Problem Areas:

  Yes

  No

  N/A

• Current Solutions

  Yes

  No

  N/A

• Which Liquids are commonly used?

  Yes

  No

  N/A

• Water Based?

  Yes

  No

  N/A

• Oil/Petroleum Products

  Yes

  No

  N/A

• Solvents

  Yes

  No

  N/A

• Other:

  Yes

  No

  N/A

• Absorbents (Mats, Pads, Rolls, Socks, Pillows, Drip Pans)

  Yes

  No

  N/A

• Mats

  Yes

  No

  N/A

• Pads

  Yes

  No

  N/A

• Rolls

  Yes

  No

  N/A

• Socks

  Yes

  No

  N/A

• Pillows

  Yes

  No

  N/A

• Drip Pans

  Yes

  No

  N/A

• Drum Storage Pallets

  Yes

  No

  N/A

Respiratory

• Employees Fit Tested and Documented?

  Yes

  No

  N/A

Lockout/ Tagout

• Are There Authorized Employees

  Yes

  No

  N/A

• Are Authorized Employees Trained?

  Yes

  No

  N/A

• Lockout Procedures Set-Up?

  Yes

  No

  N/A

• Lockout/Tagout Devices Readily Available

  Yes

  No

  N/A

Signage

• Signage in Appropriate Areas

  Yes

  No

  N/A

• RTK Up to Date and Complete

  Yes

  No

  N/A

First Aid

• Are Items in First Aid Cabinets in Compliance?

  Yes

  No

  N/A

• Emergency Numbers Posted?

  Yes

  No

  N/A

Record Keeping

• Complete

  Yes

  No

  N/A

• Easily Found

  Yes

  No

  N/A