Title Page

  • Conducted on

  • Prepared by

  • Employees must wear PPE and ensure it is kept in good condition. And report any damage
    or defects to their Supervisor immediately!

Violations Found

    PPE violation
  • Employees / contractors and visitors must wear PPE and ensure it is kept in good condition. And report any damage
    or defects to their Supervisor immediately.

  • The person was:

  • Was the employee required to wear PPE

  • Location

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • If machinery was being operated, please specify

  • Employee Name

  • Name of person

  • Date of converation

  • What mandatory PPE was not being worn?

  • Please enter the PPE not being worn

  • Action Taken

  • Comments

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.