PPE Check

• Conducted by

• Conducted on

  Date
• Location
  Address

• Nature of work

PPE Controls

• Are PPE available and sufficient to all workers?

  Yes

  No

  N/A

• Do all employees know how to use appropriate PPE?

  Yes

  No

  N/A

• Are there damaged or worn out PPE which need repair or replacement?

  Yes

  No

  N/A

List of PPE

• Helmet, EN397 with chin strap

  Yes

  No

  N/A

• Safety footwear Class: S3 (NEN-EN 345) (with ankle protection or support) or S5 boots (NEN-EN 345)

  Yes

  No

  N/A

• Gloves for general use, mechanical risk, EN 388 - 4.1.2.1.X

  Yes

  No

  N/A

• Welding gloves , Mechanical risk EN388 3.2.2.3.X, EN407 4.1.4.X.3.X

  Yes

  No

  N/A

• Mechanical risk welding gloves, Mechanical risk EN388 2.1.1.1.X, EN407 4.1.4.X.4.X

  Yes

  No

  N/A

• Safety glasses (with or without gasket) Lens 2C-1,2W1FTKN

  Yes

  No

  N/A

• High visibility breathable five-purpose work suit

  Yes

  No

  N/A

• High visibility breathable five-purpose work jacket+trousers

  Yes

  No

  N/A

• Complete system with liquid crystal welding screen with variable protection level from 5 to 13 DIN

  Yes

  No

  N/A

• FFP2 filtering facepieces

  Yes

  No

  N/A

• Split leather gaiters

  Yes

  No

  N/A

• Split leather jacket with button + velcro closure

  Yes

  No

  N/A

• Safety harness with sternal and dorsal attachment

  Yes

  No

  N/A

• Adjustable lanyard 2 hooks

  Yes

  No

  N/A

• Helmet visor

  Yes

  No

  N/A

Comments

• Other

Closing

• Full Name

• Signature

  Sign