PPE Checklist

This PPE Checklist can be used by managers and safety officials to identify sources of hazard and select the appropriate equipment. Start by recording nature of work and potential hazards that may be in contact with body parts. The template then prompts the inspector to describe the hazard,state the required PPE and check the condition of the PPE by capturing photo evidence. Lastly, it summarizes the inspection by providing recommendations.

Title Page

Company Name
Client / Site
Conducted on
Prepared by
Location

PPE Evaluation Form

Nature of work
Identify potential hazards at work (select all that apply)
- Eye
- Head/Neck/Face
- Foot
- Hand
- Body/Torso
- Fall
- Noise
- Respiratory

EYE HAZARDS

Handling/dispensing chemicals and ingredients; working around UV lights; chipping, sanding, grinding, welding, metal working; tasks that generate dust
Select all that apply for each hazard from the drop down list.
- Chemical Exposure
- Cut/Abrasions
- Dust/Flying Debris
- Dust Particulates
- Electrical Arc
- Electrical Shock
- Fall Hazard
- High Heat/COld
- Impact
- Impact/Compression
- UV/IR Radiation
- Noise Hazard
- Puncture
- Slippery/Wet Surfaces
- Other
Description of Hazard
Required PPE
Does the equipment undergo testing and in a good condition?
Take a photo
Does the equipment fit perfectly?
Take a photo

HAND HAZARDS

Handling/dispensing chemicals and ingredients; exposure to abrasive materials; using knives or other sharp objects; working with hot or cold materials; food service prep
Select all that apply for each hazard from the drop down list.
- Chemical Exposure
- Cut/Abrasions
- Dust/Flying Debris
- Dust Particulates
- Electrical Arc
- Electrical Shock
- Fall Hazard
- High Heat/COld
- Impact
- Impact/Compression
- UV/IR Radiation
- Noise Hazard
- Puncture
- Slippery/Wet Surfaces
- Other
Description of Hazard
Required PPE
Does the equipment undergo testing and in a good condition?
Take a photo
REFERENCE: Gloves are resistant to chemicals
[This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]
Does the equipment fit perfectly?
Take a photo

NOISE HAZARDS

Noise levels above 85 dBA; working around pneumatic equipment; using powered hand tools
Select all that apply for each hazard from the drop down list.
- Chemical Exposure
- Cut/Abrasions
- Dust/Flying Debris
- Dust Particulates
- Electrical Arc
- Electrical Shock
- Fall Hazard
- High Heat/COld
- Impact
- Impact/Compression
- UV/IR Radiation
- Noise Hazard
- Puncture
- Slippery/Wet Surfaces
- Other
Description of Hazard
Required PPE
Does the equipment undergo testing and in a good condition?
Take a photo
Does the equipment fit perfectly?
Take a photo

RESPIRATORY HAZARDS

Handling/using highly hazardous chemicals; tasks that generate dust and/or fumes; cutting, brazing on certain metals (stainless steel);
Select all that apply for each hazard from the drop down list.
- Chemical Exposure
- Cut/Abrasions
- Dust/Flying Debris
- Dust Particulates
- Electrical Arc
- Electrical Shock
- Fall Hazard
- High Heat/COld
- Impact
- Impact/Compression
- UV/IR Radiation
- Noise Hazard
- Puncture
- Slippery/Wet Surfaces
- Other
Description of Hazard
Required PPE
Does the equipment undergo testing and in a good condition?
Take a photo
Does the equipment fit perfectly?
Take a photo