PPE Employee Audit

• Name of Document:

  PPE Employee Assessment

• Document No.

• Drop Pin for GPS Work Activity Location:
  Address

• Prepared by:

  Christopher Cole

  Chuck Ayers

  James Shifflett

  Joseph Bailey

  Michael Dwyer

• Conducted on

  Date

• Name of Employee Audited:

PPE Program (This report and criteria will generate replacements as needed or requested):

• Is Replacement PPE Required?

  Yes

  No

  N/A

• If yes, who is responsible for the cost of replacement?

  Employee Due To Loss or Intentional Neglect

  Employer Due To Normal Wear

Personal Protective Equipment:

• White miner's hard hat or lime green depending on role is on and being used?

  Acceptable

  Replacement Required

• W.C. Spratt, Inc. reflective sticker in place and I damaged? (Damaged stickers should be replaced)

  Acceptable

  Replacement Required

• Hearing protection

  Acceptable

  Replacement Required

• Steel Toe or Composite Boots

  Acceptable

  Replacement Required

• Shaded or Clear Lens Diamondback Crossfire Safety Glasses

  Acceptable

  Replacement Required

• Class 2 / 3 Safety Vests

  Acceptable

  Replacement Required

• DeWalt Mechanics or DeWalt Nitrile Coated Gloves

  Acceptable

  Replacement Required

• Wet Weather Gear

  Acceptable

  Replacement Required

• Respirator/Dust Mask

  Acceptable

  Replacement Required

• Chaps

  Acceptable

  Replacement Required

• Bionic Face Shield

  Acceptable

  Replacement Required

• Overalls

  Acceptable

  Replacement Required

• Additional PPE

Acknowledgements:

• Management Signature:

  Sign

• Employee Signature

  Sign