Information

  • Name

High Visibility Clothing

  • High Visibility clothing must be in good condition with at least 775 square cm of reflective trim.

  • High Visibility clothing must be a color that contrasts with the environment.

Head Protection

  • Hard hat must be High Visibility and Side Impact

  • Hard Hat must be cleaned regularly and stored appropriately

  • Hard hat must be free of cracks, dents or other damage.

  • Chin strap must be used when working around helicopters

Eye and Face Protection

  • Safety Eyewear must fit properly and include side shields when necessary for worker safety.

Hearing Protection

  • Hearing protection must be worn when working in noisy conditions for prolonged periods of time or in posted noise hazard areas. WorkSafe BC's regulations regarding noise exposure are: 85dBA Lex daily noise exposure level and 140 DBC peak sounds level.

Safety Footwear

  • Must be of a design, construction and material appropriate to the protection required for the work environment. Caulk boots must be worn when working in the woods.

Rain Gear

  • Rain Gear must be adequate for conditions likely to occur throughout the day when working in the woods.

PPE supplied by Employee

Safety Footwear

  • Must be of design, construction and material appropriate to the protection required for the work environment.

Work Clothing

  • Work Clothing, needed for protection against the natural elements, must be adequate for conditions likely to occur throughout the day when working in the woods.

  • Work gloves must be adequate to protect your hands and must be born when required.

Other

  • Additional Comments:

  • I have read the PPE Policy of my company and accept the policy as outlined. By signing this form, I agree to use the appropriate PPE in the situations described above, and report any deficiencies to my supervisor.

  • Employee Signature:

  • Supervisor Signature:

  • Select date

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.