Title Page
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Site/project reference
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Date of inspection
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Inspection form provided by (supervisor/manager)
PPE checklist (operative)
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Do I have the correct gloves for the task(s) I’m doing? (Minimum cut level C)
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Do I have the correct eye protection for the task(s) I’m doing?
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Do I have the correct foot protection for the task(s) (S3 standard footwear)
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Do I have the correct hearing protection for the tasks I am completing?
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I am aware that although this is a monthly check, replacement PPE is available to me whenever I need it. (Contact supervisor/manager)
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Is my clothing (at least from the waist up) high visibility?
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Is all of my PPE and clothing in good, clean condition?
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I am aware that 'hoodies' are not allowed on site
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I have long sleeves at all times (site specific)
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I am aware that If I do not wear my PPE correctly or as instructed for use by manufacturers instructions then I am putting my own and others safety at risk and may be liable to discplinary action
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I am aware that PPE is provided by my employer and if I do not have the correct PPE, I do not complete the task - contact supervisor
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Signed by operative
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Date
