Information

  • Site / Centre Location

  • Conducted on

  • Plappered by

Personal Protective Equipment (PPE) Issue

  • Issuer Name

  • Date:

  • The articles of personal protective equipment, which has been issued to you by your Manager / Supervisor are now your responsibility.

    If you misuse or abuse the equipment you may be disciplined. In turn your employer must provide you with what is deemed as reasonably practicable for the purpose. If the equipment genuinely needs to be replaced you must inform your Manager or Supervisor.

    Your Manager / Supervisor will show you how to wear the equipment / clothing correctly. Your Manager / Supervisor will be inspecting your PPE every Quarter ( 3 months ) if present and in working order .

  • What PPE has been issued

  • Please sign below to say that you have received the personal protective equipment and the training showing how to wear the equipment correctly, and that you also understand that you may be disciplined if you misuse or abuse the equipment.

  • Employee name and signature

  • Manager / Supervisor name and signature

Personal Protective Equipment (PPE) Inspection

PPE (Personal Issue)

  • Latex Gloves (EN374/EN455) - Disposable

  • Nitrile Gloves (EN374-1:2016/ Type A)

  • Working Gloves (EN 388:2016 4.1.2.1.X)

  • Ear Defenders (EN352)

  • Mask (EN149:2001/FFP2 NRD) - Disposable

  • Safety Glasses/Goggles ( EN166 1F KN)

  • Safety Boots (S3 SRA)

  • Wellington Boots ( 200J Steel Toe Cap / S5 SRA)

  • Knee Pads (EN 14404)

  • Kneeling Mat

  • High Vis Vest (EN20471:2013 + A1:2016 Class 2)

  • Hard Hat (EN 812)

  • Bump Caps (EN 812)

  • Water Proof clothing - Coverall

  • Safety Harness (EN 354, EN 361. up to 140kg)

  • Security Tactical Vest

  • Security Stab Vest

Verified by:

  • Employee Name and Signature

  • Manager / Supervisor Name and Signature

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.