PPE Issue & Inspection Record v3

• Site / Centre Location

• Conducted on

  Date

• Plappered by

• Issuer Name

• Date:

  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

  Select Latex Gloves (EN374/EN455) - Disposable Nitrile Gloves (EN374-1:2016/ Type A) Working Gloves (EN 388:2016 4.1.2.1.X) 3D Level 5 Cut Resistant Gloves (CE EN 388 / ANSI Cut A4) 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

  • Latex Gloves (EN374/EN455) - Disposable
  • Nitrile Gloves (EN374-1:2016/ Type A)
  • Working Gloves (EN 388:2016 4.1.2.1.X)
  • 3D Level 5 Cut Resistant Gloves (CE EN 388 / ANSI Cut A4)
  • 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

• 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

  Sign

• Manager / Supervisor name and signature

  Sign

PPE (Personal Issue)

• Latex Gloves (EN374/EN455) - Disposable

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

• Ear Defenders (EN352)

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

• Safety Glasses/Goggles ( EN166 1F KN)

  Safe

  At Risk / Visual Damage

  N/A

• Safety Boots (S3 SRA)

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

• Knee Pads (EN 14404)

  Safe

  At Risk / Visual Damage

  N/A

• Kneeling Mat

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

• Hard Hat (EN 812)

  Safe

  At Risk / Visual Damage

  N/A

• Bump Caps (EN 812)

  Safe

  At Risk / Visual Damage

  N/A

• Water Proof clothing - Coverall

  Safe

  At Risk / Visual Damage

  N/A

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

  Safe

  At Risk / Visual Damage

  N/A

• Security Tactical Vest

  Safe

  At Risk / Visual Damage

  N/A

• Security Stab Vest

  Safe

  At Risk / Visual Damage

  N/A

Verified by:

• Employee Name and Signature

  Sign

• Manager / Supervisor Name and Signature

  Sign