Title Page
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Document No.
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Site/Business Unit
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Date Survey Completed
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Survey Completed By
Process/Task - duplicate
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Describe the process which the RPE is used for
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What is the physical form of Chemical
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Name of Chemical/Dust/Fume Exposed Too
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Has any professional air monitoring being completed? Provide details
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Is a COSHH Assessment In Place & readily available to user
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Does the COSHH Assessment identify type of RPE to use?
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Does the process take place outside of a confined space
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How often does the process take place
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How long is the person exposed to the chemical/fume/dust per day?
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Does the operative wear the mask for less than an hour at a time?
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Does the RPE in use meet the required assigned protection factor (APF)?
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Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
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Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate
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Is the user clean shaven allowing clear seal of RPE
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Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
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Has the user undergone a face fit test
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One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
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Does the user undergo OH checks, i.e lung function, If state details, frequency etc
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Is training in place for use and storage to users? Give details
RPE Details
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What is the current process for selecting RPE?
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What type of RPE Is used?
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Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
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Is there process for checking RPE?
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How often is RPE changed?
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Note: disposable masks marked NR must not be used for more than a single 8 hr shift
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Is a process in place for cleaning reusable RPE?
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Is the RPE suitably stored when not in use? Provide details
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Quantities of this RPE Purhased for Process per month
Process/Task - duplicate - duplicate
-
Describe the process which the RPE is used for
-
What is the physical form of Chemical
-
Name of Chemical/Dust/Fume Exposed Too
-
Has any professional air monitoring being completed? Provide details
-
Is a COSHH Assessment In Place & readily available to user
-
Does the COSHH Assessment identify type of RPE to use?
-
Does the process take place outside of a confined space
-
How often does the process take place
-
How long is the person exposed to the chemical/fume/dust per day?
-
Is the protection worn for more than 1 hour continuously?
-
Does the RPE in use meet the required assigned protection factor (APF)?
-
Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
-
Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate - duplicate
-
Is the user clean shaven allowing clear seal of RPE
-
Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
-
Has the user undergone a face fit test
-
One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
-
Does the user undergo OH checks, i.e lung function, If state details, frequency etc
-
Is training in place for use and storage to users? Give details
RPE Details - duplicate
-
What is the current process for selecting RPE?
-
What type of RPE Is used?
-
Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
-
Is there process for checking RPE?
-
How often is RPE changed?
-
Note: disposable masks marked NR must not be used for more than a single 8 hr shift
-
Is a process in place for cleaning reusable RPE?
-
Is the RPE suitably stored when not in use? Provide details
-
Quantities of this RPE Purhased for Process per month
Process/Task - duplicate - duplicate - duplicate
-
Describe the process which the RPE is used for
-
What is the physical form of Chemical
-
Name of Chemical/Dust/Fume Exposed Too
-
Has any professional air monitoring being completed? Provide details
-
Is a COSHH Assessment In Place & readily available to user
-
Does the COSHH Assessment identify type of RPE to use?
-
Does the process take place outside of a confined space
-
How often does the process take place
-
How long is the person exposed to the chemical/fume/dust per day?
-
Is the protection worn for more than 1 hour continuously?
-
Does the RPE in use meet the required assigned protection factor (APF)?
-
Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
-
Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate - duplicate - duplicate
-
Is the user clean shaven allowing clear seal of RPE
-
Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
-
Has the user undergone a face fit test
-
One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
-
Does the user undergo OH checks, i.e lung function, If state details, frequency etc
-
Is training in place for use and storage to users? Give details
RPE Details - duplicate - duplicate
-
What is the current process for selecting RPE?
-
What type of RPE Is used?
-
Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
-
Is there process for checking RPE?
-
How often is RPE changed?
-
Note: disposable masks marked NR must not be used for more than a single 8 hr shift
-
Is a process in place for cleaning reusable RPE?
-
Is the RPE suitably stored when not in use? Provide details
-
Quantities of this RPE Purhased for Process per month
Process/Task - duplicate - duplicate - duplicate - duplicate
-
Describe the process which the RPE is used for
-
What is the physical form of Chemical
-
Name of Chemical/Dust/Fume Exposed Too
-
Has any professional air monitoring being completed? Provide details
-
Is a COSHH Assessment In Place & readily available to user
-
Does the COSHH Assessment identify type of RPE to use?
-
Does the process take place outside of a confined space
-
How often does the process take place
-
How long is the person exposed to the chemical/fume/dust per day?
-
Is the protection worn for more than 1 hour continuously?
-
Does the RPE in use meet the required assigned protection factor (APF)?
-
Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
-
Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate - duplicate - duplicate - duplicate
-
Is the user clean shaven allowing clear seal of RPE
-
Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
-
Has the user undergone a face fit test
-
One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
-
Does the user undergo OH checks, i.e lung function, If state details, frequency etc
-
Is training in place for use and storage to users? Give details
RPE Details - duplicate - duplicate - duplicate
-
What is the current process for selecting RPE?
-
What type of RPE Is used?
-
Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
-
Is there process for checking RPE?
-
How often is RPE changed?
-
Note: disposable masks marked NR must not be used for more than a single 8 hr shift
-
Is a process in place for cleaning reusable RPE?
-
Is the RPE suitably stored when not in use? Provide details
-
Quantities of this RPE Purhased for Process per month
Process/Task - duplicate - duplicate - duplicate - duplicate - duplicate
-
Describe the process which the RPE is used for
-
What is the physical form of Chemical
-
Name of Chemical/Dust/Fume Exposed Too
-
Has any professional air monitoring being completed? Provide details
-
Is a COSHH Assessment In Place & readily available to user
-
Does the COSHH Assessment identify type of RPE to use?
-
Does the process take place outside of a confined space
-
How often does the process take place
-
How long is the person exposed to the chemical/fume/dust per day?
-
Is the protection worn for more than 1 hour continuously?
-
Does the RPE in use meet the required assigned protection factor (APF)?
-
Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
-
Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate - duplicate - duplicate - duplicate - duplicate
-
Is the user clean shaven allowing clear seal of RPE
-
Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
-
Has the user undergone a face fit test
-
One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
-
Does the user undergo OH checks, i.e lung function, If state details, frequency etc
-
Is training in place for use and storage to users? Give details
RPE Details - duplicate - duplicate - duplicate - duplicate
-
What is the current process for selecting RPE?
-
What type of RPE Is used?
-
Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
-
Is there process for checking RPE?
-
How often is RPE changed?
-
Note: disposable masks marked NR must not be used for more than a single 8 hr shift
-
Is a process in place for cleaning reusable RPE?
-
Is the RPE suitably stored when not in use? Provide details
-
Quantities of this RPE Purhased for Process per month
Process/Task - duplicate - duplicate - duplicate - duplicate - duplicate - duplicate
-
Describe the process which the RPE is used for
-
What is the physical form of Chemical
-
Name of Chemical/Dust/Fume Exposed Too
-
Has any professional air monitoring being completed? Provide details
-
Is a COSHH Assessment In Place & readily available to user
-
Does the COSHH Assessment identify type of RPE to use?
-
Does the process take place outside of a confined space
-
How often does the process take place
-
How long is the person exposed to the chemical/fume/dust per day?
-
Is the protection worn for more than 1 hour continuously?
-
Does the RPE in use meet the required assigned protection factor (APF)?
-
Note: APF protection determined = total airborne concentration / EH40 WEL = APF factor required
-
Is the environment suitable for the RPE used? i.e powered/BA used in confined spaces or extreme heat
User/Person - duplicate - duplicate - duplicate - duplicate - duplicate - duplicate
-
Is the user clean shaven allowing clear seal of RPE
-
Does any other item worn such as glasses, hats or other PPE allow the mask to fit correctly?
-
Has the user undergone a face fit test
-
One kind of RPE does not fit all, if RPE does not fit it will not protect the wearer
-
Does the user undergo OH checks, i.e lung function, If state details, frequency etc
-
Is training in place for use and storage to users? Give details
RPE Details - duplicate - duplicate - duplicate - duplicate - duplicate
-
What is the current process for selecting RPE?
-
What type of RPE Is used?
-
Note: P1 and P2 particle filters are not recommended for fumes unless stated by manufacturers, a gas or vapor mask should be used.
Gas or Vapor masks used with a P1 filter incorporated will have APF reduced to 4 -
IS the RPE CE marked and of an approved standard?
-
Is there process for checking RPE?
-
How often is RPE changed?
-
Note: disposable masks marked NR must not be used for more than a single 8 hr shift
-
Is a process in place for cleaning reusable RPE?
-
Is the RPE suitably stored when not in use? Provide details
-
Quantities of this RPE Purhased for Process per month
