Title Page

  • Safety Supplies - Southern Safety Terry Clarke or Connor - Email:order@southernsafetyandsupply.com - 407-281-9000

  • Job Name

  • Date of Request

  • Prepared by

  • Location

FIRST AID SUPPLIES

FIRST AID

  • the numbers in () are the minimum required to meet the ANSI standard

  • Adhesive Bandage 1" x 3" (50) - MED62550

  • Adhesive Tape 2.5 yards (2) - MED62101

  • Adhesive Tape 2.5 yards (2) - MED62101

  • Anitseptic (50) - MED21471

  • Burn Dressing (gel soaked) 4" x 4" (2) - MED66044

  • Burn Treatment (25) - MED26073

  • Cold Pack 4" x 5" (2) - MED72401

  • CPR Breathing Barrier (1) - MED89401

  • Eye Cups 6-Pack Plastic - MED71069

  • Eye Pads (2)

  • Eye Wash 4 oz (4) - MED19818

  • Eye Wash 16 oz - MED21511

  • First Aid Kit 3 Shelf - MED745M1SK

  • First Aid Refill Kit - 3 Shelf - MED745RF

  • Hand Sanitizer (10) -

  • Medical Exam Gloves (8) -

  • Roller Bandage 2" x 4 yards (2) - MED60501

  • Roller Bandage 4" x 4 yards (1) - MED62201

  • Scissors (1) - MED77101

  • Splint, Padded 4 (1) -

  • Splinter Out - MED76512

  • Sterile Pad 3" x3" (4) - MED61273

  • Tourniquet (1)

  • Trauma Pad 5" x 9" (4)

  • Triangular Bandage (2)

  • Triple Antibiotic Ointment (25) - MED22373

FALL PROTECTION

  • Harness, Blue Ironwear Carpenter SM/MD

  • Harness, Blue Ironwear Carpenter LG/XL

  • Harness, Blue Carpenter XXL

  • Harness, Labor, X-Treme MD

  • Relief Step Safety Device - MIL9099

  • Rebar Positioning Assembly -

  • Removable Concrete Anchor -

  • Ladder, Rescue

  • MIL9099_o.jpg
  • Rope Grab 5/8" -

  • Scaffold Choker 22" Green - MIL8180

  • MIL8180_o.jpg
  • Strap, Tie off 3' w/Wear -

  • Strap, Tie off 8' w/Wear -

  • Strap, Tie off 12' w/Wear -

  • 25ft Tagline Rope 5/8 with Snap Hook -

  • Carnie Yellow 2X4 Rebar Cap -

  • CARCC1002X4_o.jpg
  • Rebar Caps (100/bx)

  • Ladder Grab Bar (pair) - Extension -

  • GRD10800_o.jpg

BARRICADES

  • Debris 4FT x150FT Orange Netting -

  • Orange Plastic Barricade Netting -

  • Flagging, Red 120FT (box)

  • Flagging, Yellow OSHA 105ft (box)

  • Tape, Caution (Roll)

  • Tape, Danger (Roll)

  • Tape, Danger Reinforced (roll)

  • Tape, Danger Reinforced (roll)

  • Netting, Debris net 5'6" x 100'

HORIZONTAL LIFELINE & RETRACTABLES

  • Carabiner Auto Lock 1" Opening -

  • Red Ratchet Strap

  • Blue Ratchet Strap - RB-2EN-12BLUE

  • SafeWaze, 7FT' Dual Leg Web Retract w/Rebar Hook -

  • SafeLink StopLink Brake V2 -

  • Retractable 20 Foot -

  • Retractable 30 Foot -

  • Retractable 20 Foot Leading Edge -

  • Retractable 30 Foot Leading Edge -

  • Tether, Tool 32"-48"

  • Tether, Tool 42"-58"

PERSONAL PROTECTIVE EQUIPMENT - HEAD

  • Glasses Bulldog Indoor/Outdoor

  • Glasses, Bulldog Clear (box)

  • Glasses, Bulldog Smoke (box)

  • Over The Glass Clear -

  • Over The Glass Dark -

  • Hard Hat Liner Skullguard (replace. suspension)

  • Sideshield Clear Glasses -

  • Hard Hat, Raptor Helmet White

  • Hard Hat, UFI Full Brim Logo

  • Full Brim Faceshield Bracket Visor

  • Faceshield Bracket Visor Raptor

  • Earplugs -

  • Faceshield

  • Hard Hat Sunshade Neck

  • Sweatband Blue

  • Headlamp

  • Glasses, Lens Cleaning Towel

PERSONAL PROTECTIVE EQUIPMENT - FEET

  • White Steel Toe Rubber Boots - Size 7

  • White Steel Toe Rubber Boots - Size 8

  • White Steel Toe Rubber Boots - Size 9

  • White Steel Toe Rubber Boots - Size 10

  • White Steel Toe Rubber Boots - Size 11

  • White Steel Toe Rubber Boots - Size 12

  • White Steel Toe Rubber Boots - Size 13

  • Insoles 07 (IRONWEAR)

  • Insoles 08 (IRONWEAR)

  • Insoles 09 (IRONWEAR)

  • Insoles 10 (IRONWEAR)

  • Insoles 11 (IRONWEAR)

  • Insoles 12 (IRONWEAR)

PERSONAL PROTECTIVE EQUIPMENT - HANDS

  • Glove, Irontek Grey MD - Green

  • Glove, Irontek Grey LG - Brown

  • Glove, Irontek Grey XL - Yellow

  • Blue/Yellow LG (dz)

  • Samari Cut 4 - MD (dz)

  • Blue/Yellow XL (dz)

  • Double Palm Leather

FIRE SAFETY

  • Fire Extinguisher 10#

  • Fire Extinguisher 20#

  • Red Traffic Flag for Fire Extinguisher -

  • Fire Cabinet 30 Gal -

  • Spill Kit Oil 20 Gal -

  • Safety Can Red Gasoline - JUS7150100

  • Safety Can Yellow Diesel - JUS7150200

  • Gas Can Funnel - JUS11202Y

SIGNS - BI-LINGUAL

  • Authorized Personal Only -

  • Controlled Access Zone Do Not Enter -

  • Open Excavation Only -

  • Fall Protection Required Beyond - SGNSBMFPR106VP

  • Formwork Stripping 14x20 - SGNMSCR103VP

  • Laser in Use - SGNMRAD111VP

  • Hole Cover Sign - SGNMSCR106VP

  • Men Working Above Sign - SGNMSEQ102VP

  • Leading Edge - SGNSBMSTF014VP

  • Caution Post Tension 14 x 20 - SGNMSCR606VP

  • Safety Barricade Line In Use 14 x 20 - SGNVP1420

  • Blue Notice Outrigger Cart Load - LDIAUTHORIZEDPERSONNELUF

  • 5 in 1 Federal/State English

  • 5 in 1 Federal/State Spanish

LABELS / DECALS / TAGS

  • Scaffold Permit Complete Green Tag -

  • Scaffold Warning Do Not Use Tag -

  • Zip Ties -

  • Scaffold Warning Do Not Use Card Stock Tag -

  • Scaffold Permit Complete Green Tags -

  • Sticker, Curing Compound

  • Sticker, Form Oil

  • Sticker, Diesel

  • Sticker, Gasoline

  • Sticker, Mixed Oil/Gas

  • Tape, Water Cooler (roll)

  • Tape, Green Electrical (roll)

  • Tape, Red Electrical (roll)

VESTS

  • Class 2 Supervisor SM

  • Class 2 Supervisor MD

  • Class 2 Supervisor LG

  • Class 2 w/logo - SM

  • Class 2 w/logo - MD

  • Class 2 w/logo - LG

  • Vest, Red Rigger Class 2 MD

  • Vest, Red Rigger Class 2 LG

MISCELLANEOUS

  • Gatorade 2.5 Gal Variety 32 Packs

  • Qwik Stik Zero 50-Pack

  • Headlamp Light

  • Whip Check for Air Hose

  • Trash Can Liner 60 Gallon

  • Zip Ties, Red

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.