• Date

  • Document No.

  • Employee Name

  • Auditor Name

  • Location

Required PPE * Company Supplied Equipment

  • Clothing (correct layering, rain gear, etc)

  • Time Piece (watch, phone, IPad, etc)

  • *Safety glasses

  • *Hearing Protection

  • *Radio Fully Charged

  • All Company Equipment tethered to vest

  • First Aid Certification up to date?

  • Matches or Lighter for emergency use

  • *Whistle on gear?

  • *Survival Blanket

  • *Compass?

  • *Flashlight/Headlamp (headlamp not supplied by company)

  • Emergency use knife/multitool

  • Water and food

Required PPE General Condition

  • Rain gear

  • *Hard hat and visor. (Yearly replacement of liner)

  • *Hand protection

  • High visibility vest

  • Boots? Condition? Caulks sharp?

  • *Personal first aid kit? (min: 1 pressure dressing, 6-10 band aids, 6-10 cleansing towels)

  • *PFD Vest condition and CO2 canister in good condition

Optional Recommended PPE

  • Bear spray

  • Bear Banger

  • Cougar knife

  • Bug spray

  • Bug Net

  • Benadryl (antihistamine)

  • Sun Screen

  • Corrective Actions, Responsibility and Due Date

  • Other deficiencies Identified

  • Auditor Signature

  • Add 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.