This record is used to track Blue Plaster. Circle response Yes/No as appropriate

  • Site conducted

  • Conducted on

  • Prepared by

  • Location /area
  • This record is used to track Blue Plaster. Circle response Yes/No as appropriate

  • Date

  • Time of use

  • Record the person’s name blue plaster issued to

  • Manager: have you written the casualty initials on the plaster?

  • Manager: have you explained to the casualty what they should do if plaster is lost?

  • Manager: signature after issue

  • At the end of the shift: was blue plaster returned, removed and safely disposed?

  • Did the person leave the production facility with blue plaster on?

  • Manager signature at end of day

  • Person checked the following morning: if plaster present removed and reissued (start newline)

  • Manager signature after morning check

  • This record is used to track Blue Plaster. Circle response Yes/No as appropriate

  • Signed off by Manager on completion

  • 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.