SSF 031 Half-Mask Inspection Record

• Job Number

• Site

  Select

• Conducted on

  Date

• Site Supervisor

• Location
  Address

• Before each use Operatives must inspect their Half-Masks and record findings on this sheet.

• Inspect the following component parts and indicate status with a 'Pass' or 'Fail'

• Mask Body is Intact (no cuts or cracks)

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and should be returned to Head Office for replacement.

• Mask is Clean

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and should be cleaned and re-inspected prior to use.

• Head Harness is in good condition

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and should be returned to Head Office for replacement.

• Mask is Correctly Assembled

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and should be re-assembled and re-inspected prior to use.

• Inhalation / Exhalation Membranes intact

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and membranes need to be replaced and re-inspected prior to use.

• Protective caps in place

  Pass

  Fail

• If the mask is not in appropriate condition, it must not be used and protective caps need to be replaced and mask re-inspected prior to use.

• Appropriate Filter and Pre-Filter fitted

  Pass

  Fail

• The mask is not in appropriate condition, it must not be used and protective caps need to be replaced and mask re-inspected prior to use.

• Name & Signature of Operative

  Sign

Site Supervisor Sign-off

• Add signature

  Sign

• C. G. Comley & Sons Limited T/A Comley Demolition. Registered office: Southern Way, Rye Common, Odiham, Hook, Hampshire, RG29 1HU. Telephone: 01256 702178. Email: comley@comleydemolition.co.uk Company Registration Number: 01672195