Title Page
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Inspection Completed By:
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Confirm Site
Asset
Core Kit Condition
Kit Bag Condition
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Is the Kit Bag in good condition externally & internally?
Core Kit Items Inspection
Nitrile Flock Lined Gloves
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Are the gloves in the kit?
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Do the gloves require replacement?
Sandy Nitrile Gloves
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Are the gloves in the kit?
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Do the gloves require replacement?
Dusk Mask P2 - Box of 10
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Do you have 5 or more masks in new condition?
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How many masks do you have in new condition?
Cut Resistant Gloves
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Are the gloves in the kit?
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Do the gloves require replacement?
Vented Hard Hat
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Is the Hard Hat in the kit?
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Does the Hard Hat require replacement?
Safety Specs - Clear
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Are the specs in the kit?
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Do the specs require replacement?
Safety Specs - Smoke
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Are the specs in the kit?
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Do the specs require replacement?
Sunscreen
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Is there Sunscreen in the kit?
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Does the Sunscreen require replenishment?
Slouch Hat
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Is the Hat in the kit?
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Does the Hat require replacement?
Earmuffs
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Are the Earmuffs in the kit?
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Do the Earmuffs require replacement?
First Aid Kit
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Is the First Aid Kit in the PPE kit or in the vehicle?
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Does the First Aid Kit require replacement?
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What items have been used, need replacement or are missing from the First Aid Kit?
Basic Harness
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Is the Basic Harness in the Kit?
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Does the Basic Harness require replacement?
Adjustable Lanyard
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Is the Adjustable Lanyard in the Kit?
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Does the Lanyard require replacement?
Safety Boots
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Are the Boots in the kit?
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Do the Boots require replacement?
Barricade Tape
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Is the Barricade Tape in the Kit?
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Does the Tape require replacement?
Spectacle Pouch
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Is the Spectacle Pouch in the Kit?
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Does the Pouch require replacement?
Spectacle Cord
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Is the Spectacle Cord in the Kit?
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Does the Cord require replacement?
Electrician Pouch Lockout Kit
Electrician Pouch Lockout Kit
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Is the Electrician Pouch Lockout kit still in the Kit?
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Does the Electrician Pouch Lockout Kit require replacement?
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What items have been used, need replacement or are missing from the Electrician Pouch Lockout Kit?
Respirators & Filters
Half Face Respirator
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Is the Half Face Respirator in the kit?
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Does the Half Face Respirator require replacement?
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Are you confident that the respirator is the correct fit for you?
Full Face Respirator
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Is the Full Face Respirator in the kit?
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Does the Full Face Respirator require replacement?
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Are you confident that the respirator is the correct fit for you?
Filters
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Are the replacement filters in the kit?
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Do the Filters require replacement?
Fire Extinguisher
Fire Extinguisher
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Is the Fire Extinguisher fixed appropriately and within the vehicle?
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Does the Fire Extinguisher require replacement?
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Does the First Extinguisher have more than 3 months left before requiring servicing?
Sign off
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I confirm that I have inspected and provided an accurate response to all questions and according to policies & guidelines.