PERSONAL PROTECTIVE EQUIPMENT INSPECTION Doc Ref #: XXXX/IMS/QHSE/F/00
CHECKLIST Issue Date: DD-MM-YYYY
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QHSE FORMS Rev #: 00
Organization Name
Inspection Date
Project Ref #
Site Location
Contractor
Department
Sr.# Criteria Yes No N/A
1 PPE is available at site, ready to use and maintained properly?
When working in an area where flying objects or substance splashes are found,
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face shield, glasses are used?
Job specific PPEs such as Gloves, Face Shield, Apron, Safety shoes are provided
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when working with substances of corrosive nature and pose danger to worker?
4 Employees are trained about the use and maintenance of PPEs?
Workers are trained about falling objects and provided with Helmets to use in the
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areas where there is a danger of Falling Objects?
6 Workers are trained in the selection and maintenance of PPEs?
To prevent the physical injuries at workplace, workers are provided with foot
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protection?
8 When worker is working in high-noise area, he is provided with noise protection?
Respiratory protection is provided to workers when they are handling substance
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dangerous to health and can be inhaled?
10 Workers are trained to select, use, and maintain respiratory protection?
Workers are regularly and properly trained and instructed about the use and
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maintenance of PPEs?
12 Respiratory PPEs are routinely disinfected, and cleaned after e ach use?
13 Is there any written method available to discard the PPEs?
Competent concerned person monthly inspects the emergency PPEs and
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respirators and discard the damaged ones?
15 Is there any record of PPEs inspection kept?
Observations!
Inspected By Approved By
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