PPE Checklist

Personal protective equipment — 6-monthly check

Operative Details

Operative's Name *

Next Check Due Date *

PPE Checklist

All items required — enter the date checked and any relevant notes for each.

PPE Item Date Checked Notes

Declaration

I acknowledge receipt of and agree to wear the correct PPE and/or clothing issued to me. I agree to look after the equipment and will not use it if it becomes damaged. I also agree to report any loss or damage to my supervisor immediately.

Operative's Signature *

Actions

Actions Required *

Actions Completed By

Sign above to populate

Date Actions Completed *