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Weekly PPE Compliance Audit Check List نموذج مهمات وقاية شخصية


Weekly PPE Compliance Audit Check List
                                             Date:                                            Location:                                          Area :                                                                                                   
Type of PPE
Required
In use
Not in use
% Non-compliance
Helmet




General glasses, clear or colored




Cover all




Safety boots




General gloves




Ear plugs




Ear muffs




Face shield




Welders goggles




½ mask with filter for dust and fumes




BA set, compressed air




Welders apron




Sandblasters air-hood with air hose




Electricians rubber glove




Chemical resistant gloves




Welders face shield




Safety belt with line and hooks




Safety hardness with line and hooks




Fresh air unit with hoses and filters




Welders gloves




Total:
                          
=
=                           
:                            %

In use:             Mark up the column with the actual PPE in use for each man observed        Total: Calculate the % non-compliances for all categories of PPE.
Not in use:      Mark up the column for the PPE missing for each man observed      % Non-con:   Calculate the % non-compliance within each category of PPE

 

 

HSE Reps., name:…………………………..…………….. Title:…………………………………………            Signature:…………………………………..…


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