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    PPE Issue Form

    Uploaded by

    Balaji Thiagu
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists the employee's name and job title, the date, and the items of PPE issued, including head protection, hearing protection, eye protection, overalls, gloves, safety footwear, high-visibility clothing, specialized equipment, life jackets, breathing apparatus, and fall arrest equipment. For each item, it records the manufacturer, year, and reason for re-issuance as new, lost, damaged, or periodic replacement. The employee signs to acknowledge receipt and understanding of their responsibility to use, maintain, store, and report any loss or defects of the issued PPE.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    PPE Issue Form

    Uploaded by

    Balaji Thiagu
    13K views1 page
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists the employee's name and job title, the date, and the items of PPE issued, including head protection, hearing protection, eye protection, overalls, gloves, safety footwear, high-visibility clothing, specialized equipment, life jackets, breathing apparatus, and fall arrest equipment. For each item, it records the manufacturer, year, and reason for re-issuance as new, lost, damaged, or periodic replacement. The employee signs to acknowledge receipt and understanding of their responsibility to use, maintain, store, and report any loss or defects of the issued PPE.

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    PPE issue form

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    PPE issue form

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    © Attribution Non-Commercial (BY-NC)

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    This document records the issuance of personal protective equipment (PPE) to an employee. It lists the employee's name and job title, the date, and the items of PPE issued, including head protection, hearing protection, eye protection, overalls, gloves, safety footwear, high-visibility clothing, specialized equipment, life jackets, breathing apparatus, and fall arrest equipment. For each item, it records the manufacturer, year, and reason for re-issuance as new, lost, damaged, or periodic replacement. The employee signs to acknowledge receipt and understanding of their responsibility to use, maintain, store, and report any loss or defects of the issued PPE.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    13K views1 page

    PPE Issue Form

    Uploaded by

    Balaji Thiagu
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists the employee's name and job title, the date, and the items of PPE issued, including head protection, hearing protection, eye protection, overalls, gloves, safety footwear, high-visibility clothing, specialized equipment, life jackets, breathing apparatus, and fall arrest equipment. For each item, it records the manufacturer, year, and reason for re-issuance as new, lost, damaged, or periodic replacement. The employee signs to acknowledge receipt and understanding of their responsibility to use, maintain, store, and report any loss or defects of the issued PPE.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PERSONAL PROTECTIVE EQUIPMENT RECORD OF ISSUE

    Employee Name: Job Title:

    Date:

    The Personal Protective Equipment listed below has been issued to me in accordance with the Personal Protective Equipment at Work Regulations 1992 and The Management of Health and Safety at Work Regulations 1999.

    Whilst the PPE is in my care I understand that it is my responsibility to: a. Use & wear the PPE in accordance with any training given to me & the manufacturers instructions and guidance b. Maintain & store the PPE correctly to prevent unecessary loss or damage c. Report loss or defects when discovered to the Director in order to obtain replacements Item of PPE Issued Head Protection Hearing Protection Eye Protection Overalls Gloves Safety Footwear Hi-vis Clothing Specialised Equipment Life Jacket Breathing Apparatus Fall Arrest Equipment Gaiters Manufacturer / Year Reason for (Re)issue
    New Lost Damaged Periodic

    Manufacturer / Year

    Reason for (Re)issue


    (please tick option)
    New Lost Damaged Periodic

    Date Issued

    Signed

    Date Issued

    Signed

    Employee Signature:
    (as proof of receipt and understanding of responsibility) .

    Record Maintained by:

    Position:

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