Are you making sure that your workplace is properly set up to enforce standards of safety and health? Do you have the right tools on hand to protect your staff members from potential risks? Having a complete BCCC PPE Checklist Form in place can help. It’s an easy-to-understand document that outlines each item of Personal Protective Equipment (PPE) that should be present within the working environment, where it should be located, and who is responsible for its upkeep. On this page, we will discuss why having a BCCC PPE Checklist Form in place can create a safe work environment and provide some tips on how best to fill out one effectively.
| Question | Answer |
|---|---|
| Form Name | BCCC PPE Checklist Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | Personal Protective Equipment Inspection Checklist Form, Personal Protective Equipment Testing and Inspection Form |
Attachment 5
Personal Protective Equipment Inspection Form
Date: |
Name of Inspector: |
Location:
Specific tasks performed at this location:
PERSONAL PROTECTIVE EQUIPMENT USED
Yes
No
(or N/A)
Head Protection
Head protection is being worn when required by the JHA.
Head protection is inspected by wearer prior to each use.
The brim or shell does not show signs of exposure or excessive wear, loss of surface gloss, chalking, or flaking.
The brim or shell does not have any signs of paint or solvent use.
The brim or shell is not cracked, perforated, or deformed.
The suspension system inside hardhat does not shoe signs of deterioration, including cracking, tearing, or fraying.
Hardhat areas are marked.
Employees wear hard hats in marked areas.
Footwear
Safety footwear is being worn when required by the JHA.
Safety footwear is inspected by wearer prior to each use.
Safety footwear areas are marked.
Employees wear safety footwear in marked areas.
Safety footwear worn by employees does not show signs of excessive wear.
Chemical resistant footwear is decontaminated or disposed prior to leaving the work area.
Hand Protection
Hand protection is being worn when required by the JHA.
Gloves are inspected by wearer prior to each use.
Gloves do not show signs of exposure or excessive wear, cracking, scrapes/cuts, thinning, discoloration, or breakthrough to the skin.
Chemical resistant gloves are decontaminated or disposed prior to leaving the work area.
Body Protection/Protective Clothing
Body protection/protective clothing is being worn when required by the JHA.
Protective clothing is inspected by wearer prior to each use.
Protective clothing does not show signs of exposure or excessive wear, cracking, scrapes/cuts, thinning,
Version 1.0 Effective October 2007
discoloration, or breakthrough to the skin.
Chemical resistant clothing is decontaminated or disposed prior to leaving the work area.
Hearing Protection
Hearing protection is being worn when required by the JHA.
Hearing protection is inspected by wearer prior to each use.
Noise hazardous areas are marked.
Employees wear hearing protection in marked noise hazard areas/ equipment.
Eye/Face/Inhalation Protection
Eye/Face/Respirator protection is being worn when required by the JHA.
Eye/Face/Respirator protection is inspected by wearer prior to each use.
Eye/Face hazardous areas are marked.
Employees wear eye/face protection in marked eye/face hazard areas/ equipment.
Employees store, clean, maintain respirators properly.
Fall Protection
Equipment & PPE used, maintained according to Chapter 10, Safety Manual
Water Hazard Protection
U.S. Coast Guard approved flotation devices used, maintained.
Remarks:
Version 1.0 Effective October 2007