Use this template to evaluate which types of PPE are required to perform the task safely. There are endless onsite hazards that could damage a worker’s health. Ensuring that these risks are mitigated with the proper PPE is of utmost importance to stay in compliance with the occupational safety and health act.
INSTRUCTIONS
1. Answer the following questions by typing in your answers in the text field.
2. On the dropdown list, select the items that apply to each hazard.
3. Indicate the description of the hazard and the required PPE.
4. Complete audit by providing digital signature
EYE HAZARDS
Handling/dispensing chemicals and ingredients; working around UV lights; chipping, sanding, grinding, welding, metal working; tasks that generate dust
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
HEAD/NECK/FACE HAZARDS
Handling/dispensing chemicals and ingredients, chipping, sanding or grinding metal or wood; working below others, working on energized equipment, working in confined spaces
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
FOOT HAZARDS
Exposure to chemicals; wet environments; welding and cutting; material handling; uneven walking/working surfaces
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
HAND HAZARDS
Handling/dispensing chemicals and ingredients; exposure to abrasive materials; using knives or other sharp objects; working with hot or cold materials; food service prep
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
BODY/TORSO HAZARDS
Handling/dispensing chemicals or ingredients; exposure to abrasive materials; cutting, brazing, welding, chipping or sanding; working around electrical panels
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
FALL HAZARDS
Working on raised surfaces of 4 feet or morel; ladder use
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
NOISE HAZARDS
Noise levels above 85 dBA; working around pneumatic equipment; using powered hand tools
Select all that apply for each hazard from the drop down list.
Description of Hazard
Required PPE
RESPIRATORY HAZARDS
Handling/using highly hazardous chemicals; tasks that generate dust and/or fumes; cutting, brazing on certain metals (stainless steel);
Select all that apply for each hazard from the drop down list.
Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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