Home > Checklists > Checklist – PPE Template
This PPE checklist template is used to ensure worker safety by reviewing a list of proper protective equipment
1.1 Eye Protection Criteria
1.2 Employees Perform tasks, or work near employees performing tasks, that may produce airborne dust or flying particles
1.3 Employees handle or work near employees who handle hazardous liquid chemicals or encounter blood splashes
1.4 Eyes of employees exposed to other potential physical or chemical irritants.
1.5 Employee exposed to intense light or lasers
2.1 Eye Protection Criteria
2.2 The employee handles or works near employees who handle hazardous liquid chemicals
2.3 Employees’ faces are exposed to extreme heat.
2.4 Employees’ faces are exposed to other potential irritants.
3.1 Is the Owners Corporation sign clean and clearly visible?
3.2 Tools or other objects can potentially fall from above and hit your employee in the head
3.3 Are employees’ heads, when standing or bowing, near exposed beams, machine parts, pipes, etc.?
3.4 Employees work with or are in close proximity to electrical wires or electrical wire components.
4.1 Tools, heavy equipment, or other objects can roll, fall, or hit employees’ feet.
4.2 Employees work with or are near exposed electrical wiring or electrical wiring components.
4.3 Employees handle or work with those who handle molten metal
4.4 Employees work with explosives or are in an explosive atmosphere
5.1 Employee hands may come into contact with tools or materials that can abrade, bruise, or cut
5.2 Employees handle chemicals that can irritate the skin or come into contact with blood.
5.3 Employees place their hands and arms near the extreme heat
5.4 Employees’ hands and arms are placed exposed to electrical wiring or ear components.
6.1 Bodies of employees exposed to irritating dust or chemical splashes
6.2 Bodies of employees exposed to sharp or rough surfaces
6.3 Bodies of employees exposed to extreme heat
6.4 Bodies of employees exposed to acids or other dangerous substances
7.1 Employees are exposed to loud noise from machines, tools, music systems, etc.
Name and Signature