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AEL INTELLIGENT BLASTING OPERATIONAL

EXCELLENCE

ISSUE OF PERSONAL PROTECTIVE EQUIPMENT

NAME…………………………………………. CO.NO…………
I……………………………………………hereby accept responsibility for items below drawn and signed for by myself and
accept that I will report to supervisor, damaged or lost so that it will be replaced immediately. I agree to wear, or
use in the proper manner, the protective equipment issued to me for the protection of my health and safety as
specified at the entrance to various area in the work or as detailed in the operating procedures and other official
company document

I realized that if I fail to wear this equipment and as a result I sustain an injury, the workman’s compensation
commissioner will be informed and this may jeopardize my right to compensation. I have also read and understand
section 14’’ General duties of employees at work’ ’and section 38(1) (0) offence and penalties of the occupational
health and safety Act.

Signed…………………. Date…………………. Witness…………………… Date……………………….

Description Date Sign Description Date Sign

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