DZ-GHBR-00-GEN-HSE-PDR-0013

May 2022
Personal Protective Equipment (PPE) Rev.00

PPE REQUEST FORM

Name of Requestor: Cherif Hellal Department: Subsurface

Work Location: ALG HMD GH REB Drilling

Date of Receive:

Date of Request: 4 March 2023 Sign for Received:

(To be signed by the requestor when received PPE)

PPE Description Size Quantity Remark

Helmet Regular /

Coverall 1 42(L)*2, FR type

(Available Size: XXXL / XXL / XL / L / M / S / XS)

Hearing Protection Regular /

Eyes Protection / Safety Glasses Regular 1 1 dark, 1 clear

Hand Protection / Safety Gloves /

Foot Protection / Safety Shoes / 43*1,

1
Boots
Others: Mask with cartridge filter Regular /

HSE Officer
Employee Line Manager Stock Controller
(Verify PPE &
(Requestor) (Approver) (Provider)
Record)
Sign: Sign: Sign: Sign:

Cherif Hellal

( Operations Geologist )

Name: Name: Name: Name:

Date: 07 January 2023 Date: Date: Date: