ARDL/IMS/OHSMS-

PPE INSPECTION
Date Auditor:
Name of the job
Area/Location
Name of the Contractor
Name of the Safety
Officer

Serial Salient Attribute No of No of %

No. persons persons Compliance
at site complying
01 Use of Safety Helmet with chin strap in position by
Supervisor and Engineers
02 Use of Safety Helmet with chin strap in position by
workers
03 Use of Safety Shoes/Gumboots by Supervisor and
Engineers
04 Use of Safety Shoes/Gumboots by workers
05 Use of Full body Harness with fixing to proper support
above platform while working above 2m height.
06 Use of Single lanyard Full Body Harness
07 Use of Double lanyard Full Body Harness
08 Use of Hand Gloves
09 Use of Safety Goggles by Chippers/Grinders
10 Use of Face shield by Chippers/ Grinders
11 Use of Face Shield by Welders
12 Use of Nose protection
13 Use of Ear protection
14 Use of fall Arrestor by workers for height jobs.
15 Provision of Safety Net, if required.
16 Use of Life Line , if provided
17 Use of Insulated Hand Gloves by Electricians/Helpers
18 Use of Dust Respirator, Blasters’ Hoods, Aprons for
Blusters
19 Whether standard PPEs are used?
20 Dedicated Identification No. provided at full body
harness and inspected by authorized person ?

Signature of the Ambuja Neotia responsible person: - Signature of the Contractor Safety Officer:-