23/10/2021, 16:56 PPE Checklist - SafetyCulture

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Nature of work

Enter text

Identify potential hazards at work (select all that apply)

Eye Head/Neck/Face Foot Hand Body/Torso

Fall Noise Respiratory

Handling/dispensing chemicals and ingredients; working around UV lights; chipping,

sanding, grinding, welding, metal working; tasks that generate dust

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Select all that apply for each hazard from the drop down list.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

Description of Hazard

Enter text

Required PPE

Enter text

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Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

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.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

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Description of Hazard

Enter text

Required PPE

Enter text

Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

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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.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

Description of Hazard

Enter text

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Required PPE

Enter text

Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

Handling/dispensing chemicals and ingredients; exposure to abrasive materials; using

knives or other sharp objects; working with hot or cold materials; food service prep

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Select all that apply for each hazard from the drop down list.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

Description of Hazard

Enter text

Required PPE

Enter text

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Does the equipment undergo testing and in a good condition?

Yes No

REFERENCE: Gloves are resistant to chemicals

[This is an example of how you can use iAuditor to include best practice reference images
in your templates to assist with inspections]

Does the equipment fit perfectly?

Yes No

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.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

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Description of Hazard

Enter text

Required PPE

Enter text

Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

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Working on raised surfaces of 4 feet or morel; ladder use

Select all that apply for each hazard from the drop down list.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact

Impact/Compression UV/IR Radiation Noise Hazard
Puncture Slippery/Wet Surfaces Other

Description of Hazard

Enter text

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Required PPE

Enter text

Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

Noise levels above 85 dBA; working around pneumatic equipment; using powered hand
tools

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Select all that apply for each hazard from the drop down list.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock
Fall Hazard High Heat/COld Impact
Impact/Compression UV/IR Radiation Noise Hazard

Puncture Slippery/Wet Surfaces Other

Description of Hazard

Enter text

Required PPE

Enter text

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Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

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.

Chemical Exposure Cut/Abrasions Dust/Flying Debris

Dust Particulates Electrical Arc Electrical Shock

Fall Hazard High Heat/COld Impact
Impact/Compression UV/IR Radiation Noise Hazard
Puncture Slippery/Wet Surfaces Other

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Description of Hazard

Enter text

Required PPE

Enter text

Does the equipment undergo testing and in a good condition?

Yes No

Does the equipment fit perfectly?

Yes No

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RECOMMENDATION

State recommendations here

Enter text

COMPLETION

Auditor's Full Name and Signature 

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things,
workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to
determine if the use of such checklist is permissible in your workplace or jurisdiction.

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