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Management documents Health and Safety documents

PPE issue record form template

Reviewed 2 June 2021

A model ppe issue record form template to assist you in managing this event with a best practice method.

PPE issue record

Name:  
Department:  

The personal protective equipment (PPE) listed below is issued to you in accordance with the Management of the Health and Safety at Work Regulations 1999 and the Personal Protective Equipment at Work Regulations 1992.

It is your responsibility to:

  • wear and use the provided PPE in the circumstances where a need for it has been identified by the Company and in accordance with the manufacturer's instructions
  • inspect their issued PPE daily before use
  • immediately report any damage or defects to the equipment to the issuer for maintenance or replacement
  • not misuse or damage any PPE provided
  • inform the issuer of any problems in the use of the PPE

PPE issued Issue date (if known) PPE usage training given (where required) Employees Signature
       
 

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