PERSONAL PROTECTIVE EQUIPMENT ISSUED REGISTER

I, _________________________________________, (ID Number: __________________________),

hereby acknowledge that I have received the below mentioned items in good working condition.

I hereby acknowledge the following:

1) I will wear the required PPE as and when needed, as indicated by Risk Assessments /
Employer Instructions / Client Specs;
2) I will maintain the PPE received in a good condition;
3) I will report any loss, stolen or damaged PPE to my Manager/Supervisor immediately;
4) I will not modify the PPE in any manner; and
5) I am aware of the limitations of PPE and realize that I am responsible to follow a safe system
of work, as laid down by my Employer, to ensure my safety.

Employee Name: _______________________ Employee Sign: _____________________________

Item Date PPE issued Quantity Sign (Issued by) Sign (Employee)

10

1
Document Approved by: CEO
 11

12

13

14

15

2
Document Approved by: CEO