| Company Name | Date | ||
|---|---|---|---|
| Project / Site | |||
| Supervisor / Contact | Phone | ||
| PPE Item | Required | Provided | Worn Correctly | Comments |
|---|---|---|---|---|
| Hard Hat / Helmet | ||||
| Safety Glasses / Goggles | ||||
| Hearing Protection | ||||
| High-Visibility Vest / Clothing | ||||
| Gloves | ||||
| Protective Footwear | ||||
| Respiratory Protection | ||||
| Other PPE (Specify) |