| Date | Inspector Name | ||
| Location | Department |
| PPE Item | Condition OK? | Comments |
|---|---|---|
| Hard Hat / Helmet | ||
| Safety Glasses / Goggles | ||
| Hearing Protection | ||
| Face Shield | ||
| Gloves | ||
| High Visibility Vest/Clothing | ||
| Protective Footwear | ||
| Respirator / Masks | ||
| Fall Protection Equipment | ||
| Other |