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    Ppe Issuance Record Form Rev 0 PDF

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    Muzhafar Azhar
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists 9 types of PPE including safety helmets, shoes, gloves, goggles, breathing protection, face shields, ear protection, and safety harnesses. For each item issued, the date, quantity, and employee's signature are recorded. The employee is responsible for proper use and storage of the PPE and reporting any losses or defects. HSE has the right to withhold PPE if it is misused or damaged. The cost of replacing lost or damaged items 1 and 2 within one year will be deducted from the employee's salary.

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    Ppe Issuance Record Form Rev 0 PDF

    Uploaded by

    Muzhafar Azhar
    517 views2 pages
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists 9 types of PPE including safety helmets, shoes, gloves, goggles, breathing protection, face shields, ear protection, and safety harnesses. For each item issued, the date, quantity, and employee's signature are recorded. The employee is responsible for proper use and storage of the PPE and reporting any losses or defects. HSE has the right to withhold PPE if it is misused or damaged. The cost of replacing lost or damaged items 1 and 2 within one year will be deducted from the employee's salary.

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    PPE ISSUANCE RECORD FORM REV 0.pdf

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    This document records the issuance of personal protective equipment (PPE) to an employee. It lists 9 types of PPE including safety helmets, shoes, gloves, goggles, breathing protection, face shields, ear protection, and safety harnesses. For each item issued, the date, quantity, and employee's signature are recorded. The employee is responsible for proper use and storage of the PPE and reporting any losses or defects. HSE has the right to withhold PPE if it is misused or damaged. The cost of replacing lost or damaged items 1 and 2 within one year will be deducted from the employee's salary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    517 views2 pages

    Ppe Issuance Record Form Rev 0 PDF

    Uploaded by

    Muzhafar Azhar
    This document records the issuance of personal protective equipment (PPE) to an employee. It lists 9 types of PPE including safety helmets, shoes, gloves, goggles, breathing protection, face shields, ear protection, and safety harnesses. For each item issued, the date, quantity, and employee's signature are recorded. The employee is responsible for proper use and storage of the PPE and reporting any losses or defects. HSE has the right to withhold PPE if it is misused or damaged. The cost of replacing lost or damaged items 1 and 2 within one year will be deducted from the employee's salary.

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    of 2

    HSE DEPARTMENT

    PERSONAL PROTECTIVE EQUIPMENT (PPE) ISSUANCE RECORD


    Name:
    IC/Passport :
    Position:
    Note: this form should be retained in the staff member’s personal file

    DATE EMPLOYEE’S REMARK


    NO TYPE OF PPE ISSUED QUANTITY
    ISSUED SIGNATURE
    1 Safety Helmet (Yellow, White, Red)
    2 Safety Shoes (Low, Medium, High Cut)
    BRAND :……………………………….
    MODEL :……………………………….
    SIZE :…………………………………...

    3 Gloves (Cotton, Semi Leather, Full Leather)

    4 Safety Goggles (Clear, Black)

    5 Breathing Protection (Surgical Mask, N95,


    Welding Respirator)

    6 Face Shield (Half, Full)

    7 Ear Protection (Ear Plug, Ear Muff)

    8 Working at Height (Safety Harness)

    9 Others (Special Request)

    ……………………………………………….....
    .

    Prepared By: Checked By: Acknowledged By:

    ………………. ………………. ……………………


    Storekeeper Muzhafar Bin Azhar Mohd Saari
    HSE Executive Production Manager

    cc. Admin

    1|Page
    The PPE listed has been issued to the above named employee in accordance with the Occupational
    Safety and Health Act 1994 and Factory and Machinery Act 1967.

    The employee has a responsibility to:


     take reasonable care of the PPE provided;
     use PPE in accordance with the training and instruction given;
     to keep the PPE clean and return it to its place of storage after use; and
     report any loss or defect immediately to HSE Personnel/ Store.
     HSE have a right to ceased PPE if misuse or damaged.
     If item 1 & 2 lost or damaged because of own negligence less than one year, YLESB will not
    cover and cost will be deduct from your salary.
     For item 3, 4, 5, 6, 7,8 will be issue one off after induction, for normal usage you may issues from
    store.

    Agreed By :

    ……………….

    Name : ……………………………
    IC / Passport No : ………….............................
    Position : …………………………….

    2|Page

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