PPE Issue Report
PPE Issue Report
This report outlines a safety concern regarding a tear in the right glove, emphasizing the need for prompt resolution to ensure employee well-being and workplace safety.
Employee Information:
|
Name: |
[Name] |
|
Job Title: |
|
|
Department: |
|
|
Date of Report: |
|
|
Contact Number: |
|
|
Email: |
PPE Details:
|
Type of PPE: |
Safety Gloves |
|
Brand/Model: |
|
|
Issue Description: |
|
|
Date Issue Noticed: |
|
|
Location: |
Issue Severity:
|
Severity Level: |
Medium |
|
Impact on Safety: |
Action Taken:
|
Immediate Action: |
The affected glove has been replaced with a spare one from the supply. |
|
Recommendations: |
Verification and Follow-Up:
|
Verifier's Name: |
[Name] |
|
Verification Date: |
|
|
Resolution Date: |
|
|
Follow-Up Actions: |
Signatures:
I, [Your Name], the undersigned, acknowledge the accuracy of the information provided in this PPE Issue Report. I confirm that I reported the issue on the specified date.
Employee's Signature:
[Your Name]
[Job Title]
[Month Day, Year]
I, [Name], the [Safety Supervisor], have reviewed and verified the reported PPE issue. I confirm the actions taken and the resolution date as stated.
Safety Supervisor's Signature:
[Name]
[Job Title]
[Month Day, Year]
