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.
Name: | [Name] |
Job Title: | |
Department: | |
Date of Report: | |
Contact Number: | |
Email: |
Type of PPE: | Safety Gloves |
Brand/Model: | |
Issue Description: | |
Date Issue Noticed: | |
Location: |
Severity Level: | Medium |
Impact on Safety: |
Immediate Action: | The affected glove has been replaced with a spare one from the supply. |
Recommendations: |
Verifier's Name: | [Name] |
Verification Date: | |
Resolution Date: | |
Follow-Up Actions: |
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.
[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.
[Name]
[Job Title]
[Month Day, Year]
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