New Employee Ppe Hazardous Assessment Form printable pdf download

Masons Supply Co.

Safety

Hazard Assessment For PPE

Use with WAC 296-800-160 Personal Protective Equipment (PPE)

This tool can help you do a hazard assessment to see if your employees need to use personal

protective equipment (PPE) by identifying activities that may create hazards for your employees.

The activities are grouped according to what part of the body might need PPE.

This tool can also serve as written certification that you have done a hazard assessment as

required by WAC 296-800-16010 Document your hazard assessment for PPE. Make sure that the

blank fields at the beginning of the checklist (indicated by *) are filled out (see below,

Instructions #4).

Instructions:

1. Do a walk through survey of each work area and job/task. Read through the list of work

activities in the first column, putting a check next to the activities performed in that work

area or job.

2. Read through the list of hazards in the second column, putting a check next to the hazards

to which employees may be exposed while performing the work activities or while present in

the work area. (for e.g., work activity: chopping wood; work-related exposure: flying

particles).

3. Decide how you are going to control the hazards. Try considering engineering, work place,

and/or administrative controls to eliminate or reduce the hazards before resorting to using

PPE. If the hazard cannot be eliminated without using PPE, indicate which type(s) of PPE will

be required to protect your employee from the hazard.

4. Make sure that you complete the following fields on the form (indicated by *) to certify that

a hazard assessment was done:

*Name of your work place

*Address of the work place where you are doing the hazard assessment

*Name of person certifying that a workplace hazard assessment was done

*Date the hazard assessment was done

Once you have completed the assessment, please make a copy for your records and send the

original to the Human Resource Department.

OREGON

WASHINGTON

2637 SE 12

Avenue

6018 234

Street SE, Suite A

Portland, OR 97202

Woodinville, WA 98072

(503) 234-4321

(425) 487-6161

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New Employee Ppe Hazardous Assessment Form