New Employee Ppe Hazardous Assessment Form Page 3
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4HANDS/ARMS
Work activities, such as:
Work-related exposure to:
Can hazard be eliminated without the use of PPE?
baking
material handling
blood
Yes
No
cooking
sanding
irritating chemicals
If no, use:
grinding
sawing
tools or materials that could scrape,
Gloves
welding
hammering
bruise, or cut
Chemical resistance
working with glass
extreme heat/cold
Liquid/leak resistance
using computers
other:
Temperature resistance
using knives
Abrasion/cut resistance
dental and health care services
Slip resistance
other:
Protective sleeves
Other:
FEET/LEGS
Work activities, such as:
Work-related exposure to:
Can hazard be eliminated without the use of PPE?
building maintenance
explosive atmospheres
Yes
No
construction
explosives
If no, use:
demolition
exposed electrical wiring or
Safety shoes or boots
food processing
components
Toe protection
Metatarsal protection
foundry work
heavy equipment
Electrical protection
Heat/cold protection
logging
slippery surfaces
Puncture resistance
Chemical resistance
plumbing
tools
Anti-slip soles
trenching
other:
Leggings or chaps
use of highly flammable materials
Foot-Leg guards
welding
Other:
other:
BODY/SKIN
Work activities such as:
Work-related exposure to:
Can hazard be eliminated without the use of PPE?
baking or frying
chemical splashes
Yes
No
battery charging
extreme heat/cold
If no, use:
dip tank operations
sharp or rough edges
Vest, Jacket
fiberglass installation
other:
Coveralls, Body suit
irritating chemicals
Raingear
sawing
Apron
other:
Welding leathers
Abrasion/cut resistance
Other:
OREGON
WASHINGTON
2637 SE 12
Avenue
6018 234
Street SE, Suite A
th
th
Portland, OR 97202
Woodinville, WA 98072
(503) 234-4321
(425) 487-6161
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