Appendix B PPE Hazard Assessment Worksheet
Appendix B PPE Hazard Assessment Worksheet
Appendix B PPE Hazard Assessment Worksheet
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FEET/LEGSTask or Work Area, such as:building maintenanceconstructiondemolitionfood processinganimal handlinglogging (ex. chainsaw)plumbingtrenchingweldingName task or work area:BODYTask or Work Area, such as:baking or fryingbuilding maintenancebattery chargingconstructiondip tank operationsutility workfiberglass installationscaffold useirritating chemicalsaerial lift usesawingworking near wateritem under pressurelive electrical workuse of highly flammable materialsName task or work area:HAZARD(s):objects that can roll over feethazardous chemicalsmaterial handlingexposed electrical wiring orcomponentsheavy equipment (ex. Forklift,pallet jack)slippery surfacestoolsName other hazard:HAZARD(s):chemical splashesextreme heat/coldsharp or rough edgesexposed electrical wiring orcomponentsheight of more than 10 feet onscaffoldheight of 6 feet duringmaintenance/construction activitiestraffic controlhunting / gun fireName other hazard:Can hazard be eliminated without the use of<strong>PPE</strong>?Yes NoIf no, use:Safety shoes or bootsToe protectionMetatarsal protectionElectrical protectionHeat/cold protectionPuncture resistanceChemical resistanceAnti-slip solesLeggings or chapsLong pantsClosed toe shoeName other <strong>PPE</strong>:No <strong>PPE</strong> RequiredCan hazard be eliminated without the use of<strong>PPE</strong>?Yes NoIf no, use:High Visibility ClothingFluorescent orange vest & capFlame Retardant ClothingCoveralls, Body suitChemical resistant suitArc Flash <strong>PPE</strong>Fall arrest/restraint equipmentApronPersonal Floatation DeviceWelding leathersAbrasion/cut resistanceName other <strong>PPE</strong>:No <strong>PPE</strong> Required4
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