Personal Protective Equipment (PPE) Usage Checklist

Stay safe in the fields! 🌾 Our comprehensive Personal Protective Equipment (PPE) Usage checklist for agriculture ensures you're protected from hazards like pesticides, sun exposure, and machinery. Download now & keep your farm crew healthy! #agriculture #ppe #safety #farming #checklist

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Eye and Face Protection

1 of 10

Ensuring adequate protection from splashes, dust, flying debris, and sunlight.

Type of Eye/Face Protection Required?

Is the Eye/Face Protection ANSI Z87.1 Approved?

Describe any damage or defects observed on eye/face protection (scratches, cracks, fogging, etc.)

Condition of Lens Clarity (1-10, 10=Perfect)

Fit Check Performed?

Notes/Comments Regarding Eye/Face Protection.

Head Protection

2 of 10

Protecting against falling objects, impacts, and sun exposure.

Type of Head Protection Used?

If 'Other' selected above, please specify:

Hard Hat Age (in years)

Is the Hard Hat Damaged?

Describe any damage to the hard hat (if 'Yes' to above)

Is the Hard Hat Clean?

Attach Photo of Hard Hat (if damaged or questionable)

Date of Last Hard Hat Inspection

Hand Protection

3 of 10

Preventing skin contact with chemicals, pesticides, and abrasive materials.

Type of Gloves Used

If 'Other' glove type selected, please specify:

Glove Thickness (mils)

Glove Chemical Resistance Rating (if applicable)

If 'Other' chemical resistance rating selected, please specify:

Potential Hazards Hand Protection Required For:

Glove Condition After Use

Employee Name

Body Protection

4 of 10

Shielding the body from chemical exposure, insects, and physical hazards.

What type of body protection is required for the task?

Fabric Weight (oz/sq yd) - if applicable (e.g., for coveralls)

Material of Body Protection (e.g. Cotton, Polyester, Tyvek)

If 'Other' selected for Material, please specify:

Is the body protection chemical resistant?

If yes, specify which chemicals the protection is rated for:

Upload Photo of Body Protection (for record-keeping)

Condition of body protection - before use

Foot Protection

5 of 10

Protecting feet from punctures, impacts, chemicals, and slipping hazards.

Footwear Type Selected:

If 'Other' selected above, please specify footwear type:

Boot Condition - Soles:

Boot Condition - Upper:

Sole Thickness (mm)

Slip Resistance Rating (if available)

Last Inspection Date

Any repairs needed? If so, please describe.

Respiratory Protection

6 of 10

Preventing inhalation of dust, fumes, gases, and vapors.

Respiratory Hazard Assessment Completed?

Type of Respirator Required (Based on Assessment)

Respirator Fit Test Date (MM/DD/YYYY)

Next Respirator Cartridge/Filter Change Date

Cartridge/Filter Type

Respirator Properly Donned and Fit-Checked?

Notes on Respirator Usage/Condition

Respirator Training Record

Hearing Protection

7 of 10

Reducing exposure to excessive noise levels.

Is a noise hazard assessment completed?

What type of hearing protection is required?

Noise Level (dBA) measured at work area:

Are employees trained on proper fitting and use of hearing protection?

Describe any noise reduction procedures implemented:

Is hearing protection readily available?

Insect/Vector Protection

8 of 10

Minimizing bites and stings from insects and other pests.

What type of insect/vector protection is required?

Which areas have high insect/vector activity?

DEET Concentration (%) (if applicable)

Specific areas/times of day where extra precautions are needed

Date of last inspection/treatment of insect-repellent clothing

Is repellent being used?

Any reported insect/vector related incidents or concerns?

PPE Inspection & Maintenance

9 of 10

Ensuring PPE is in good working order and properly cared for.

Last PPE Inspection Date

Notes on PPE Condition During Last Inspection

Number of damaged or defective items found

Type of Cleaning Agent Used (if applicable)

If 'Other' cleaning agent used, specify:

Which PPE items were inspected?

Upload photos of damaged PPE (if applicable)

Condition of straps and buckles (Head Protection)

Training & Awareness

10 of 10

Confirming employees are properly trained on PPE selection, use, and limitations.

Have you received training on the hazards associated with agricultural chemicals?

Were you trained on the correct PPE selection for your assigned tasks?

Briefly describe the PPE training you received:

Date of last PPE training:

Do you understand the limitations of your PPE?

Which of the following PPE topics were covered in your training? (Select all that apply)

Name of Trainer:

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