Sample Certificate of Hazard Assessment
BODY PART. AFFECTED PPE REQUIRED. YES/NO TYPE OF PPE REQUIRED Personal Protective Equipment Worksheet. Employer: Location: Workplace Assessed/Evaluated Dates(s): Hazard(s) Assessed/Evaluated By: Eye Hazards? Yes No Required Personal Protective Equipment - EYE Frontal & Side Impact Electrical Arc Molten Metal Chemical Splash Injurious Light/Heat ... ................
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