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Document HSE-FR-006

HSE Proforma Revision 2.0


Personal Protective Equipment Order Contract C020359/SCO
SKSWood Sdn. Bhd.
Sheet

No. 000001
NAME: BADGE NO:

TRADE: LOCATION:

TO BE ISSUED FROM: VENDOR ADININ HARDWARE SDN BHD

DELIVER TO: ON (DATE): TIME:

ITEM DESCRIPTION SIZE QUANTITY SIZE QUANTITY


COVERALLS - WITH SKSWood LOGO (Pls tick)
Grey Polymix 65/35% SMALL X LARGE
Red Polymix 65/35%
1.
Grey 100% Cotton MEDIUM XX LARGE
Disposable Coveralls
Dancel Yellow Rainsuits LARGE XXX LARGE

STEARNS ORANGE LIFE VEST SMALL LARGE


2
(LIFE-JACKET) MEDIUM X LARGE

KRUSHERS
MT.ISA
3 SAFETY BOOTS
DINGO
YELLOW RAINBOOTS

MSA DISCOVERY (CLEAR / DARK)


4. SAFETY GLASSES UVEX OVERSPEC (CLEAR / DARK)
WELDING GOGGLES

WELDER GLOVES
YELLOW TIG WELDING HANDGLOVES
5 SAFETY GLOVES
POLKA DOT GLOVES
RUBBER GLOVES

3M DUST MASK
6. DISPOSABLE
EARPLUGS

7. SAFETY HELMET - JSP HELMET C/W CHIN STRAP (WHITE / GREEN / RED / BLUE / YELLOW)

8. CANVAS TOOL BAG 24"

ADDITIONAL ITEMS: DESCRIPTION SIZE QUANTITY


9.
10.
11.
12.

REASONS FOR ISSUE :

NEW EMPLOYEES REPLACEMENT OTHERS (Pls specify)_____________________________

Name: Signature: Date:


Issued By
Name: Signature: Date:
Received By

APPROVED BY HSE DEPARTMENT:


Date:
POSTED INTO DATABASE BY:
Date:

White: HSE Dept. Green: Requisitioner. Pink: Vendor

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