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Cartridge Respirator Replacement Logsheet Form

The document is a Daily Inspection Checklist for Cartridge Type Respirators, outlining essential check items such as face piece, head straps, valves, filters/cartridges, air supply systems, and rubber/elastomer parts. Each item includes specific descriptions to assess their condition before use. The checklist is to be filled out with dates and signatures to ensure compliance and safety.

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randy Orton Xelix
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53 views

Cartridge Respirator Replacement Logsheet Form

The document is a Daily Inspection Checklist for Cartridge Type Respirators, outlining essential check items such as face piece, head straps, valves, filters/cartridges, air supply systems, and rubber/elastomer parts. Each item includes specific descriptions to assess their condition before use. The checklist is to be filled out with dates and signatures to ensure compliance and safety.

Uploaded by

randy Orton Xelix
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Daily Inspection Checklist

(Cartridge Type Respirator)

Project: Location:

Inspection to be carried out before every use Duration: From: to:

Sr. Dt: Dt: Dt: Dt: Dt: Dt: Dt:


Check Items Description
No.
Cracks, tears, or holes,
1. Face piece Face mask distortion,
Cracked or loose lenses/face
shield
2. Head straps Breaks or tears, Broken buckles
Residue or dirt
3. Valves
Cracks or tears in valve material
Approval designation
Gaskets
4. Filters/Cartridges
Cracks or dents in housing
Proper cartridge for hazard
Breathing air quality/grade,
5. Air Supply Systems Condition of supply hoses/
connections, regulators, and valve
6. Rubber/Elastomer Parts Softness, Deterioration
Checked by: - Name- Signature:
Designation: -

Good/Acceptable: √ Not good/Unacceptable: X Not Applicable: N/A

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Daily Inspection Checklist
(Cartridge Type Respirator)

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