P
PTID
ACROS REFERENCE SHEET
DATE:___/___/___
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Respondent Answers |
Requirements and Features |
Was PPE [CORRECT]? |
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R |
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R19. Location: |
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HEADWEAR |
R28_30_33. Headwear Worn: |
DK, None [HEADWEAR]:_________________________________________ _____________________________________________________ _____________________________________________________ [HFEATURES]: _____ Hat with wide brim all the way around, hood, hooded respirator, helmet, or helmet respirator _____ The headwear, or a cover over the headwear, in the specified material _____ No special features
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EYEWEAR |
R39_41. Eyewear Worn: shield |
DK, None [EYEWEAR]: __________________________________ _____________________________________________________ _____________________________________________________ [EFEATURES]: _____ Glasses with side and brow protection _____Goggles _____Splash-proof goggles (shielded openings) _____Face shield _____Full-face respirator or helmet respirator with face shield _____Any of the above checked items _____No special features
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CLOTHING
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R49_56_57. CLOTHING WORN:
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DK, None [CLOTHING]: __________________________________ _____________________________________________________ _____________________________________________________ [CFEATURES]:
_____Coveralls or its equivalent _____Coveralls, or its equivalent, in the specified material _____No special features |
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RSCREEN1. Pesticide 1: ___________________________________________________________________________
RSCREEN2. Pesticide 2: ___________________________________________________________________________
RSCREEN3. Pesticide 3: ___________________________________________________________________________
RSCREEN4. Focus Pesticide: _______________________________________________________________________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Jeremy Beach |
File Modified | 0000-00-00 |
File Created | 2021-01-28 |