# Form - PPE Issue and Return Record > Fire Service Safety Management System, version 0.3.3 (2026-10-25). The Human Factor. Document FSSMS-FRM-19. > > Canonical: https://thehumanfactor.ca/library/fire-service-safety/form-ppe-issue-and-return-record > > Licence: CC BY-NC-SA 4.0 with the Adopting Agency Grant (https://creativecommons.org/licenses/by-nc-sa/4.0/) > > General information only, not legal, medical or other professional advice. Verify every requirement against the current official text of the law, standards and manufacturer instructions that apply to you. Obtain your own legal review and consult your joint health and safety committee before adopting anything. You adopt, adapt, implement and rely on this material entirely at your own risk and on your own responsibility. Full terms: Terms of Use, thehumanfactor.ca. **Purpose.** One record per member that shows every protective element issued to them, its serial number and date of manufacture, the fit measurements it was issued against, and the member’s acknowledgement of how to wear, inspect, clean and store it. It starts the per-garment record the program requires [(NFPA 1850, 2026)](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-issue-and-return-record#ref-nfpa-1850) and is the evidence of the employer’s duty to provide and maintain adequate protective equipment under the applicable occupational health and safety statute and regulations ([J13 Firefighter PPE and Protective Equipment](https://thehumanfactor.ca/library/fire-service-safety/j13-firefighter-ppe-and-protective-equipment)). (S1) ## Part A: Member and fitting | Field | Entry | |:---|:---| | Member ID | | | Station and assignment | | | Career / volunteer / paid-on-call | | | Fitted by (role) and date | | | Fitted over station wear with SCBA worn, full range of motion checked | Yes / No | | Coat: chest, sleeve length, coat length (cm) | | | Trousers: waist, inseam, outseam (cm) | | | Glove size | | | Boot size and width | | | Helmet circumference (cm) | | | Hood size (if sized) | | | Stock pattern fits / tailored pattern required / custom order placed (date) | | | Next fit check due (24 months, or sooner on change) | | ## Part B: Elements issued One row per element. Set 1 and Set 2 are both recorded; hoods and gloves at two per member minimum. | Element | Set | Manufacturer and model | Serial number | Date of manufacture | Certification standard and edition | Size | Date issued | Issued by | Member initials | |:---|:---|:---|:---|:---|:---|:---|:---|:---|:---| | Coat | 1 | | | | [NFPA 1970 (2025)](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-issue-and-return-record#ref-nfpa-1970) | | | | | | Trousers | 1 | | | | [NFPA 1970 (2025)](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-issue-and-return-record#ref-nfpa-1970) | | | | | | Coat | 2 | | | | | | | | | | Trousers | 2 | | | | | | | | | | Helmet | | | | | | | | | | | Hood 1 | | | | | | | | | | | Hood 2 | | | | | | | | | | | Gloves pair 1 | | | | | | | | | | | Gloves pair 2 | | | | | | | | | | | Boots | | | | | | | | | | | Other (wildland, rescue, water, hi-vis, hearing, eye) | | | | | | | | | | ## Part C: Member acknowledgement | Statement | Member initials | Date | |:---|:---|:---| | I have been shown how to don and doff this ensemble to limit contamination | | | | I have been shown the routine inspection card and what to report | | | | I have been shown routine cleaning and the cleaning area, and I understand gear is never laundered at home, in a laundromat or in a shared machine | | | | I have been shown where this gear is stored at the station (not in living areas, not in the cab, not in sunlight) | | | | Volunteer home storage (if applicable): I will store this gear in the department bag in a space away from living areas, children and vehicle cabs, and I will not take gear home after a fire exposure until it has had routine cleaning | | | | I know how to raise a concern about fit, damage or contamination and who will answer me within five working days | | | ## Part D: Loaner issue | Loaner element | Serial | Size | Reason (own gear at cleaning / inspection / repair / custom order) | Issued (date, by) | Due back | Returned (date, condition) | |:---|:---|:---|:---|:---|:---|:---| | | | | | | | | ## Part E: Return and transfer | Element and serial | Returned on | Condition on return (A to E) | Reason (member leaving / reissue / retirement / transfer) | Received by | Disposition | |:---|:---|:---|:---|:---|:---| | | | | | | | ## Fields | Field | Type | Required | Who completes | |:---|:---|:---|:---| | Member ID, station, status | Text | Yes | {{PPE Coordinator}} | | Fit measurements (coat, trousers, gloves, boots, helmet, hood) | Numbers, cm or size | Yes | Fitting personnel | | Fit decision and custom order | Choice, date | Yes | Fitting personnel | | Next fit check due | Date | Yes | {{PPE Coordinator}} | | Element rows: model, serial, date of manufacture, standard, size, issue date | Text, date | Yes, every element | {{PPE Coordinator}} | | Member initials per element | Initials | Yes | Member | | Acknowledgements | Initials, date | Yes; home storage row only for members who keep gear at home | Member | | Loaner rows | Text, dates | When a loaner is issued | {{PPE Coordinator}} or station officer | | Return rows | Text, date, category | On return | Receiving officer | ## Instructions 1. Complete Parts A to C at recruitment and whenever a new element or a new set is issued. Re-fit after pregnancy, a significant change in body size or fitness, or an inspector’s fit concern. 2. Enter each serial number in {{Records system}} the same day. The record created here is updated by [Form - PPE Advanced Inspection Checksheet](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-advanced-inspection-checksheet), [Form - PPE Cleaning and Repair Log](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-cleaning-and-repair-log) and [Form - PPE Retirement Record](https://thehumanfactor.ca/library/fire-service-safety/form-ppe-retirement-record) for the life of the element. 3. A member may ask for a copy of their record at any time and receives it within 10 business days. 4. Keep the completed form for the life of every element on it plus the retention period in [05 Document Control and Records](https://thehumanfactor.ca/library/fire-service-safety/document-control-and-records). > **Tip: Volunteer and composite departments** > > Keep Part D stocked: a loaner issue at a volunteer hall should take minutes, not a trip to headquarters. Pre-position loaners in the sizes that hall’s members need. ## Jurisdiction requirements This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it. | Topic | What to check in your jurisdiction | Page | |:---|:---|:---| | Firefighter PPE and Protective Equipment | The general PPE duty (adequate equipment, training in its use, maintenance by a competent person, inspection before each use) and any protective ensemble standard a regulation names for structural firefighting (Parts B and C) | [J13 Firefighter PPE and Protective Equipment](https://thehumanfactor.ca/library/fire-service-safety/j13-firefighter-ppe-and-protective-equipment) | ## References National Fire Protection Association. (2025). *NFPA 1970, Standard on protective ensembles for structural and proximity firefighting, work apparel, open-circuit self-contained breathing apparatus (SCBA) for emergency services, and personal alert safety systems (PASS)* (consolidates NFPA 1971, 1975, 1981 and 1982). National Fire Protection Association. (2026). *NFPA 1850, Standard on selection, care, and maintenance of protective ensembles for structural and proximity firefighting and open-circuit self-contained breathing apparatus (SCBA)* (consolidates NFPA 1851 and 1852).