PPE SAMPLE APPROVAL AND PRE-SHIPMENT VERIFICATION CHECKLIST
Blank buyer working template - adapt to the order and applicable requirements.
Sample approval, shipment release and receiving acceptance are separate decisions.

ORDER CONTROL
Buyer:
Project:
Order reference:
Supplier:
Record revision / date:
Reviewer / role:
Person authorized to release shipment:
Shipment reference / planned scope:

GATE 1 - SAMPLE AND DOCUMENT BASELINE
Repeat this section for each distinct product configuration.
Order line:
PPE category:
Exact model / variant:
Sample ID / location:
Document ID / version / date:
Document issuer / model coverage / reviewed scope:
Photo evidence references:
Quantity / unit (pieces, pairs, sets or kits):
Size / color split:
Fit review participants / sizes / findings / limitations:
Complete PPE combination / compatibility findings / instructions:
Logo artwork version / dimensions / color / location / application method:
Manufacturer decoration instructions or confirmation reference, where relevant:
Packing instruction revision / carton or kit allocation / labels:
Decision: Approved / Pending / Rejected
Approval scope and conditions (appearance, fit, documents, packing, other):
Open issues / owner / due date:
Reviewer name / signature / date:
Superseded baseline reference, if applicable:

GATE 2 - PRE-SHIPMENT VERIFICATION
Inspector / reviewer / qualifications or assigned responsibility:
Inspection date / location:
Order / shipment / lot or batch references, where available:
Agreed checks / acceptance criteria:
Sampling scope and selection agreed by buyer and qualified inspector:
Number and identity of units / cartons checked:
Checks not performed / limitations:

Repeat this section for each requirement checked.
Order line / item or carton reference:
Approved requirement / baseline revision:
Observed result:
Evidence reference:
Discrepancy ID / description:
Proposed disposition:
Action owner / due date:
Correction evidence / recheck result:
Accepted deviation scope / approving authority, if applicable:
Closure name / signature / date:

SUBSTITUTION CONTROL
Original line / model / baseline:
Proposed substitute / reason:
Changed properties / document coverage / size / compatibility / schedule effect:
Safety review / sample or trial required:
Decision / authority / date:
New baseline revision if approved:

GATE 3 - SHIPMENT RELEASE
Decision: Hold / Recheck / Released
Shipment reference:
Authorized lines / quantities / units:
Excluded lines / quantities and segregation instructions:
Conditions / remaining actions:
Evidence and closed discrepancy references:
Authorized decision maker / role:
Signature / date:

RECEIVING - SEPARATE ARRIVAL CHECK
Receiving location / date / reviewer:
Shipment and packing-list references:
Carton identity / quantity / size allocation / visible-condition findings:
Discrepancies / evidence / action owner:
Receiving acceptance decision under purchase agreement:
Name / signature / date:

LIMITS
This template does not certify PPE, establish document authenticity by itself,
prove all units' performance, or replace hazard assessment, required testing,
respirator program duties, training, user inspection, maintenance or replacement.
Agree inspection and sampling with the responsible buyer and qualified inspector;
no universal AQL or sample size is prescribed. Apply relevant destination and
workplace requirements. Store completed records with appropriate access controls.