HAZARD ID / INDUCTION / SECURITY FORM - duplicate

• Document No.

• File

• Site

• Conducted on

  Date

• Prepared by

• EAC Number

• Location
  Address

• Purpose of Visit

Hazard Identification.

• Identify Evacuation Poin

• Identify Exit Points

• Party members with no EAC. Please complete induction in next section.

• Other work parties on site. (Where appropriate, identify yourself with party and familiarise with hazards and controls)

• Personal Protective Equipment

• Notes

• Read Hazard ID Board

• Notes

• Locate nearest First Aid Kit

• Note location of Fire Extinguishers

• Notes

• Notes

• Do not climb

• Notes

Identify Hazards and means of control

• Identified Hazards
  Note: Report all uncontrolled Hazards to Contract Manager on Form TP 514

Hazard

• Hazard description

• Eliminate<br>Isolate<br>Minimise

  Eliminate

  Isolate

  Minimise

• Controls Required to: Eliminate, Isolate, Minimise

ALL PARTIES MEMBERS TO SIGN ACKNOWLEDGEMENT OF HAZARDS

• Please complete your name and signature below

Work Party Member

• Add signature

  Sign

SITE SECURITY CHECK (Where Praciical)

• All gates secure

  Yes

  No

• Fences secure, no holes, wires taut

  Yes

  No

• Fences clear of cover / obstacles (1mtr)

  Yes

  No

• Security system working

  Yes

  No

• Vegetation encroaching on site

  Yes

  No

• Change in neighbouring land use

  Yes

  No

• Change in environment eg. Roading

  Yes

  No

• Notes:

Report Asset Damage to Field Services Manager immediately verbally, then on Form TP 511. Report Security Breach to Field Services Manager immediately verbally, then on Form TP 518.

• SECURITY SYSTEM ARMED ON EXIT<br>(Last party to leave site must arm security system

  Yes

  No (Other parties on site)