Title Page

  • I am completing the following.

  • Conducted on

  • Completed by

  • Personnel

Permitted Items Guidelines

  • Personal items permitted in the bakery for all employees are:
    Single band, smooth wedding rings (or similar)
    Water bottles with a pop up lid, provided bottles are see-through and clearly marked with owners name.

  • Goodman Fielder acknowledges that individuals may have the need to take personal items, other than those listed above into the production facility which may include:
    Eyeglasses or Safety Glasses
    Approved Gloves
    Locker Key
    LOTO key
    Medication (approval required)
    Jewellery items for medical or religious reasons.

Personal Permitted Items Request/Register

  • If an employee has grounds to take any of the above listed items into the production facility they must be declared on this form. Employee must also list where items are usually kept and provide detail about the condition of the item. Items listed below will be reviewed by Team Manager and the Quality Manager for suitability and safety. Approval will be granted based on this criteria.
    You are not approved to take this item inside the facility until your Team Manager informs you the approval has been signed.

  • Employee Name and Signature

  • What is your work area ?

  • Date

  • What personal item do you want to take into Production Facility ?

  • What is the reason ?

  • Where will the item be kept ?

  • Add media

  • What is the condition of the Item ?

  • Approval by Team Manager or Line Leader If no items requested please approve this section only.

  • What personal item do you want to take into Production Facility ?

  • What is the reason ?

  • Where will the item be kept ?

  • Add media

  • What is the condition of the Item ?

  • Approval by Team Manager or Line Leader

  • What personal item do you want to take into Production Facility ?

  • What is the reason ?

  • Where will the item be kept ?

  • Add media

  • What is the condition of the Item ?

  • Approval by Team Manager or Line Leader

  • What personal item do you want to take into Production Facility ?

  • What is the reason ?

  • Where will the item be kept ?

  • Add media

  • What is the condition of the Item ?

  • Approval by Team Manager or Line leader

  • What personal item do you want to take into Production Facility ?

  • What is the reason ?

  • Where will the item be kept ?

  • Add media

  • What is the condition of the Item ?

  • Approval by Team Manager or Line Leader If items listed please approve each item individually and take to QA Manager for overall approval.

QA Manager Approval

  • Is approval given for the employee stated above to take the mentioned items into the facility ?<br>If no items are requested please approve to close complete document.

  • Sign here if approval is given. If approval is not given for all items please return to Team Manager for amendment.

  • Comments

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.