Title Page

  • Conducted on

  • By (supervising staff member):

  • For (new staff member/Contractor/Volunteer):

  • Lawrie Emmins Reserve 2-88 Sayers Road Laverton North, VIC 3026

SEMP Induction

  • By checking the boxes below YOU acknowledge that you have been shown an up to date copy of the SEMP (there is one maintained on site at all times) and informed about the following items to a satisfactory level. If at any point you are unsure DO NOT tick the box and continue! Ask your supervising CityMX staff member for more information until you are satisfied that you understand the actions required to meet our environmental responsibilities on site.

    SEMP opening page.PNG
  • I have been shown the location of the SEMP on site and confirm that the emergency procedures and contact telephone numbers are displayed in a prominent area at CityMX during track operations and maintenance works.

  • I understand that the major environmental risks at this site relate to airborne dust, excessive noise, erosion, contaminated materials and waste, and hazardous chemicals and further acknowledge that I am aware of all measures to control these risks as detailed in the SEMP.

  • I understand that all CityMX employees, sub-contractors and any other personnel accessing the site must comply with the SEMP.

  • I understand that the SEMP does not remove the requirement for employees or contractors to prepare other job specific health, safety or environmental documents when undertaking track operations and maintenance works, including but not limited to: - Health and safety management plan. - Job safety analysis (JSA/SWMS). - Dial before you dig.

  • I understand that the base level of the site is lined with geofabric and covered with a 0.5m marking layer of clean fill soils. In the event that this marker layer is exposed, or the geofabric liner is damaged I must immediately stop work and report this to CityMX Management who will take further action.

  • I acknowledge that I have been shown Laverton Creek immediately adjacent east of the CityMX site and am aware that surface water from rainfall is likely to run off to this area if not diverted elsewhere.

  • I am aware that in the event of an environmental incident, priority should be the safety of personnel and the community that may be potentially affected. All steps should then be taken to minimise the risk of environmental damage.

  • I am aware that typical first response to an environmental emergency may include: - Ensure personnel can be removed safely from the emergency location. - Containment of any pollution using booms, silt fences, absorbents, bunding or interceptor traps. - Temporary repair or isolate failed source (e.g. plant, vessel). - Sampling the impacted material (e.g. soil or surface water).

  • I understand that no chemicals are allowed to be stored on site and no washing of vehicles, plant or equipment is allowed to take place on site.

  • I understand that all staff, sub-contractors, and volunteers must wear appropriate Personal Protective Equipment (PPE) in the course of performing their duties on site (if you are unclear see the CityMX Risk Assessment or your own Job Safety Analysis).

  • I understand that any environmental or property damage (including damage to adjacent roads, car parks or toilet facilities) must be reported to CityMX Management with photographic evidence immediately upon being recognised.

  • Name of SEMP inductee

  • Best contact number (mobile preferred)

  • Email contact

  • Car Driver’s Licence

  • I (the inducted) confirm that I have received a detailed induction on the SEMP and CityMX's environmental monitoring and reporting obligations. I believe I am competent in the areas I have been assessed in and understand my responsibilities as an employee of CityMX.

  • Date

  • Role

  • Induction given by:

  • I (supervising CityMX staff member) confirm that I have inducted the above person and confirm that they have been provided with all the documentation and reference material to operate in their intended role.

  • Date

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.