Title Page
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Conducted on
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Employee Name
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Prepared by
Lone working
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Has the employee been issued the Evobead Lone worker policy?
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Does the employee understand their responsibilities outlined within the policy?
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Has the employee received the appropriate H&S Induction training for the manufacturing plant?
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Has the employee been signed off on the Manufacturing Plant training matrix?
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Has the employee been issued with all appropriate PPE?
- Gloves
- Bump Cap
- Safety Boots
- Safety Glasses
- Ear Defenders
- Hi Viz Uniform
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Has the employee been made aware of all emergency contact numbers?
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Has the employee been made aware of the CCTV recording system within the factory?
Employees Duties & Responsibilities: All Employees must
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Comply with Evobead's "Lone Worker" policies and procedures
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Ensure dynamic risk assessments are undertaken
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Report unsafe activities or faulty equipment to their line manager/factory foreman
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Report all accidents or near misses, using the Company's accident/incident reporting procedure
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In the event of an emergency, use contact numbers provided
Training Confirmation
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I confirm that I have read and fully understand my duties and responsibilities within the Lone Worker policy issued.
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Employee Name
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Employee Signature
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Supervisor Name
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Supervisor Signature