Rivergum Homes General Site Induction

• Site Address

• Date and time site induction conducted

  Date
• Location
  Address

• Document No

• Employer Name

• Employer Phone No.

• Employee Name

• Position of Employment

• General Induction Card Date

  Date

• General Induction Card Number

• General Induction Card photo

  Yes

  No

  N/A

• I have attended a WMS/Safety Plan/Risk Assessment induction by my employer

  Yes

  No

  N/A

• Other Certificates of Competency/Permits (cert number/class)

My signature below confirms that I have been instructed in and understand the following:

• 1. Site specific induction carried out by Rivergum Homes

• 2. My employer's site specific health & safety plan or work method statements

• 3. Worker's obligations under the Workplace Health & Safety Act

• 4. Who to contact if there is an emergency, incident or hazard, who is the designated first aid officer and where to access the first aid kit

• 5. Report any OH&S event to the Safety Advisor if not available to the Site Supervisor

• 6. I am aware of Rivergum Homes' Safety Policy and that it is included in the Project Safety Plan

• 7. I have been advised where I can access all relevant legislation, codes of practice and standards at Rivergum Homes

• 8. I have been advised about the Dispute Resolution Process and understand that if I am not in agreement with the OH&S Dispute Resolution process, that I can request a new Dispute Resolution Process and this process is to be raised and resolved at project induction, this new agreed process will be entered into the Project Safety Plan

• 9. I am aware that the National Code of Construction 2015 applies to this project

• 10. I have been informed of all common plant and details about how it is to be used

• If supplying plant and equipment: I have completed and forwarded the Plant & Equipment Checklist App-ME:13M and confirm that there have been no changes to the checklist provided.

  Yes

  No

  N/A

• I hold the appropriate licenses and qualifications for the work I will undertake on this project.

  Yes

  No

  N/A

• I will also follow health and safety instructions as directed by Rivergum Homes and understand I may be denied access to the project if I fail to follow health and safety provisions on site.

  Yes

  No

  N/A

• Worker Signature

  Sign

• I agree with the Dispute Resolution Process

  Yes

  No

  N/A

• In an emergency, please contact:

• Phone No.

• Medical Conditions/Allergies

RIVERGUM HOMES USE ONLY

• I have sighted the abovementioned General Safety Induction Evidence and licenses and the abovementioned person has been provided with a specific induction for this project which addressed the items required for site inductions in the Project Safety Plan:

• Peter Paterson

  Sign

As a Rivergum Homes worker/subcontractor I am aware and have been given the opportunity to raise any issues with the following points:

• I am aware that I am to wear appropriate Personal Protective Equipment relative to the task I am performing and have been given training in its use

  Yes

  No

  N/A

• I have been advised who to contact if an incident occurs

  Yes

  No

  N/A

• All safety issues should be reported to a Rivergum Homes Representative

  Yes

  No

  N/A

• I am aware all rubbish is to be placed in designated areas

  Yes

  No

  N/A

• I am aware only licensed scaffolders are to erect/dismantle scaffold over 4 meters and only licensed scaffolders may alter the scaffold.

  Yes

  No

  N/A

• If an area is barricaded I must avoid walking through the barricaded area

  Yes

  No

  N/A

• Work areas are to be kept clean and tidy at all times

  Yes

  No

  N/A

• I must carry my general Induction card (White Card) at all times on site

  Yes

  No

  N/A

• I must not be affected by drugs or alcohol anytime whilst working on site

  Yes

  No

  N/A

• I will not engage in any activities that will bring Rivergum Homes into disrepute

  Yes

  No

  N/A

• Smoking is only permitted in designated areas where there is no risk of fire or damage to house, cigarette butts must be disposed of appropriately

  Yes

  No

  N/A

• No fighting or over aggressive behavior will be tolerated

  Yes

  No

  N/A

• I certify that I have undergone Rivergum Homes Subcontractor Induction Training and have been made aware of Site Rules, WHS management Plan and Code of conduct

  Sign

• Induction given by:

  Sign