Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Basic Safety Induction Form
Contractors Company Name.
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Select date
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What is your company name or if you have be sub contracted , your company and who are you working for.
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Contractors full name
Access to the Darwen Site
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Do you understand that All visitor & Contractors must sign at No 1 security before entering the site.
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Do you understand that All visitor & Contractors must also sign out at No 1 security before leaving the site.
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Has it been explained the identification badges must be collected from security and worn clearly at all times and handed back when your work is completed.
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Do you understand that we have a Mandatory site rule that all contractors must wear a high visibility waistcoat or jacket.
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Has the inductor explained that the employer ( Crown Paints & Hempel) has a legal obligation for employees and visitors?
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Do you understand that must be met and escorted to and from their place of intended work. Or be sent to a specific office or department and seen by a responsible Crown Paints employee.
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Do you understand that this site has several ATEX zoned areas around this site, like the Alkyd and White Spirit tank farm, and can only be entered under a permit to work?
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Do you understand that site is covered by a CCTV system and that images are recorded by security?
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Do you understand that your visit must be by request or schedule visit or appointment only. And also have a point of contact.
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Do you understand that all contractors must report to a manager of the department, before starting work to get the relevant work permits and safety instructions.
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Do you understand that all contractors must report to a manager of the department, when all work is completed so all work permits and safety instructions can be signed off and the worked checked and the area inspected.
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Do you understand that this company has a stop and search policy in place and this applies to all person entering and leaving site and their vehicles?
Site Routes & Departments.
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Has it been explained before starting any work you should speak to the person escorting you, or the department manager where you are working in regards to the permit to work needed for all work being carried out?
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Has it been explained that you cannot leave your workplace and wander about the site unless given permission to do so?
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Are you aware that there is a 10 MPH speed limit, and all vehicles must get a pass before entering and must only park in designated parking bays only, or were instructed to do so?
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Do you understand that whilst moving about the department or site that you should only use designated pedestrian work way if marked, do not enter any areas marked keep out unless correct permit is issued. I.e. Chemical storage areas, flameproof areas, etc.these areas should always be marked with signs.
Crowns Smoking Policy
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Do you understand there is a stringent no smoking policy on this site and it is allowed in designated OUTDOOR smoking shelters only?<br>This also includes the use of e-cigarettes
Site Fire Alarm system
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If you see a fire or a large chemical spill please exit by the nearest door and if the Fire Alarm is not already going off hit the nearest fire brake glass situated by all proper door exits.
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Has it been explained that how to active fire alarm break glasses and if that they cannot be found that the manual system is - yell loudly
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Do you understand that in case of a fire in the department you are working in, that the fire alarms will sound CONTINUOUS. THIS MEAN YOU MUST REPORT BACK DIRECTLY OT SECURITY. if that is not possible follow the rest of the employees and contact the nearest fire marshal letting him know were you were working and who for.
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Do you understand that if the Fire Alarm is an interment or broken signal it means that there is an incident somewhere on site and that you should possible get ready to evacuate as well, of get advice from the department manager?
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Do you now know what to do if a fire breaks out?
Mobile Phones & Elecronic Equipment.
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Do you understand that The use of mobile Phone and any electronic equipment portable, i.e. Portable radios, IPods, MP3 players is strictly forbidden except in works canteen?
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Do you also understand that no cameras or video equipment must be used without first informing the department manager or the permit writers permission & restricted the only the equipment being worked on or as part of a quote for new equipment.
Safety Footwear & P.P.E,
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Have you explained what PPE should be worn and stressed importance?
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As part of your personal protection it is important that you follow the instructions off the permit to work and wear the recommended and appropriate level of protection needed for the work you are permitted to do as stated on the work permit. Do you understand these requirements?
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Have you been informed that you need to wear Hi- visibility waistcoat or jacket at all times, and that this a Mandatory site rule.
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Do you understand that Anti static footwear (Boots / shoes) must be in good condition and fit for purpose and worn at all times whilst working on site?
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Has it been explained that there are Mandatory hearing protection zone that requires all employees to wear hearing protection of some description?
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Has it been explained that there are Mandatory eye protection zones that requires all employees to wear eye protection of some description?
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Has it been explained what is expected of employees to behave in a safe manner and not put themselves or others at risk (no fooling around)?
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Has the inductor explained that you may be expect employees to use PPE Personnel Protective Equipments. I.e. Chemical protection suits, glasses, the correct gloves, helmets and or bump caps.
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Will you provided using your own P.P.E ? <br>Is it fit for purpose and in date?
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Has it been explained that if they see something unsafe they should fix it immediately if they can or report it to their supervisor?
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Has it been explained that due to the size of the business there are first aid train personnel ?<br>
Has it been explained were everything is regarding your welfare needs or have you been show them. I.e. Smoke shelters, Canteen facilities, toilets and restrooms.
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Have you told them where the assembly point is in case of evacuation?
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Have you shown them where the first aid kits are located?
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Have you shown the workplace hazard signs and what they mean?
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Have you shown them where the dangerous areas in the workshop are?
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Have you shown them where the drinking water is?
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Have you shown them where the toilets, sinks, showers, kitchens are?
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Have you shown them where the fire hoses, fire blankets and fire exits are?
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Have you been introduced to others employees?
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Have you shown them where employees can smoke?
General safety signs.
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Has it been explained about the different coloured safety signs around this site and their meanings,
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Do you understand that all waste generated by yourselves must be removed by yourself or disposed of only with the correct authorisation from the person responsible for you whilst on site or the person who sign and filled in your permit to work? <br>Without exceptions
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Has it been explained that you the employee has a legal obligation for yourself, and your fellow workers and other visitors?
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Do you understand that this company has a waste stream management system in place and not all wastes can be disposed of unless it is controlled?
Complete training
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Are you qualified to do the task or work required and have the relevant qualifications or certifications if needed?
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Have you, or company you work for, supplied a method statement for the work you are here to do?
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Have you got the relevant licences to drive or operate any machinery that you may be required to use on this site?
Working at Heights
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Do you understand that if you to use Safe Access / Working at Heights equipment like MEWP,s Cherry Pickers, that they can only be used by the contractor if they produce the relevant license or certification to prove it?
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Do you understand that If your work requires you to work on Scaffolding you must be familiar with and have knowledge of Approved Code Of Practice for assemblies and fall restraint procedure
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Do you have a Anti - slip device for a ladder, as this is Mandatory on this site?
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Will you need ladders or other such equipment to do the work? <br><br>This should also be done under a permit to work dependant on the work to be carried out.
All tools
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Are all your tools fit for purpose and in good condition? Have you explained the risks and hazard for this item?
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Do you understand the need for a lock out procedure and have you explained the lock out procedures you will need or require to do the tasks safety and correctly?
Compressed Air
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Do you understand the risks and hazard for this item, and the need for it to be restricted use, with the correct protection like working pressure gauges and pressure relief mechanisms in place?
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Have you explained the lock out procedures?
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Has it been explained what to do if items using compressed air needs repairs?
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Have you explained anything they must not do?
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Have you explained anything they must not do?
Electricity and electrical equipment.
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Do you understand that before working on any electrical machinery that requires isolation and locking off and the fuses removing if possible and tested before any work is started and must be done under a Permit To Work.?
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Has it been explained that if using any tools or equipment they must be protected RCD's and 110 volts were possible and must be PAT tested and in date ?
Waste and Effluent Control.
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Do you understand nothing whatsoever is permitted to into the drains?
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Do you understand that no Hazardous waste to be disposed of on this site without prior agreement?
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Will you make sue you contact the Site Waste Manager if further information is required?
Manual Handling.
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Has it been discussed about any concerns or issues regarding the work to be carried out?
Mechanical Handling Equipment ( MHE )
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Are you qualified to use this equipment?
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Do you hold a licence to drive this equipment and is it up to date?
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Have you got it with you?
Chemical Hazards
Cylinders, (LPG, OXYGEN,ACETYLENE, any other pressurised gases etc.)
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Are all your hoses in good condition, with no jubilee clips, and the correct regulators for the relevant gases, and that they or intact and in good condition?
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Have they been transported correctly, upright if needed?
Asbestos
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Are you aware of what to look for, i.e. Signs , sticker, type of material. Etc.
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Do you understand that if you suspect that asbestos or( asbestos containing) material may be present?
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Do you know who to contact ie manager, permit issuer or site contact?
Inductors printed and signature
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Printed Name of inductor.
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Name of inductor.
Contractors printed and signature
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Printed Name of contractor
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Name of Contractor.
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Select date
