Title Page

  • Site conducted

  • Site:

  • Client

  • Project Name/Number

  • Date and Time

  • Inductee Full Name

  • Inductee Contact Number

  • Inductee Company/Business Name

  • Inductee Role

INDUCTION

INDUCTION BOOKLET

  • Review induction booklet

  • I have read and understand the contents of the induction booklet. If I had queries or questions regarding the contents of the induction booklet, I have sought clarification from the Site Supervisor and have a clear understanding prior to beginning work.

COMPENTENCY & LICENSES

  • Please take a photo of valid Construction Induction Card (i.e. white or red card)

  • I have uploaded a valid copy of my Construction Induction Card.

  • Please take a photo of all licenses and tickets, relevant to the work you are undertaking

  • I have uploaded all relevant licenses and proof of competency, prior to undertaking work requiring valid tickets in Victoria.

  • I have a clear understanding that if I do not have a license or have not provided proof of competency, I will not undertake works requiring tickets in Victoria, on this site.

SWMS

  • I have read the SWMS relevant to works being undertaken on site and I understand the hazards and relevant controls as per SWMS.

  • Please upload a photo of your signature on relevant SWMS (and front page of signed SWMS)

DOCUMENTATION

  • I have viewed a copy of the completed HSE Coordination Plan, understand the document and know where it is located on site.

  • I have viewed a copy of Super Gardens Environmental Management Plan (EMP), understand the document and know where it is located on site.

  • I have viewed a copy of the Site Specific Construction Environmental Management Plan (if required), understand the document and know where it is located on site?

  • This project did not require a CEMP and therefore I have not sighted it.

  • I have viewed a copy of the Traffic Management Plan (if required), understand the document and know where it is located on site?

  • This project did not require a TMP and therefore I have not sighted it.

  • I have viewed a copy of the site specific Dial Before You Dig map/s, understand the document and know where it is located on site.

  • This project did not require a DBYD and therefore I have not sighted it.

COMMUNICATION

  • I am clear on roles of workers on site, I know the Site Supervisor, and where their contact number is displayed.

  • I have sighted any recent/relevant Toolbox communications prior to undertaking works.

  • I understand the incident reporting procedure.

  • The site rules have been communicated to me and I have a clear understanding of them.

  • I understand that if I am unsure of work expectations or my duties on site, I will communicate with the Site Supervisor.

TOOLS AND EQUIPMENT

  • I confirm my tools/equipment are fit for purpose, i.e. right tool for the job

  • I am not bringing tools/equipment on site for use.

  • I confirm my tool/equipment are fit for use, i.e. check for damage, test and tag, storage, guards.

  • I am not bringing tools/equipment on site for use.

  • The electrical tools and cords are protected from damage i.e. construction sites electrical tooling must be connected to an RCD and extension cords protected from damage or preventing trip hazards, e.g. raised above and over or covered.

  • I am not bringing tools/equipment on site for use.

PPE

  • I am clear on the PPE requirements on this site.

  • What PPE is mandatory for this site?

  • I will discuss this with the Site Supervisor and will not work onsite until I understand the PPE requirements.

  • My PPE is in good working order and can provide adequate protection from hazards on site.

EMERGENCY PREPARDNESS

  • I have viewed a copy of the Site Map (with Emergency Evacuation Point), understand the document and know where it is located.

  • I know who the First Aid trained person on site is, and where their contact number is located.

  • I understand my responsibilities in an emergency situation.

  • I understand the incident reporting procedure.

SIGN OFF

  • By signing this form, I guarantee that all the questions have been answered truthfully and to the best of my knowledge.

  • Signature

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.