PRINCIPAL CONTRACTOR (PC) SAFETY INDUCTION (site handover)

• Site / Location

• Conducted on

  Date

• Prepared by

• Address

• Date:

  Date

• PC Representative # 1

• Phone:

• Job title

• PC Representative # 2

• Phone:

• Job Title

• Dates the PC will occupy this site eg: From date / to date

  Date

• Provide details of site area to be occupied

• Add site map / photos

  Media

• Known CoGC hazards identified with site

• Traffic

  Yes

  No

  N/A

• Will there be a traffic management plan in place

  Yes

  No

  N/A

• Excavations

  Yes

  No

  N/A

• Will exclusions zones be identified and will a spotter in place

  Yes

  No

  N/A

• Energy Isolation

  Yes

  No

  N/A

• Will ALL power sources be identified and isolated

  Yes

  No

  N/A

• Underground Services

  Yes

  No

  N/A

• Have BYDA plans been obtained and are they onsite - will controls been put in place

  Yes

  No

  N/A

• Overhead Services

  Yes

  No

  N/A

• Will ALL Overhead Services be Identified and what controls will be in place

  Yes

  No

  N/A

• Mobile Plant

  Yes

  No

  N/A

• Will exclusions zones be identified and will a spotter be put in place

  Yes

  No

  N/A

• Working at heights

  Yes

  No

  N/A

• What controls will be put in place

  Yes

  No

  N/A

• Flora and Fauna

  Yes

  No

  N/A

• What controls will be put in place

  Yes

  No

  N/A

• Biological

  Yes

  No

  N/A

• What controls will be put in place

  Yes

  No

  N/A

• Has CoGC received copy of PC WHSMS

  Yes

  No

  N/A

• Does the WHSMS Plan address ALL relevant risks / hazards and controls required

  Yes

  No

  N/A

• Request Changes to WSHMS

  Yes

  No

  N/A

• Are there any planned changes to the site to be undertaken as part of this project

  Yes

  No

  N/A

• Provide further details

• Additional Notes or comments:

Important City of Gold Coast Contact Information

• Emergency Fire and Evacuation CoGC Contact - Protective Services Officer Ph: 5581 6055 #2

• Notifiable WHS Incidents Contact - Protective Services Officer Ph: 5581 6055 #2

• Security Breach (Member of Public) Police Involved - Protective Services Officer Ph: 07 5581 6055 #2

• Council Representative (Business Hours) - City Laws James Lacey Ph: 07 5581 6631

• Council Representative (Business Hours) - Ben Murphy Ph: 07 5581 6214

• Work Health Safety Representative - April Wanless Mobile: 0402 766 408

• Environmental Representative - Jemma Purandare Ph: 07 5582 8858

• Communications Representative - Ben Murphy Ph: 07 5581 6214

CoGC (Council) Reporting Requirements

• The Site Manager (or delegate) will inform CoGC as soon as possible (but within 2 hours) of any serious incident that has caused or has the potential to cause: * Death, Environmental incidents, Reputational incident, Safety or environmental incident that may be required to be notified to a regulator (Safework QLD, DESI etc), or Any Fire via phone call.

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• The Site Manager (or delegate) will inform CoGC Representative Ben Murphy of any other issues or concerns when occupying the site (with 24 hours), or as soon as practicably possible via phone call or email.

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Signatures

• Date of Induction

  Date

• Inductee #1:

  Sign

• Inductee #2:

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• CoGC Safety Advisor :

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• Council Representative:

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