Site Induction Centenary Pool Refurbishment

Inductee Details

• Company

• Name

• Address

• Phone number

• General Induction Card Number

• Photo of Inductee with general induction card and special licenses/plant operators tickets.

  Media

Next of kin details

• Name

• Phone number

• Conducted on

  Date
• Location
  Address

Section 1. Do you understand the following?

• 1.1 - DANGEROUS INCIDENT. Report any dangerous incident immediately to your supervisor. <br>All Dangerous Incidents must be reported to the JM Kelly Site Manager immediately.

  Yes

  No

• 1.2 - HAZARD & DANGEROUS SITUATIONS. <br>Any hazard or dangerous situation must be reported to site management.

  Yes

  No

• 1.3 - FALLS FROM HEIGHTS.<br>Physical barriers, fall prevention or fall arrest systems must be used where there is a risk of injury from fall.

  Yes

  No

• 1.4 - WORK INJURY. All work related injuries are to be reported to the PC and recorded.

  Yes

  No

• 1.5 - SAFETY HARD HAT AND SAFETY FOOT WEAR. To be warn at all times.

  Yes

  No

• 1.6 - RESPIRATORY PROTECTION. To be warn / used as required and directed.

  Yes

  No

• 1.7 - HEARING PROTECTION. To be warn as required and / or as directed.

  Yes

  No

• 1.8 - EYE PROTECTION. To be used when performing overhead work or as required and / or as directed.

  Yes

  No

• 1.9 - HAND PROTECTION. To be warn as required and / or as directed.

  Yes

  No

• 1.10 - SUSPENDED LOADS. Don't walk under or place any part of body or limbs under a suspended load.

  Yes

  No

• 1.11 - HAND RAILS AND EDGE PROTECTION. Do not stand on, climb on or remove.

  Yes

  No

• 1.12 - PROTECTIVE CLOTHING. To be supplied by inductee's employer and to be warn as required and / or as directed Shirts must be warn for sun protection.

  Yes

  No

• 1.13 - LADDERS. Ladders only to be used when all other safe means of access, such as scaffold, EWP's are not practicable to use. Ladders are to be used for access purposes only. Ladders are to be on firm ground, extend 1 metre above the top access level and must be secured against movement. All ladders must be industrial grade and labelled accordingly. Work can only be performed from the platform of a platform step ladder. If the platform is higher than 2m a JM Kelly work at height permit form JMK-PP-10s is to be issued.

  Yes

  No

• 1.14 - LOOR OPENINGS / PENETRATIONS. Floor and wall penetration covers are to be secured and labelled. Do not remove penetration covers without having other controls in place to prevent a person or object falling through the opening

  Yes

  No

• 1.15 - MANUAL HANDLING. Lifting to be strictly in accordance with advisory standard for manual handling. ie. Bend knees, keep back straight, do not twist your body while lifting and ensure there is a clear area for smooth lift and set down.

  Yes

  No

• 1.16 - HAZARDOUS CHEMICALS. S.D.S. and Risk Assessments to be kept on site and a copy to be given to the PC. Substances must be stored and used strictly in accordance withe the manufactures instructions. All containers must be labelled with the product name and safety instructions.

  Yes

  No

• 1.17 - WORK IN CONFINED SPACES. You must obtain a confined space entry permit from the Site Manager or WHSA prior to entering a confined space for any reason.

  Yes

  No

• 1.18 - PORTABLE ELECTRICAL EQUIPMENT. Must be tested and tagged by a competent person every 3 months (test and tag registers to be kept on site for inspection as required).

  Yes

  No

• 1.19 - ELECTRICAL EXTENSION LEADS. Must be protected from mechanical damage, damage by liquids or damage by high temperatures. Electrical extension leads are not to exceed 30m in length and must be suspended above head height by insulated hangers from the power supply outlet to the work location.

  Yes

  No

• 1.20 - TRENCHING AND EXCAVATIONS. Excavations deeper than 1 metre are to be barricaded. Excavations 1.5 metres or deeper - must be shored; or battered or benched at 45 degrees. excavated material must be kept 1 metre back from the edge of the excavation / trench when plant or machinery is operating in close proximity to the excavation / trench. <br>All excavation work must be approved in writing by the Site Manager on form JMK-PP-10d (Excavation Control Guide) prior to the work commencing.

  Yes

  No

• 1.21 - ELEVATED WORK PLATFORMS (EWP). Only trained personnel are to operate EWP's. Pre-start maintenence and safety checks are to be carried out in accordance with the manufactures / suppliers and WH&S requirements. Operators of boom type EWP's where a harness system is required must be issued with a JM Kelly working at height permit form JMK-PP-10s. Daily pre-start checks must be recorded in the EWP log book.

  Yes

  No

• 1.22 - FALL ARREST/TRAVEL RESTRAINT HARNESS SYSTEMS. Workers using fall arrest/travel restraint system must be trained in the safe use of the system and be issued with a JM Kelly work at height permit (form JMK-PP-10s) prior to using the harness system.

  Yes

  No

• 1.23 - MOBILE SCAFFOLD. Workers are not to be on mobile scaffold while it is being moved. Castor brakes to be locked on before working from mobile scaffold. Mobile scaffold is to be constructed with hand rails, bracing and access in accordance with manufacturer's instructions.

  Yes

  No

• 1.24 - SCAFFOLD. Do not climb on the outside of scaffold. Use access ladders and /or stairs Do not stand on or climb over hand rails. Do not alter scaffold unless you are a licensed scaffolder.

  Yes

  No

• 1.25 - OXY-ACETYLENE EQUIPMENT. Must have Flashback Arresters fitted and fire extinguisher And be secured in an upright position.

  Yes

  No

• 1.26 - HOT WORK. You must ensure an appropriate permit is issued prior to commencing work.

  Yes

  No

• 1.27 - ELECTRICAL WORK. Live Electrical Work is NOT to be undertaken at site without approval from the Site Manager. Only competent persons are permitted to perform electrical work.

  Yes

  No

• 1.28 - HOUSEKEEPING. Work areas are to be kept clean and tidy, rubbish and waste materials are to be cleaned up regularly and placed in the waste bins for disposal.

  Yes

  No

• 1.29 - ALCOHOL & DRUGS. It's against JM Kelly's policy for persons affected by alcohol, drugs or substances of abuse to carry out any work on site.

  Yes

  No

• 1.30 - PRESCRIBED MEDICATION. Persons who are taking prescribed medication that may cause drowsiness or other side affects must advise the Principal Contractor before commencing work.

  Yes

  No

Section 2.

• 2.1 - CONSTRUCTION WHS MANAGEMENT PLAN. Have you been shown the location &/or read the JM Kelly Construction Management Plan?

  Yes

  No

• 2.2 - SAFE WORK METHOD STATEMENT (SWMS) . Have you read and signed your employers SWMS.

  Yes

  No

• 2.3 - Do you have a First Aid Certificate?

  Yes

  No

• 2.4 - Have you received a copy of the JM Kelly Company Rules and Safety Guide?

  Yes

  No

• 2.5 - Have you completed a General Industry Induction in accordance with the current issue of the Work Health and Safety Act & Regulations?

  Yes

  No

• 2.6 - Have you been advised whether a WH&S Advisor has been appointed to site?

  Yes

  No

• 2.7 - Have you been advised whether a WH&S committee exists for the site?

  Yes

  No

• 2.8 - Have you been advised that you are able to access current Work Health and Safety Legislation, Australian Standards, Codes of Practice & other relevant Legislation from the JM Kelly database at the site office on request of the Site Manager?

  Yes

  No

• 2.9 - Have you been trained in the use of Personal Protective Equipment and are you aware it is a requirement of JM Kelly that you appropriate P.P.E. whilst on site?

  Yes

  No

• 2.10 - Are you aware that you must wear Hi-Visibility vest/shirt, safety footwear and a hard hat while you are on a JM Kelly construction site?

  Yes

  No

• 2.11 - Have you been shown the location of the underground services on site?

  Yes

  No

• 2.12 - Have you been advised of the Emergency Response Procedures, and the JM Kelly nominated assembly point, in case of site emergency?

  Yes

  No

• 2.13 - Are you aware that Walkman & iPod type radios are prohibited on site?

  Yes

  No

• 2.14 - Have you been advised where to obtain on site First Aid?

  Yes

  No

• 2.15 - Have you been advised of the name and contact details of the site First Aid Officer/s?

  Yes

  No

• 2.16 - Have you been advised the location of the Fire Extinguishers on site?

  Yes

  No

• 2.17 - Have you been advised the location of the nearest medical facility nominated for treatment of personnel from this site?

  Yes

  No

• 2.18 - Are you aware that you must not enter areas that are cordoned off for safety reasons?

  Yes

  No

• 2.19 - Are you aware that only Licensed Scaffolders are to erect and dismantle scaffolding from which a person or thing may fall 4 metres or more?

  Yes

  No

• 2.20 - Do you have any allergies? ( If Yes, specify )

  Yes

  No

• 2.21 - Do you have any illnesses, injuries or latent health problem and / or condition that may be aggravated, exacerbated or caused by your work? ( if yes, specify )

  Yes

  No

• 2.22 - Are you taking any prescribed medication that could cause drowsiness or have any side affects that may affect your safety while working at this site?

  Yes

  No

• 2.23 - Have you been advised the location of the spill containment kit?

  Yes

  No

• 2.24 - Are you aware that vehicles leaving the site must use the designated shake down exit in order to prevent soil from being deposited on public roads?

  Yes

  No

• 2.25 - Have you been advised of the controls being used to prevent silt from entering storm water drains?

  Yes

  No

• 2.26 - Have you been advised of the dust suppression controls (water spray) are to be used to prevent dust becoming a nuisance on site?

  Yes

  No

• 2.27 - Have you been advised that JM Kelly recycles waste materials where possible and that non-recycle materials are to be kept separate from each other?

  Yes

  No

• 2.28 - Are you aware that control measures must be used to prevent excessive noise?

  Yes

  No

• 2.29 - Have you been advised that site works can only be performed between the hours of 6.30am to 6.30pm (Monday to Saturday) and that noise generating activities cannot operate on Sundays or public holidays.?

  Yes

  No

• 2.30 - Do you undertake to execute your work in accordance with the Work Health and Safety Act & Regulations, Site Rules and Site Instructions given to you by JM Kelly for this site?

  Yes

  No

Sign Off

• Inductee Signature

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• On Site Representative Signature

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• Select date

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