Title Page
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Document No.
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Audit Title
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Company
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Conducted on
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Prepared by
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Location
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Personnel
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NAME:
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CONTACT NUMBER:
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TRADE / OCCUPATION:
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TRADE REGISTRATION NUMBER:
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Photo of card.
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COMPANY:
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MANAGER:
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CONTACT NUMBER:
SITE OH&S COORDINATION PLAN
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Has nearest hospital and medical centre locations been identified?
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Has emergency assembly point location been identified?
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Has site specific hazards been identified to contractor or employee?
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Has the mandatory site safety rules been explained to contractor or employee?
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Has GJ Gardner Homes contact information been identified to contractor or employee?
AMENITIES
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Has vehicle parking locations been identified or explained?
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Has first aid kit locations and first aid officers been identified?
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Have toilet locations been identified?
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Has water supply locations been identified?
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Has power supply locations been identified?
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Has rubbish bin locations been identified and general housekeeping explained to contractor or employee?
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Has the process of loading/unloading delivery trucks or vehicles been explained?
INCIDENT NOTIFICATION
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Has the process of reporting any incident, accident, injury or near miss been explained to contractor or employee?
ADMINISTRATION
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Has the GJ Gardner Homes Code of Conduct been explained?
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All contractor or employee's electrical tools and equipment been tested and have current tags?
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Are Material Safety Data Sheets (MSDS) available where required?
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Does contractor or employee have appropriate certificates or licensing to carry out works onsite?
SIGN OFF
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Have you been given the opportunity to ask questions about this form and has your question been answered so you have complete understanding of everything mentioned above?
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I agree to communicate, report any site specific hazards or incidents to the Project Manager and other personnel onsite.
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I understand it is my responsibility to stay safe and not to conduct any activity where I feel incapable or at risk and will notify the relevant personnel if so.
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I acknowledge I have been inducted in Heath & Safety requirements as outlined above. I am aware of my responsibilities, Policies, Procedures and the Code of Conduct applicable to the work required.
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