• NAME:

  • CONTACT NUMBER:

  • TRADE / OCCUPATION:

  • TRADE REGISTRATION NUMBER:

  • Photo of card.

  • COMPANY:

  • MANAGER:

  • CONTACT NUMBER:

SITE OH&S COORDINATION PLAN

  • Has nearest hospital and medical centre locations been identified?

  • Has emergency assembly point location been identified?

  • Has site specific hazards been identified to contractor or employee?

  • Has the mandatory site safety rules been explained to contractor or employee?

  • Has GJ Gardner Homes contact information been identified to contractor or employee?

AMENITIES

  • Has vehicle parking locations been identified or explained?

  • Has first aid kit locations and first aid officers been identified?

  • Have toilet locations been identified?

  • Has water supply locations been identified?

  • Has power supply locations been identified?

  • Has rubbish bin locations been identified and general housekeeping explained to contractor or employee?

  • Has the process of loading/unloading delivery trucks or vehicles been explained?

INCIDENT NOTIFICATION

  • Has the process of reporting any incident, accident, injury or near miss been explained to contractor or employee?

ADMINISTRATION

  • Has the GJ Gardner Homes Code of Conduct been explained?

  • All contractor or employee's electrical tools and equipment been tested and have current tags?

  • Are Material Safety Data Sheets (MSDS) available where required?

  • Does contractor or employee have appropriate certificates or licensing to carry out works onsite?

SIGN OFF

  • 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?

  • I agree to communicate, report any site specific hazards or incidents to the Project Manager and other personnel onsite.

  • 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.

  • 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.

  • Add signature

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