Title Page

  • Prepared by

  • Workers Name

  • Position/Title

  • Phone Number

  • Company Name

  • Emergency Contact

  • Emergency Contact Phone Number

  • Medical Conditions (if any)

  • Select date

  • Construction Industry Induction Card (photo)

Section 3 - HSE items

Non Negotiables (if the next three items are not ticked the worker cannot proceed to work on site)

  • General Construction Induction Card

  • Personal Protective Equipment (high vis vest and steel capped boots)

  • Housekeeping

  • COVID-19

  • SWMS (for high risk construction work only. Must be read, signed and a copy retained on site)

  • UNDERGROUND SERVICES: If you are digging with a mechanical aid you MUST locate all services in the area prior to digging. You must also talk with the Site Manager before digging and complete a Permit to Dig document.

  • Electrical equipment to be tested and tagged (three monthly intervals)

  • Emergency Procedures; * location of fire extinguishers * muster point * first aid kit * emergency contact numbers * amenities * nearest medical facility

  • Site Specific Start Times

  • Weekend Work

  • Hazardous Substances Register (Safety Data Sheets)

  • Exclusion Zones

  • All hazards, near misses, and incidents to be reported to the Site Manager

  • No Alcohol/drugs to be consumed on site

  • DO NOT alter/tamper/move equipment provided for your safety (e.g. scaffold) or equipment provided for the protection of the environment (e.g. sediment fences)

  • High Risk Work Licence? (do you have one? If so, please provide to Site Manager for copying)

  • Miscellaneous

  • Apprentice/Trainee (if you are an apprentice/trainee you must complete the next section with your supervisor)

  • LAST PERSON TO LEAVE SITE MUST SHUT AND LOCK THE GATE

  • Inductor's signature

  • Inductee's signature

Apprentice/Trainee

  • If you are an apprentice or trainee your Supervisor must tick and sign on the form below, what tools you have been trained to use on this site:

Tool

  • Nail Gun (Coil type)

  • Nail Gun (Framing type)

  • Drop Saw

  • Power Saw

  • Planer

  • Angle Grinder

  • Drill (Hammer/Large)

  • Reciprocating Saw

  • Multi-tool

  • Fix Out Gun

  • Other (please specify)

  • undefined

  • I can confirm I have received the HSE induction training and will adhere to all HSE rules and instructions issued by Villa World

  • Apprentice/Trainee signature

  • Supervisor signature

  • Inductor's 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.