Visionstream - Visitor's Site Induction Record v.3

• Site Details

• The person conducting the Visitor’s induction and the person performing the role of escort must be a fully inducted Visionstream representative. Prior to the Visitor entering the site, the person conducting the induction must inform the Visitor of the hazards at the site, emergency procedures and any relevant conditions of entry, including the risk control measures. Visitors must then sign the below induction register.

• Site Supervisor

• Date

  Date
• Location
  Address

• Description of Work

Visitor Induction

• Site Supervisor MUST ensure all visitors to this site are inducted to the following requirements:

• Scope of Works

  Yes

  N/A

• Site Access and Egress

  Yes

  N/A

• First Aid Kit & First Aid Officer

  Yes

  N/A

• Evacuation / Emergency Procedures & Assembly Point

  Yes

  N/A

• Personal Protective Equipment

  Yes

  N/A

• Amenities (Nearest Toilet)

  Yes

  N/A

• Fire Extinguishers

  Yes

  N/A

• Site Hazards

  Yes

  N/A

• Plant Management (Exclusion Zones)

  Yes

  N/A

• Other(Specify)

Conditions of Entry

• • Visitors must be accompanied by an authorised Visionstream escort at all times
  • Visitor must comply with all instructions given by their escort
  • A reflective safety vest must be worn if high visibility clothing is not being worn
  • Fully enclosed steel-capped safety footwear must be worn at all times
  • Long sleeve shirts and long trousers must be worn on site
  • Safety helmets/hard hats maybe required be worn as required by risk assessment
  • Safety glasses must be worn
  • Gloves must be carried and worn if required
  • Any incident or hazard must be reported immediately to your escort
  • In the event of an emergency visitors are required to follow all instructions given by the escort

Inductees Acknowledgement (Please Read Before Signing)

• The signatures below are confirmation that I have been inducted onto the site and that I am aware of the hazards and I will comply with all lawful instructions given to me by the Site Supervisor or their representative.
  
  By signing this form, I acknowledge that I have read and accepted the above conditions.

• Visitor Log

Visitor

• Inductee Name

• Organisation

• Purpose of Visit

• Date

  Date

• Inductee Signature

  Sign

• Inducted By