Title Page
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Document No.
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Site
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Conducted on
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Company
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name
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Who has responsibility for reporting hazards
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It is your duty to report any hazards, injuries or unsafe practices to management
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As a worker you have a responsibility to protect yourself and others
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You will not do any job you do not feel qualified or trained to do safety
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You are aware that you need to wear work boots with non slip soles
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You are aware you must wear steel capped boots
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You are aware you need to wear long pants and shirts plus hat or sun screen for sun protection
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You are aware of the risk of loose clothing being tangled in machinery
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You are aware of the need for eye protection when working in the workshop, outdoors or around machinery, chemicals, fences or in the sun.
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You are aware of the need to wear PPE in hazardous jobs including in the workshop and around chemicals.
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You are aware that clothes should be cleaned of chemicals, fuels, oils etc after each day at work
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You are aware of the no smoking rule inside buildings, farm machinery or where their is a risk of igniting a farm fire
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You are aware of the no illicit drugs rule
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You are aware of the risk of tetanus, Q fever and Covid and have had the vaccinations
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You are aware of the no consumption of alcohol rule during work hours
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You have advised your manager of any medical conditions or medication you need to take
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You are aware that children are not permitted around machinery unsupervised
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You are aware of the risk of ear damage with loud noises and the need to wear ear muffs
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You are aware of the hazards that require you to wear PPE including gloves, masks, respirators,
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You have taken a chemical handling course before handling chemicals
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You are aware a helmet must be wore when riding motor bikes or quad bikes
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You are aware you cannot ride on the back of utes and trucks
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You are aware of the need to drive at a responsible speed around the farm sheds or near other vehicles in the paddock and around the farm
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You are aware of the risk of heights and will not climb onto high and dangerous sheds, silos, windmills, houses, trees.
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You will follow the safe handling instructions on chemicals
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You are aware of the risks of being under machinery without ensuring the machine cant fall on you.
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You are aware of how to use fire extinguishers and the fire fighting unit
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You are aware that before starting a machine you must check it can operate safely
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You are aware of the hazards of water and will not enter dams or tanks without a water wise partner watching
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You are aware of the need to report unsafe machinery or equipment or infrustructure to the management
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You are aware of how to undertake fencing safely
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You are aware of the risks of being run over by moving machinery
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You are aware of the risks of moving parts on machinery incl PTOs
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You are aware to check all electrical appliances are safe before you use them
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You are aware of the importance of guards on machinery and will replace them when removed
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You are aware than when a machine has a seatbelt fitted you will use it
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You are aware of the risks of low power lines and high machinery
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You are aware of the need to use appropriate harnesses when climbing or at heights
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You are aware of the contact numbers for emergencies and will carry a mobile phone when working alone
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You are aware of where the first aid kit is located
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Before starting work you will let people know what you work plan is for the day, when where you are likely to be
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You have read the emergency plan
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You are aware of who is trained in first aid locally
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You know how to fill in a injury register form
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I acknowledge that I have personally answered the questionnaire and agree to abide by all the requirements outlined in the induction