SMA Fitouts Site Safety Induction Form

Name *

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Before commencing work on any SMA Fitouts building sites, you must complete all inductions required under the relevant legislation and our procedures e.g. General Safety Induction, Site Specific Induction and Safe Work Activity Induction.

Prior to completing the induction have you read and understood SMA Fitouts “HSEQ Site Management Plan for Projects” *

Yes
No

Induction Form

YOUR EMPLOYER/BUSINESS(PCBU)

Name off Employer/Business

Address of Employer/ Business

Employer Phone

EMERGENCY CONTACT PERSON

Emergency Contact Person’s Name *

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Last

Relationship to You *

Emergency Contact Number *

INDUCTED PERSON DETAILS

Inducted Persons First Name *

First

Last

Inducted Persons Address *

Inducted Persons Your Occupation / Trade *

List Class/Type of Inducted Person *

List the Class/Type and Registered No. of all your Trade Certificates, High Risk Work Licenses etc related to your work on this site, e.g. Electrician, Plant Operator, Crane, Rigger, First Aider, Demolition, etc.

Are you of Aboriginal or Torres *

Yes
No
Prefer Not To Say

Have you completed a Construction Industry ‘General Safety Induction’? *

Yes
No

Have your received Work Activity/SWMS Inductions for your work on this site. *

Yes
No

Do you have a medical condition that poses a health or safety risk to you or others on site? *

Yes
No

(e.g. Diabetes, deafness, heart/lung condition, allergy, etc)

Are you taking any medications? *

Yes
No

SITE SAFETY CHECKLIST

You MUST verify that you are aware of the following items prior to commencing or entering SMA Fitouts Sites.
Note: contractor cannot proceed until all items are checked off

Please Select Yes to Verify & Accept all Checkboxes Below, otherwise you may not be accepted on Site

Yes
No

Amenities

Shown location of amenities

First aid station / officer

Shown location of first aid station

Fire fighting equipment

Shown location of firefighting equipment

Evacuation

Informed on fire evacuation procedure and evacuation meeting point

Entrances and exits

Shown location of entrances and exits

Skin protection

Shown location of skin protection facilities and aware of risks associated with exposure to sun

Safety Officers

Informed of the identity of safety officers Informed of the identity of first aid officers

Safety equipment/ PPE

Fully aware of the use of safety equipment specified by your employer and aware of the consequences of not complying.

Clean build

Informed on clean build site regulations

Electrical safety and equipment tagging

Electrical equipment used by you must be fitted with a current safety test tag, and all electrical leads are kept off the ground

Main electrical power lines / electrical hazards

You have familiarised yourself with any overhead electrical power lines or electrical safety hazards

Safety data sheets

You have Safety Data Sheets (SDS) on site detailing any dangerous, harmful, or flammable material you are using

Working near heavy machinery

You are aware of the dangers associated with working near moving, heavy machinery such as excavators and cranes

Manual handling

You will not manually handle anything that may injure your back/ limbs, and you will not stack materials unsafely

Working at Heights > 2.0 metres

You understand that working at heights exceeding 1.80m is dangerous and working without fall protection is prohibited. NOTE: You are NOT permitted to adjust or remove any parts of scaffold, handrails, or forms of fall arrest equipment unless you are the appointed, licenced scaffolder for this project.

Power tools and equipment:

You will NOT use power tools or other equipment unless you have adequate experience in their use. You WILL notify the supervisor if you require training before commencing.

Floor penetrations / temporary structures

You understand that you must be cautious of wall and floor penetrations, and temporary structures at all times

Hot Work permits / approvals / qualifications

You will not carry out welding or similar "hot work" without the relevant qualifications and approvals to do so

Environmental protection

You will ensure that contaminated material / water does not enter the stormwater or sewerage system and maintain erosion control systems to prevent contamination from occurring.

Harassment in the workplace

You will not bully, intimidate, or verbally or physically assault any person within or surrounding the work site

SMA Fitouts Site WHSE Rules

General

1. It is the responsibility of every person entering this site to obey the safety rules, procedures, and Codes of Practice and to be involved in safety management, preventing accidents and ensuring safe work practices.

2. All personnel on this site must obey the directions of the Site Manager in relation to safe site conduct.

3. Alert fellow workers if you see them neglect safety.

4. Watch and advise young or inexperienced fellow workers.

5. Offensive language, clothing and general skylarking is NOT permitted on any SMA Fitouts Sites

6. All personnel on site must advise the Site Manager before proceeding with potentially dangerous works, e.g. hot works, trenching, excavation, confined spaces and working at heights.

General Construction WHS Induction

7. All persons must display evidence of completing the General Construction WHS Induction training prior to being site inducted by SMA Fitouts to commence work on the work site.

Site information

8. All personnel and visitors on site must know:

9. All access and egress points and emergency evacuation procedures

10. The Name and Address of this Project

11. First Aid location, names of First Aid Officers

12. Location of firefighting equipment

13. Contact details for Out of hours, incidents, and emergencies

Site Induction

14. ALL Workers entering site need to undertake the SMA Fitouts Site Induction prior to starting works on site.

Safe work method statements

15. Safe Work Method Statements must be prepared and used for all work activities assessed as having a safety risk.

16. ALL SWMS must be reviewed and approved by SMA Fitouts

Toolbox Talks

17. Regular discussions must be held with workers on site to consult on site safety matters. Whenever new hazards or tasks have been identified or when site conditions have changed a toolbox talk will be carried out to communicate this to all personnel on site

Safety Helmets, Safety Footwear, and Hi Visibility Vest/Top

18. Safety helmets, Hi Visibility Vests, Safety Footwear must be worn by all supervisors, employees, contractors and subcontractors, workers in the construction area at all times

19. Safety helmets, Hi Visibility Vests, and Closed Footwear must be worn by all visitors in the construction area at all times. The visitors must be accompanied by an SMA Fitouts Representative at all times- that has completed the full Site-Specific induction, whilst in the work zones.

Accidents, Incidents and Near Misses

20. Accidents, incidents, near misses and injuries must be reported immediately to the Site Manager and applicable subcontractor’s site representative in charge.

21. Persons injured must be assisted immediately, and ambulance and/or first aid officer called. Phone 000 for an ambulance or Emergency Services

22. All accidents/incidents/near misses, large or small, must be reported immediately to the Site Manager.

23. Any dangerous occurrence must be reported immediately to the Site Manager.

Alcohol, Drugs and Smoking

24. The consumption of, or being under the influence of, alcohol and illegal drugs on site is prohibited.

25. If an intoxicated person is found on site, they will be dismissed from site immediately for the remainder of the day. If the person commits the offence a second time, they must be dismissed from site indefinitely.

Amenities

26. Access to clean toilets and meal facilities, cool, clean drinking water, and the other facilities in accordance with the requirements of the Safe Work Australia, location of amenities as per site establishment plan.

Emergency Evacuation

27. Arrangements will be described in the Site Induction and clearly identified to persons on site. as per evacuation diagram.

First Aid

28. All persons requiring first aid treatment are to contact the First Aid Officer who must administer the treatment, and record the reason for treatment (accident/ incident or illness) in the First Aid Register, together with the person’s name, his employer and the and nature of the accident, incident or illness.

Fire Prevention

29. Fire prevention must be used by all persons on the work site. An appropriate fire extinguisher must be on hand for all welding sets and oxy acetylene work. All extinguishers are to be tested and tagged in accordance with AS – i.e. every 6 months.

30. Fire extinguishers and other firefighting equipment must be placed in strategic locations on site. They must be secure and labelled correctly.

31. Ensure all workers are aware of Fire and Bushfire Protection and Prevention Measures

Safety Signage

32. The required statutory, emergency, and general safety signage is to be erected and maintained throughout the project.

Work Areas / Housekeeping

33. Work areas must be kept clean and tidy, with rubbish and other safety hazards cleaned up promptly.

34. Clean up rubbish promptly.

35. Stack and store materials safely.

36. Wipe up spills

37. Keep walkway, stairs, and access points clear

38. Use sanitary facilities provided

39. Keep toiler, change rooms, offices, and lunch areas clean

40. Leads and cables:All leads and power cables to be supported above any work area and passageway to provide clear access for personnel and vehicles or positioned in a safe manner as directed by the Site Manager or Safety Representative. Do not run leads along floor or from one level to another. Use electrical stands. Only one lead to be used. Do not connect lead to lead.

41. Temporary boards: All temporary electrical boards must be fitted with an earth leakage device/ residual current device. Leads are to run through hole in base of panel. Do not wrap lead around hole or through hole and tie knot in lead to secure. Lids of temporary boards to be kept closed.

Agreement *

I certify that all the above information is true and correct. I have the necessary training to undertake the tasks allocated to me by my employer and I am medically fit to safely perform the respective tasks required of me on this project. I have completed the Site Safety Induction and understand my WHS and Environmental obligations and responsibilities on this project.