Site Induction Checklist Example
Example document for Site Induction Checklist. Use this as a reference when creating your own.
Professional Review Required
This document involves significant legal, financial, or compliance considerations. You must have a qualified professional review and approve this document before use. Do not rely on this template as legal advice.
Document: Site Induction Checklist
Example Document
Last updated 7/29/2026
Project Details
Project Name: Northside Apartment Complex Build Site Address: 42 Smith Street, Parramatta NSW 2150 Date of Induction: 15/10/2023 Inductor Name: David Miller Inductor Position: Site Supervisor
Worker Details
Worker Name: Sarah Jenkins Company: Sparky Electrics Worker Role: Licensed Electrician Phone Number: 0412 345 678 Email: sarah@sparkyelectrics.com.au Photo of Worker: Attached ID Card
Qualifications & licences Check
| Type | Licence Number | Expiry Date | Sight Verified | Initials |
|---|---|---|---|---|
| White Card | CPCCWHS1001 | 12/2025 | YES | SJ |
| High Risk Work Licence | 3456789 | 05/2024 | YES | SJ |
| Electrical Licence | 99887766 | 11/2026 | YES | SJ |
Site Specific Safety Rules Discussion
- Site Access and Egress:
- Worker understands entry and exit points. Gate access code is 1234.
- Worker understands sign in and sign out procedures via the tablet.
- Personal Protective Equipment (PPE):
- High visibility clothing provided and worn.
- Safety boots provided and worn.
- Hard hat provided and worn.
- Eye protection available if required.
- Hearing protection available if required.
- Sun protection discussed.
- Hazards Specific to This Site:
- Overhead power lines identified. Must stay 3m clear.
- Asbestos register reviewed. No asbestos in zone A.
- Confined spaces identified. N/A
- Excavation areas marked. Do not cross yellow tape.
- Traffic management plan explained. Trucks use rear entry only.
- Emergency Procedures:
- Location of First Aid kit: Site office near sink.
- Location of Fire Extinguishers: Near hoist and site office.
- Location of Emergency Assembly Point: Front car park.
- Emergency contact number: 000
- Evacuation alarm signal explained. Siren wail.
- Site Facilities:
- Location of toilets and wash facilities. Ground floor container.
- Location of drinking water. Coolers on each floor.
- Meal and break areas. First floor lunch room.
- Environmental Controls:
- Waste management procedures explained. Bins are at the rear.
- Dust and noise control measures explained. Water down dust.
- Restrictions on smoking and eating. Smoking in designated bay only.
- Alcohol and Drugs:
- Worker understands the zero tolerance policy for alcohol and drugs.
Verification
Worker Signature: S Jenkins Date: 15/10/2023
Inductor Signature: D Miller Date: 15/10/2023
Notes
This example shows a completed induction for a trade specialist. Note the specific hazards listed for this particular site, such as the overhead power lines and excavation zones. The inductor has checked physical licences and recorded numbers. The worker has initialed every point to confirm active listening and understanding.
About this Example
Part of the Site Induction Checklist document collection
Document Type
Site Induction Checklist
A form used to record that a worker has received the necessary safety information and training before entering a worksite.