Contractor WHS Induction Checklist

Company Name: [INSERT COMPANY NAME] Site Address: [INSERT SITE ADDRESS] Date of Induction: [INSERT DATE]

Contractor Details

Company/Contractor Name: [INSERT CONTRACTOR NAME] Contact Person: [INSERT CONTACT NAME] Phone Number: [INSERT PHONE NUMBER] Email: [INSERT EMAIL ADDRESS]

Worker Details (Complete for each worker)

Worker Name: [INSERT WORKER NAME] Position/Trade: [INSERT TRADE]

1. Verification of Documents

Please attach copies of relevant documents.

• Current White Card (General Construction Induction Training)
• Card Number: [INSERT NUMBER]
• Expiry Date: [INSERT DATE]
• High Risk Work License (if applicable)
• License Number: [INSERT NUMBER]
• Class of License: [INSERT CLASS]
• Public Liability Insurance Certificate of Currency
• Insurer: [INSERT INSURER]
• Amount: $[INSERT AMOUNT]
• Expiry Date: [INSERT DATE]
• Safe Work Method Statements (SWMS) reviewed (for high risk construction work)
• Date Reviewed: [INSERT DATE]

2. Site Rules and Access

Induction confirms the worker understands the following:

• Site operating hours are [INSERT START TIME] to [INSERT END TIME].
• Smoking is only permitted in designated areas.
• Alcohol and illicit drugs are strictly prohibited on site.
• Speed limit on site is [INSERT LIMIT] km/h.
• Sign in and sign out procedures are located at [INSERT LOCATION].
• Visitor and delivery procedures have been explained.

3. Site Specific Hazards

The following hazards have been discussed:

• Moving plant and vehicles (e.g. forklifts, cranes)
• Overhead powerlines
• Underground services
• Hazardous chemicals and substances (SDS locations)
• Asbestos containing materials (if applicable)
• Working at heights requirements
• Confined spaces (if applicable)
• Noise exposure and hearing protection zones

4. Personal Protective Equipment (PPE)

I understand that the following PPE is mandatory for this site:

• Safety boots (compliant with AS/NZS 2210.1)
• High visibility clothing (Class D/N)
• Hard hat
• Safety glasses
• Hearing protection
• Sun protection (long sleeves, hat)
• Specific respiratory protection (e.g. P2 mask)

I confirm I have been issued with the necessary PPE or I am providing my own compliant PPE.

5. Emergency Procedures

The worker has been instructed on:

• Location of first aid kits and first aid officers
• Location of fire extinguishers and blankets
• Location of emergency assembly point
• Method of raising the alarm (who to call, how to call)
• Evacuation routes and exits
• Location of emergency contact numbers
• Location of Material Safety Data Sheets (SDS)

6. Incident and Hazard Reporting

The worker understands they must:

• Report any injury or near miss immediately to the supervisor.
• Report any unsafe condition or behaviour immediately.
• Not interfere with or misuse anything provided for health and safety.

7. Facility Information

• Location of toilet facilities
• Location of drinking water
• Location of meal/break areas
• Waste disposal procedures

Acknowledgement

I, the undersigned worker, acknowledge that I have received a site induction for [INSERT COMPANY NAME]. I understand the information provided above regarding site rules, hazards, PPE, and emergency procedures. I agree to comply with all reasonable instructions regarding work health and safety while on site.

Worker Signature: ______________________ Date: //______

Inductor Signature: ______________________ Printed Name: ______________________ Date: //______