Site Induction Checklist Template

Project Details

Project Name: [ENTER PROJECT NAME] Site Address: [ENTER FULL STREET ADDRESS] Date of Induction: [DD/MM/YYYY] Inductor Name: [FULL NAME OF INDUCTOR] Inductor Position: [e.g. Site Manager, Safety Officer]

Worker Details

Worker Name: [FULL NAME] Company: [e.g. ABC Plumbing Pty Ltd] Worker Role: [e.g. Electrician, Labourer, Carpenter] Phone Number: [MOBILE NUMBER] Email: [EMAIL ADDRESS] Photo of Worker: [ATTACH PHOTO]

Qualifications & licences Check

Type	Licence Number	Expiry Date	Sight Verified	Initials
White Card	[NUMBER]	[DATE]	YES / NO	[ ]
High Risk Work Licence	[NUMBER]	[DATE]	YES / NO	[ ]
Other Qualifications	[DETAILS]	[DATE]	YES / NO	[ ]

Site Specific Safety Rules Discussion

1. Site Access and Egress:

• Worker understands entry and exit points.
• Worker understands sign in and sign out procedures.

2. 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.

3. Hazards Specific to This Site:

• Overhead power lines identified.
• Asbestos register reviewed.
• Confined spaces identified.
• Excavation areas marked.
• Traffic management plan explained.

4. Emergency Procedures:

• Location of First Aid kit: [ENTER LOCATION]
• Location of Fire Extinguishers: [ENTER LOCATION]
• Location of Emergency Assembly Point: [ENTER LOCATION]
• Emergency contact number: 000 or [ENTER SITE NUMBER]
• Evacuation alarm signal explained.

5. Site Facilities:

• Location of toilets and wash facilities.
• Location of drinking water.
• Meal and break areas.

6. Environmental Controls:

• Waste management procedures explained.
• Dust and noise control measures explained.
• Restrictions on smoking and eating.

7. Alcohol and Drugs:

• Worker understands the zero tolerance policy for alcohol and drugs.

Verification

I confirm that I have received the site induction and I understand the safety rules and hazards discussed above. I agree to follow all reasonable instructions while on site.

Worker Signature: __________________________ Date: __________________________

I confirm that I have provided the site induction to the worker named above and have verified their understanding.

Inductor Signature: __________________________ Date: __________________________