Site Specific Induction

Name *

First Name

Last Name

Which Cubo Projects employee has taken you through the following Site Specific Induction?

Michael

Bobby

Brian

Matt

Annesley

Peter

Ryan

Other

Are you qualified and competent for the works that you are required to complete on this building site? *

Yes

Do you understand the procedures for reporting incidents, injuries and hazards? *

All forms are located at www.cubogroup.com.au/ohse-documents.

Yes

Have you read and do you understand the Cubo Projects workplace safety rules?

These are listed in the Coordination Plan and also on the front fence site sign.

Yes

Have you been taken through the relevant Safe Work Method Statement (SWMS) process for any high risk activities that you will be performing on this building site? Do you know where to access a blank form prior to commencing any works? *

Visit www.cubogroup.com.au/ohse.

Yes

If you require any specialised equipment to perform your job and tasks, do you have the required training to perform these tasks? *

Yes

Do you have the following Personal Protective Equipment (PPE) supplied for you to perform your job tasks? Hard Hat (when required), Safety Glasses, Safety Boots, Long Sleeve Shirt (where required) and High visibility clothing (where required)? *

Yes

Have you been shown the emergency protocols and procedures, and have you been shown the following: Assembly point, closest medical facility, contact details of emergency services, provisions for emergency communications? All of this information is also listed on our site sign on the front fence. *

Yes

I have read Cubo Projects Occupational Health, Safety & Environmental Coordination Plan and understand the emergency evacuation location. *

Yes

Have you been shown where all of the relevant firefighting equipment is located? *

For example: fire extinguisher, hose reels (where applicable)

Yes

Have you been shown where the following facilities are located such as: Crib Sheds, Site office, site toilet, fresh drinking water, cleaning products? *

Yes

Have the the Cubo Projects workplace security procedures been explained? *

Yes

Did the member of Cubo Projects tell you who the relevant Health and Safety representative is? *

Yes

If you need any further information, have any questions on the above then you will not hesitate to ask a Cubo Projects employee. *

I understand

Where applicable, material safety data sheets (MSDS) for any hazardous products I am working with are available to view upon request. *

I understand

The immediate and surrounding work area has been assessed for any uncontrolled risks and is safe to conduct the required work. *

I agree

Crystalline Silica and Silicosis is a serious health hazard amongst the construction industry. *

For more information about the risks and to find the best practice of cutting and working with these products, please visit https://www.safeworkaustralia.gov.au/silica.

I understand and will visit the URL provided

I acknowledge that I am not permitted to alter scaffolding *

I acknowledge that I am not permitted to alter scaffolding

It is understood that persons are responsible for cleaning up their own rubbish and leaving the workplace in a safe and secure condition at all times. *

Yes

Upon leaving the site, It will be left secure from unauthorised access *

Yes

I will ensure that all extension leads, corded power tools and appliances are tested and tagged, guarded, serviced and maintained as applicable. *

Yes

I have viewed and understand the Cubo Projects site safety rules included in the Occupational Health, Safety & Environmental Coordination Plan and agree to work in accordance with these rules. *

Cubo Projects Occupational Health, Safety & Environmental Coordination Plan.

Yes

This now concludes the Cubo Projects Site Specific Induction, we appreciate your patience in completing this but it ensures you are kept safe when working with us. Please confirm that you are happy for Cubo Projects to collect your data listed above to ensure we have it on record. Your data will be kept safe according to Australian Privacy laws. *

Yes, I confirm