HSE Induction Form
o     Geocycle
                                                                       o     Lafarge Emirates Cement
                           Business Unit
                                                                       o     Ready Mix Gulf
                                                                       o     Readymix Muscat
Induction Details
Trainer
Individual Category         ☐ 1 - Employee          ☐ 2 - Permanent Contractor           ☐ 3 - Temporary Contractor
Induction Date
Induction Duration        ☐ 1 - Day          ☐ 2 - Days       ☐ 3 - Days
INDUCTION DETAILS – Part 1
                                                                                             o   General Site Rules
                                  o   HSE Policy
                                  o   HSE Rules                                              o   HSE Reporting
General HSE
                                  o   Emergency Preparedness and Response                    o   VPC/BOG
Awareness
                                  o   Occupational Health And Hygiene
                                                                                             o   Rewarding & Consequence Management
                                  o   Personal Protective Equipment
                                                                                                 Program
INDUCTION DETAILS – Part 2
                                  o   Risk management & SWI (Explanation)
                                  o   Mobile Equipment & Onsite Traffic                      o   Hazardous Substances
                                  o   Working at Height                                      o   Vibration
                                  o   Energy Isolation                                       o   Hot Material
                                  o   Confined Space                                         o   Coal Mill Safety
                                  o   Machine Guarding                                       o   Alternative Fuels
Operational HSE                   o   Hot Work
Awareness                                                                                    o   Lone Working
                                  o   Concrete Delivery And Placement                        o   ACERT
                                  o   Hearing Conservation                                   o   Construction Safety
                                  o   Ergonomics                                             o   Quarry Safety
                                  o   Electrical Safety                                      o   Silo Cleaning
                                  o   Lifting And Supporting Loads                           o   Concrete Pumping
                                  o   Asbestos                                               o   Tools & Equipment
INDUCTION DETAILS – Part 3
Job Based                         o   Essential Plant Rules And Processes
Awareness
                                  o   Plant / Facility Tour
MANDATORY SAFETY EQUIPMENT CHECKLIST
Mandatory Personal Protective Equipment                       ☐ YES    ☐ NO
Safety Uniform and/or High Visibility Vest                     ☐ YES       ☐ NO
SIGNATURES (to be signed by the trainer)
 ASSESSMENT STATUS
☐ Excellent      ☐ Satisfactory         ☐ Poor
(requires reorientation)
Acknowledgement ( I have read and understood my responsibilities as set out above. I promise to follow and promote these guidelines
during the course of my work)
                                                                                                                     Signatures
             Employee / Contractor Name                                    Designation
HSE Induction Form
                     o   Geocycle
                     o   Lafarge Emirates Cement
Business Unit
                     o   Ready Mix Gulf
                     o   Readymix Muscat