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001 Induction Checklist

The document is a Safety Induction Form for a company, outlining personal data requirements, safety briefing topics, and responsibilities related to health, safety, and environmental practices. It includes sections on personal protective equipment, safe and unsafe acts, environmental considerations, and traffic safety. Additionally, it emphasizes the importance of compliance with safety policies and procedures to maintain a safe workplace.

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Adibah Nadzirah
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19 views2 pages

001 Induction Checklist

The document is a Safety Induction Form for a company, outlining personal data requirements, safety briefing topics, and responsibilities related to health, safety, and environmental practices. It includes sections on personal protective equipment, safe and unsafe acts, environmental considerations, and traffic safety. Additionally, it emphasizes the importance of compliance with safety policies and procedures to maintain a safe workplace.

Uploaded by

Adibah Nadzirah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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HEALTH, SAFETY AND

[COMPANY ENVIRONMENT DEPARTMENT


SAFETY INDUCTION FORM
LOGO] HSE/SF/001
PAGE 1 OF 2

Project Name

Contract No

A. Personal Data
Full Name
Identification Card/Passport
Gender Male Female
Company Name
Position
Phone Number
Signature of Application

B. Attach Document before Safety briefing


Copy of IC/Passport & Work Permit

C. Safety Briefing
1. Responsibilities & Accountability 2. Company Safety & Health Policy Statement
 All personnel must take reasonable care  Explanation on Safety & Health
for their own health and safety, and that Policy
of others who may be affected by their  Explanation on HSE Objective
actions.
 Employees must comply with safety
instructions and cooperate with all efforts
to maintain a safe work environment.
 Employers must provide a safe and
healthy workplace, including adequate
training, PPE, and supervision.
 Everyone is accountable for identifying,
reporting, and managing hazards in the
workplace.
 Disciplinary actions may be taken in cases
of safety violations or negligence.

3. Personal Protective Equipment 4. HIRARC


requirements  Excavation
 Safety Helmet  Hotwork
 Safety Shoes  working at height
 Safety Vest  Scaffold work
 Dust Mask  blasting work
 Body Harness  working near water/above water
 Eye Protection  Nightwork
 Ear plug
 Safety Gloves
5. Safe & unsafe acts/ conditions 6. Environment
 Rigging & Slinging

1
HEALTH, SAFETY AND
[COMPANY ENVIRONMENT DEPARTMENT
SAFETY INDUCTION FORM
LOGO] HSE/SF/001
PAGE 2 OF 2

 Earthwork/excavation  Waste control construction,


 Scaffolding/netting domestic, schedule waste
 Machinery guarding  5R practices (reduce, reuse, recycle,
 Working at height rethink, respect)
 Demolition & blasting  Energy saving. Water, electricity &
 Night work fuel
7. Traffic safety 8. Others
 Follow and obey traffic  Emergency procedure
signboard displayed  Personal hygiene
 limit vehicle speed at site  Drugs and alcohol
 Work at designated area  Health & welfare
 Follow instruction from  Penalty
flagman
 Avoid distraction near traffic

D. Department of Occupational Safety and Health


Name Signature & Stamp
Position
Date

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