QSH SYSTEM ADMINISTRATION PROCEDURE MANUAL

SITE SAFETY INDUCTION CHECKLIST Page 1 of 2

QSH SYSTEM ADMINISTRATION PROCEDURE MANUAL
SITE SAFETY INDUCTION CHECKLIST Page 2 of 2
LOCATION / TRADE :

1.0 RESPONSIBILITY & ACCOUNTABILITY

OCCUPATIONAL SAFETY & HEALTH ACT 1994
SECTION 24 SECTION 25

2.0 COMPANY'S SAFETY & HEALTH POLICY STATEMENT

EXPLANATION ON SAFETY & HEALTH POLICY EXPLANATION ON SHE OBJECTIVES

3.0 GREEN CARD (CIDB) / NIOSH COUPON / WORKING PASS

GREEN CARD NIOSH COUPON

4.0 PERSONAL PROTECTIVE EQUIPMENT REQUIREMENTS

SAFETY HELMET WELDING SHIELD
SAFETY SHOES DUST MASK
SAFETY / BELT RESPIRATOR
EYE PROTECTION GLOVES
EAR PROTECTION SAFETY VEST

5.0 HAZARD IDENTIFICATION, RISK ASSESSMENT & CONTROL

WORKING AT OR NEAR THE RESIDENTS AREA PLANT / EQUIPMENT & MACHINERY
WORKING BESIDE ROAD TRAFFIC – ROAD SAFETY WELDING
WORKING ON BRIDGES / ABOVE WATER CONFINED SPACE
WORKING NEAR POWER LINES WORK PLATFORM
PUBLIC SAFETY ACCESS/EGRESS
HEAVY LIFTING / LAUNCHING MANUAL/POWER TOOLS
SAFETY REQUIREMENTS ELECTRICAL
SERVICES - FIBRE OPTIC / TNB / ETC
HOUSEKEEPING
MATERIAL ARRANGEMENT / STORAGE
EXCAVATION – UNDERGROUND SERVICES AND TRENCHES
WORKING AT HEIGHTS OR EDGE FLOOR

6.0 OTHERS
ACCIDENT/INCIDENT REPORTING DRUGS & ALCOHOL
EMERGENCY RESPONSE PROCEDURE HEALTH & WELFARE
FIRE PREVENTION THIRD PARTY SAFETY REQUIREMENT
PERSONAL HYGIENE SECURITY

I have received a Safety Induction on the above mentioned items and topics and duly acknowledge and confirm that I understood
them and shall comply with the safety requirements on this project. I hereby acknowledged on behalf of my workers (as per
attendance list) that they had been given induction on the above mentioned items.

CONDUCTED BY: ACKNOWLEDGED BY:

Name : Name :
Signature : Signature :
Date : Date :

Note: Use Attendance Form for induction list record.