(Logo of Company)

SUPERVISION OF MACHINERY (COMPETENT PERSON)

Document Title
GENERAL MACHINERY REGULATION 2(1)
Applicable Company Document Revisio Issue Element
Number n Date number
(Name of Company) XXX/OHS/GMR 1 0/0/2019
2(1)

Approval Name Job Title Signature Date

Document Owner

Approved by

OCCUPATIONAL HEALTH AND SAFETY ACT, 1993

SUPERVISION OF MACHINERY (COMPETENT PERSON)
GENERAL MACHINERY REGULATION 2(1)

(APPOINTEE’S NAME)

I, (Appointer’s Full Name) the (Legislative reference of appointment) appointee of

(Appointer’s Area) hereby appoint you (Appointees Name) as the General Machinery
Regulation 2(1) appointee for (Premises).

In terms of this appointment you must ensure that all machinery is in compliance with the
occupational health and safety legislation, implement a planned maintenance program and
ensure that the statutory machinery records are kept and maintained.

You are required to report any deviations of the legislation and above-mentioned
requirements to (CEO/Section 16(2) Appointee).

Be sure of my personal interest and commitment in your effort.

Your appointment is valid from (Start Date) to (End Date)

……………………………… (Date)
(Appointer’s Signature) Date

ACCEPTANCE

I, (Appointee’s Full Name) understand the implications of the appointment as detailed above
and confirm my acceptance.

………………………………. (Date)
(Appointee’s Signature) Date

Document number: XXX GMR 2(1)

Revision: 1
Title: GMR 2(1) Page 1 of 1