G-MIM-HSEC-ASS-Mount Isa Mines Site Visitor Induction Assessment - Surface (120201)

ASSESSMENT DETAIL AND TRAINEE SIGN OFF

Name: Company: Date of Birth: Contact No.

Emergency Contact Name: Emergency Contact No. Reason for Visit:

On completion of this assessment please sign to confirm you agree with and accept the overall Assessor Name:
outcome of the assessment
Did the trainee achieve the required standard of this assessment? Yes / No
Visitor’s Signature: Date: Assessor’s Signature: Date:
Visitors and Accompanied Workers (including work experience workers/students) shall only be able to enter the lease accompanied by a fully inducted and authorised Mount Isa Mines
representative (or other person, approved in writing by the Site Senior Executive) at all times whilst on the lease. As the Authorised Representative, I confirm that I am aware of my
obligations in accordance with the Mining and Quarrying Safety & Health Regulation 2001 and G-MIM-HSEC-PRO-Site Access and Security - Workers and Visitors (120000)
Representative’s Name: Representative’s Signature: Date:

Date Visitor Induction Entered into the Register:

INSTRUCTIONS TO THE ASSESSOR

1. Preparing for the Assessment
Ensure the venue, equipment and
materials are available and safe to use.
2. Conducting the Assessment
Clearly explain what will be required of
the Trainee. Explain that medical details
are required in the event of an
emergency and so additional controls –
if required – may be put into place to
ensure their safety during their visit. It is
important the trainee understands that
answering ‘yes’ to having any conditions
does not necessarily mean they will be
denied access to site.
The authorised Mount Isa Mines
representative (or approved person)
shall ensure the Visitor or
Accompanied Worker is taken through
the Mount Isa Mines Visitors Induction
DVD, Surface Assessment and
Underground Assessment (if they will
be going underground)
3. Recording Results
Each checkbox must be completed
using one of the following options:
 Standard Achieved
 Not Yet Achieved
If you mark a check box incorrectly,
draw a line through it, mark the
correct response alongside and initial
the change.
4. Finalising the Assessment
This is assessment is designed to
reinforce critical safety & health
requirements to the visitor. The
outcome of this assessment is not a
competency. Therefore, one or more
results of Not Yet Achieved does not
mean they may not come onto site,
but you must discuss the correct
answer with them and record the
discussion next to the appropriate
question on the assessment. Replay
the relevant section of the DVD if
necessary
Inform the trainee of the assessment
outcome and discuss with them,
ensuring feedback is clear and
constructive. If the trainee does not
agree with your decision, ensure they
are advised of the appeals process (if
required). Ensure this assessment is
signed off by both yourself and the
trainee. For quality improvement
purposes, encourage the trainee to
complete a training evaluation form.
5. Records Management
The completed Assessment with all
supporting evidence shall be returned to
the Site Security Office.
Record of assessment shall be made in
the Visitors Induction Register. The DVD,
assessment and register are located on
the HSEC Page of the Intranet.
Accompanied Workers shall also
complete the relevant area specific
inductions prior to performing the
required task or activity.
The Mount Isa Mines Site Visitors
Induction is valid for a period of 6 months.

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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YOUR SAFETY AND HEALTH OBLIGATIONS – PLEASE READ

As a visitor entering this mine lease you have certain obligations imposed by the Mining and Quarrying Safety and Health Act 1999. It is a requirement of the Act that you are aware of the
following:
Section 36 of the Act states:
1. A worker or other person at a mine who may affect safety and health of persons at a mine or as a result of operations, has the following obligations –
(a) to comply with this Act, standard work instructions, and procedures applying to the worker or person that form part of a safety and health management system for the mine;
(b) if the worker or other person has information that other persons need to know to fulfil their obligations or duties under this Act, or to protect themselves from the risk of injury or
illness – to give the information to the other persons;
(c) to take any other reasonable and necessary course of action to ensure that persons are not exposed to unacceptable levels of risk.

2. A worker or other person at a mine has the following additional obligations at the mine –
(a) to manage the risk of injury or illness to himself or herself or any other person in the worker’s or other person’s own work activities, so that the risk is at an acceptable level;
(b) to ensure, to the extent of the responsibilities and duties allocated to the worker or other person, that the risk of injury or illness to any person is managed in the work and activities
under the worker’s or other person’s control, supervision, or leadership, so that the risk is at an acceptable level.;
(c) to the extent of the worker’s or other person’s involvement, participate in and conform to the risk management practices of the operations;
(d) to comply with instructions given for safety and health of persons by the mine operator or site senior executive for the mine or a supervisor at the mine
(e) to work at the mine only if the worker or other person is in a fit condition to carry out the work without affecting the safety and health of others;
(f) not to do anything wilfully or recklessly that might adversely affect the safety and health of someone else at the mine.

You are to comply with the requirements of G-MIM-HSEC-PRO-Site Access and Security - Workers and Visitors (120000). For a quick guide, refer to the requirements for Visitors versus
Accompanied Workers below:

Site Visitor Induction Card Colour Health Assessments JSEA Required Record on Visitor
Required Induction Register

Visitor Yes Red None No Yes

Accompanied Worker Yes Amber Alcohol Test only. Yes Yes

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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YOUR MEDICAL DETAILS

You must complete the medical questionnaire below so we can manage any possible risk of injury to yourself or others during your visit,
and care for you in the event of an emergency.
1. Do you suffer from any medical condition that may affect you while on the Mount Isa Mines site?
 IF
CONDITION  IF YES CONDITION CONDITION  IF YES CONDITION  IF YES
YES

Heart Disease Fear of enclosed spaces or heights Epilepsy Inability to climb ladders.

Cannot achieve normal vision even with Other:

Kidney Disease Loss of consciousness
spectacles

Diabetes Impaired hearing Tripping/Falling If you answered YES to any of the above,

please explain how this condition is

Impaired ability to walk over rough
Pregnant Impaired balance
controlled below:
ground
2. List any medications you may be required to take whilst you are on site:
3. List any medications you take which could make you drowsy or affect your balance whilst you are on site:
4. Are you allergic to any medications, foods or other substances? No Yes - please give details:
5. How do you rate your personal fitness? Above Average Average Poor
6. Visitors may be required to undertake alcohol and drug testing. I confirm that I am not under the influence of any alcohol, medication or illicit drugs.
Yes No - please give details:
7. Is there any reason you would not be able to wear the following while you are on site – respirator, long sleeved shirt and long pants, hard hat, safety glasses and steel capped footwear?
No Yes - please give details: Note: Only safety approved spectacles may be worn.
Manager’s Name:
In cases where additional detail is requested or has been indicated for any of the above, discussions have taken place and approval is given for this application subject to any conditions listed
below.

Manager’s Signature: Date:

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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Instructions to the Trainee – Written Theory Assessment

Before beginning you may ask questions to ensure you understand the correct procedure. If necessary, you may also seek clarification of the correct procedure during the assessment.
Do not approach this assessment as if it is the first time you have performed the task; it is assumed that you have had adequate practice. Your competence will be assessed based on your
actions during the assessment, and answers you provide to the underpinning knowledge questions. You will be told when to begin.
To establish the reasons for your decisions and actions, you may be asked questions either during or after the assessment. If at any stage the Trainer/Assessor calls out, “STOP!” you must stop
immediately. Do not complete the action you are conducting. Simply freeze. If at any stage you are unsure of how to safely proceed, tell your assessor immediately.

1. WRITTEN ASSESSMENT
Standard
Questions & Answers
Achieved
1. Whilst on site you are required to wear your Visitor or Accompanied Worker tag in plain view:
In operational areas
In offices and buildings
At all times
In vehicles

2. When walking on site you must:

Keep to designated walkways
Give way to all mobile equipment
Remain visible to equipment and machinery
All of the above

3. Which of the following acts are you allowed to perform whilst on site?
Manual labour
Operate plant and mobile equipment
Drive a vehicle
None of the above

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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Standard
Questions & Answers
Achieved
4. Barricades are erected for restricting access to hazardous areas. Visitors are not permitted to enter a barricaded area:
True
False

5. Which of the following is prohibited on site? (You may select more than one answer)
Possession or use of alcohol
Possession or use of illegal drugs
Cold and flu tablets
Prescription drugs

6. Mount Isa Mines permits smoking in:

Company buildings
Company vehicles
Designated areas
Lead processing areas

7. When on site the minimum personal protective equipment for visitors in operational areas is:
Hard hat
Safety Glasses
Steel capped safety boots
Long sleeved shirt and long pants
All of the above

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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Owner: HSEC - Snr - Emergency and Protective Services Version: 6 Valid To: 13/06/2020

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 G-MIM-HSEC-ASS-Mount Isa Mines Site Visitor Induction Assessment - Surface (120201)

Standard
Questions & Answers
Achieved
8. In the event of an emergency you must:
Stay with your Representative at all times
Evacuate to the nearest emergency assembly point
Follow directions from you Representative
All of the above

9. In the event of an emergency the number from any site telephone to call is:
Mobile Phone: Internal Phone:

ONCE YOU HAVE COMPLETED YOUR MEDICAL DETAILS AND ASSESSMENT RETURN THIS PAPERWORK TO YOUR SITE REPRESENTATIVE.
A COPY OF THIS ASSESSMENT WILL BE REQUIRED TO OBTAIN YOUR SITE ACCESS CARD FROM SECURITY

Approver: HSEC - General Manager Review: 48 Effective: 13/06/2016

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