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Safety Induction Attendance Form Sample

This document is an attendance form for a health, safety, and environmental induction. It collects information such as names, ID numbers, companies, and signatures of attendees. It also contains a checklist of topics that may have been covered during the induction, including PPE, permit to work systems, scaffolding inspections, and safe work procedures for tasks like working at heights or in confined spaces. The form is used to document who attended the induction and which health, safety, and environmental topics were briefed.

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ChyeAmshariYuman
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2K views1 page

Safety Induction Attendance Form Sample

This document is an attendance form for a health, safety, and environmental induction. It collects information such as names, ID numbers, companies, and signatures of attendees. It also contains a checklist of topics that may have been covered during the induction, including PPE, permit to work systems, scaffolding inspections, and safe work procedures for tasks like working at heights or in confined spaces. The form is used to document who attended the induction and which health, safety, and environmental topics were briefed.

Uploaded by

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

HEALTH, SAFETY & ENVIRONMENTAL INDUCTION ATTENDANCE FORM

BORANG KEHADIRAN TAKLIMAT KESIHATAN, KESELAMATAN & ALAM SEKITAR

Project / Projek : Date / Tarikh :

Location / Tempat : Time / Masa :

No CIDB NTSP Gender Company Position Telephone No Siganture


Full Name Nama Penuh I.C. No. / Passport No.
Bil Yes No Yes No Jantina Syarikat Jawatan No Telefon Tandatangan

10

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INDUCTION TOPIC CHECKLIST / SENARAI TOPIK TAKLIMAT (Please tick which is topic have been briefed / Sila tandakan topik yang telah diterangkan

HSE policy brief/Penerangan polisi HSE PESB Permit to works / Surat kebenaran bekerja
Personnel protective equipments / Peralatan perlindungan diri Equipments & tool inspection / Pemeriksaan peralatan kerja
Workers Pass or workers ID / Pas atau pengenalan diri pekerja HSE Meetings (tool box, weekly HSE meeting)
Assembly area & ERP / Tempat berkumpul dan pelan keselamatan Safe working at height / Keselamatan kerja ditempat tinggi
Smoking area, Toilet & etc. / Kawasan merokok, tandas dan lain-lain Gas cylinders secure / Menjamin keselamatan silinder gas
Barricades & signages / Kepungan & papan tanda keselamatan Safe works of Lifting & rigging / Keselamatan kerja mengangkut
Scaffolding (Inspection tag) / Keselamatan perancah Safe works in confined space / Keselamatan kerja diruang terkurung
General housekeeping / Penjagaan kebersihan Drugs,liquor,gambling or fighting / Dadah, minuman keras, berjudi atau bergaduh
Others / Lain-lain : ………………………………………………………………………………

Presented By / Talimat Oleh :


Name / Nama :
Signature / Tandatangan :

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