Work Safety Induction
 
System
UnitID 1 1
Date 2001/5/4 2001/5/4
Started 14:41 14:54
Finished 14:54 15:02
Employment
Employer Ajax Mart  Ajax Mart 
Contact Jim Check  Jim Check 
Employee Sally Newjob  Bill Smith 
AgeYears <18  >25 
Position Checkout  Storeman 
Experience No  Yes 
NumberofYears 11 
Supervisor Jan Super  Jack Man 
Date 2001/5/4 14:44  2001/5/4 14:56 
Policies
Laws Yes  Yes 
Regulations Yes  Yes 
SafetyRepresentative Yes  Yes 
SafetyCommittee Yes  Yes 
RighttoRefuseWork Yes  Yes 
InjuryManagement Yes  Yes 
ReportingHazardsto Jan Super  Jack Man 
Manual Handling
Bending Yes  Yes 
Lifting Yes  Yes 
Loads Yes  Yes 
Weights Yes  Yes 
RepetitiveMovement Yes  Yes 
Symptoms Yes  Yes 
SafeWorkPractice Yes  Yes 
MechanicalAssistance Yes  Yes 
PastTraining No  Yes 
Electricity
ResidualCurrentProtection Yes  Yes 
LockingOutTagging Yes  Yes 
CordsLeadsPlugs Yes  Yes 
ElectricalMaintenance Yes  Yes 
WetAreas Yes  Yes 
WorkNearPowerLines N/A  Yes 
Mechanical
HandHeldEquipment N/A  Yes 
Machinery Yes  Yes 
LaddersSteps Yes  Yes 
GoodsLiftingEquipment N/A  Yes 
Vehicles N/A  Yes 
Other Trolleys   
Maintenance Yes  Yes 
QualificationsCertificates No  Yes 
Workstation
Chair Yes  Yes 
Desk Yes  Yes 
Keyboard Yes  Yes 
Monitor Yes  Yes 
Documents Yes  Yes 
Layout Yes  Yes 
ReachZones Yes  Yes 
Environment Yes  Yes 
BreaksandExercises Yes  Yes 
Haz. Substances
MaterialSafetyDataSheets N/A  Yes 
Chemicals N/A  Yes 
Solvents Yes Yes 
SyntheticFibres N/A  N/A
SilicaDust N/A  N/A
Asbestos N/A  N/A
Herbicides N/A  Yes 
SubstancesOther    
SymptomsSubstances No  Yes 
SafeWorkPracticeSubstances No  Yes 
Hazards(Other)
SlipTripFalls Yes  Yes 
FallsHeight N/A  Yes 
FallsDepthVoid N/A  N/A 
FallingObjects Yes  Yes 
ConfinedSpaces N/A  Yes 
NoiseVibration N/A  Yes 
Biological N/A  Yes 
ViolenceAggression Yes  Yes 
FireExplosions Yes  Yes 
PPE
Availability N/A  Yes 
Suitability N/A  Yes 
MaintenancePPE N/A  Yes 
Training N/A  Yes 
Emergency
Procedures Yes  Yes 
ExitsEvacuation Yes  Yes 
PersonneltoContact Yes  Yes 
Telephone Yes  Yes 
FirstAid Yes  Yes 
Training Program
ManualHandling Checkout Manual Handling  Heavy Manual Handling 
CompletedMH    
MachineryVehicles   Forklift Certificate 
CompletedMach    
PPE    
CompletedPPE    
EmergencyFirstAid Basic Demonstration   
CompletedEmergency    
TrainingOther Violence/Hold Up   
CompletedOther