Induction To Site

Name *

Phone Number *

I work for ... *

Site Name or Address *

Covid-19 *

I don't have any symptoms associated with Covid-19, I haven't been in contact with any known or suspected cases, and I don't feel unwell ? Please don't enter this worksite if you can't tick this box. Please note that you are required to sign in with the NZ Covid Tracer App in addition to our requirements

There is a LMC Building and Construction Worker on site and I'll check in with them after filling this form. (Please check off the following items and submit the form)

There is NO LMC Building and Construction Worker on site (Please check off the following items and submit the form)

I agree to abide by the following; *

I have read or will read and understand the Hazard Board and notes for this site

I will discuss with any workers on site how my work may impact them and add any hazards to the hazard board

I have the required PPE for my work

I have a first aid kit available for my use

I am aware of the site amenities

I am aware and understand the site emergency plan (located with the hazard board)

I understand the site specific rules or security measures (located with the hazard board)

If I have any question, I will ring 021 96 85 96 and discuss with Luke Chambers who is the PCBU of this jobsite

Site Induction