VISITOR / CONTRACTOR QUESTIONNAIRE

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# Has the Visitor/Contractor been given, shown or described to him/her Yes No N/A
1 Conditions of Work – Contractor/Subcontractor (WHSP 0020)  
2 Work Health and Safety Policy (WHSP 0001)  
3 General Safety Rules (WHSI 0001)  
4 Drug and Alcohol Policy (WHSP0009)  
5 Traffic management Plan (WHSI065)  
6 GMP – Maintenance Personnel (QWI 001)  
7 Smoke Free Workplace Policy (WHSP0036)  
8 Hygiene Policy (QWI 060)  
9 Emergency Evacuation Procedure (WHSP 0026) – Exits/Assembly Area  

MAJOR HAZARDS

HAZARD PRECAUTION Understood
Forklift(Predestrian) Pedestrians watch out for Forklifts
Do not walk within 4 metres of reversing vehicle
Do not walk alongside an operating forklift – rear-end swing
Do not stand near rear wheels (turning)
Forklift(Operator) Give way to Pedestrians
Sound horn when approaching roller doors

Response Completed
I have been shown / received instruction as above
I have completed the induction
Comments :