Safety Induction Questionnaire

Employee / Contractor Worker Particulars

Name Designation NRIC number / FIN WP Expiry Date Nationality Date of Birth Company Trade Training Date Time

Company, trade and designation can be suggested from previous forms on this device. Nationality provides country-name suggestions. Personal attendee details and signatures are not saved for suggestions.

Part #1 PPE (Personal Protective Equipment)

Safety helmets, safety shoes/boots, safety harnesses and ear plugs must be worn as required when entering or working on the worksite.

Yes No

Personal Protective Equipment must be properly maintained and inspected regularly.

Yes No

Damaged Personal Protective Equipment MUST not be used.

Yes No

Safety glasses must be worn when carrying out grinding, cutting, hacking or any other activity that produces sparks or flying particles.

Yes No

Welding goggles or an appropriate welding shield must be worn when carrying out welding or other applicable hot work.

Yes No

Part #2 Fire Safety

Fire extinguishers, a fire watcher and fire blankets must be available at all times during hot work.

Yes No

Ensure that there are no incompatible activities, combustible materials or flammable materials in the vicinity before starting hot work.

Yes No

All welding equipment, hoses and electrical connections must be checked before starting work and again after breaks.

Yes No

Report immediately to your supervisor if any fire extinguisher, hose or equipment is damaged.

Yes No

In the event of a minor fire, use the nearest suitable fire extinguisher if it is safe to do so. Pull the safety pin, aim at the base of the fire, squeeze the handle and sweep from side to side. Report the incident to your immediate supervisor.

Yes No

In the event of a major fire, move away from the fire to a safe location and alert others by shouting, "Fire! Fire! Fire!"

Yes No

Know and follow the evacuation procedure in the event of a fire emergency.

Yes No

Hot work may only commence after the Hot Work Permit has been approved and clearly displayed at the work area.

Yes No

Gas cylinders must be properly secured and must not be left free-standing or unattended.

Yes No

All requirements stated in the Hot Work Permit must be strictly complied with.

Yes No

Part #3 Electrical Safety

Report any faulty electrical connection, tool or equipment immediately to your supervisor.

Yes No

All electrical equipment and tools must be properly earthed where required and checked by a competent person (LEW) regularly.

Yes No

Do not tamper with electrical connections. Ensure that all safety devices are functioning correctly.

Yes No

Do not enter switchgear rooms, transformer rooms or substations without proper authorisation.

Yes No

All electrical cables must be properly elevated or otherwise protected from damage.

Yes No

Switch off electrical appliances and equipment after use.

Yes No

All rotating cutting tools, such as hand grinders and power saws, must be fitted with the appropriate protective guards.

Yes No

Never use tools or equipment unless you have been trained and authorised to use them.

Yes No

Do not use binding wire or wire rope to tie or suspend electrical cables.

Yes No

All extension connections must use approved industrial type plugs and sockets.

Yes No

Generator sets must be properly earthed where required, provided with a suitable fire extinguisher, drip tray and shelter.

Yes No

Part #4 Working at Height

Damaged safety harnesses must not be used.

Yes No

When working at heights where there is a risk of falling more than 2 m, a safety harness must be worn and both safety hooks must be secured to suitable anchorage points.

Yes No

Workers must be briefed by their supervisor before carrying out work at height.

Yes No

All scaffolds must be erected, altered and dismantled only by competent persons.

Yes No

Do not tamper with or modify an erected scaffold.

Yes No

Do not move or push a mobile scaffold while any person is on it.

Yes No

Scaffolds must have safe access to the working platform. The working platform must be fully boarded and properly arranged to prevent tripping or tipping hazards.

Yes No

Damaged A-frame ladders with broken steps, spreaders or other defective parts must not be used.

Yes No

Do not stand or work on the top three steps of an A-frame ladder.

Yes No

Part #5 Accident / occurrences reporting procedures

Report all accidents, near misses, injuries, fires, and damage to company equipment or property immediately to your supervisor or safety personnel.

Yes No

During an emergency, all personnel must proceed to the designated assembly point.

Yes No

Part #6 First Aid

Know where to obtain first aid treatment on site (Project Office).

Yes No

All injuries, whether minor or serious, must be treated and reported to your supervisor immediately.

Yes No

Only trained first aiders should provide first aid treatment.

Yes No

Part #7 House Keeping

Maintain good housekeeping daily and clean up the work area before leaving the site.

Yes No

Keep all work areas, access routes, passageways and stairways free from obstruction.

Yes No

Dispose of food waste in the designated food waste bins.

Yes No

Dispose of construction waste in the designated waste bins.

Yes No

Part #8 General Rules & Regulations

Comply with Chiu Teng Construction Pte Ltd's safety rules and regulations, as well as all applicable statutory requirements, at all times.

Yes No

Smoking is strictly prohibited on site at all times.

Yes No

Attendance at the daily Toolbox Meeting is compulsory before starting work.

Yes No

Before starting any work that requires a Permit to Work, the permit application must be submitted to the safety personnel.

Yes No

All Permits to Work must be approved by the Project Manager and clearly displayed at the work location. NO PERMIT, NO WORK.

Yes No

All requirements and conditions stated in the relevant Permits to Work must be complied with at all times.

Yes No

Workers will be issued with a security pass, which must be clearly displayed at all times.

Yes No

Threatening, attempting to threaten, or using abusive words or gestures towards supervisory staff or safety personnel while they are carrying out their duties is a serious offence.

Yes No

DO NOT OPERATE ANY MACHINERY without authorisation from the CTC Project Manager or Safety Personnel.

Yes No

Remain within your designated work area. DO NOT LOITER around the void deck or other unauthorised areas.

Yes No

Report any unsafe activity or condition to your supervisor immediately.

Yes No

WHEN IN DOUBT, ASK YOUR SUPERVISOR.

Yes No

Do not work with chemicals unless you have been properly briefed by your supervisor or safety personnel.

Yes No

Follow all safety instructions given by your supervisor.

Yes No

Workers are not allowed to stay overnight, cook, wash clothes or bathe on site.

Yes No

Do not carry out any work that may endanger yourself or others.

Yes No

Do not discharge muddy water directly into any drain.

Yes No

Do not waste water. Ensure all water taps are turned off when not in use.

Yes No

Declaration

I have fully understood and accept the contents of the Chiu Teng Construction Pte Ltd, Tanglin Halt C1 Project Safety Induction Course.

I understand and agree to comply with all safety rules and regulations of CTC, Tanglin Halt C1, as well as all applicable statutory requirements.

Accepted by

The attendee's name will be taken from the particulars above.

Translated by (if applicable)

Name

Safety Induction Course Questionnaire

Employee / Contractor Worker Particulars

Part #1 PPE (Personal Protective Equipment)

Part #2 Fire Safety

Part #3 Electrical Safety

Part #4 Working at Height

Part #5 Accident / occurrences reporting procedures

Part #6 First Aid

Part #7 House Keeping

Part #8 General Rules & Regulations

Declaration

Accepted by

Translated by (if applicable)