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Employee Orientation Check List – Safety

Tab 16G

Employee Name
MM slash DD slash YYYY

This Check list is a guideline for conducting employee safety orientations for employees new to this Aldrich + Associates’ project. Once signed by both the Safety Representative and the Employee, it serves as documentation that the orientation has taken place.

Place a check in the box to indicate that the subject was discussed:

Explain the company safety program including:

- Serious consequences for horseplay / Fighting / Drug & Alcohol Use.
- Smoking Policy
- Good Housekeeping Practices

Discuss Personal Protective Equipment Required
Lines of Communication and Responsibility for Immediately Reporting Accidents
First Aid Supplies, Equipment and Training
Proper Lifting Techniques

By placing a signature below, the employee acknowledges that they will abide by the Guidelines contained within the Site Specific Safety Plan and report any condition or activity perceived to be unsafe to my immediate supervisor or the Site Safety Representative.

MM slash DD slash YYYY