Jobsite Sign-in - Walker Homes

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Full Name*

Job/Role*

Company Name*

Site Contacts

Site Supervisor: Shawn Leibold
519-379-4455

Site Hours

Monday-Friday: 7:30am - 4:30pm

Consent*

I have read and understand the Site Contacts and Site Hours*

Parking

There is no parking on the main road as it is a fire route. You may park on the driveways of the houses which are under construction.

Consent*

I understand where I can and cannot park*

Nearest Hospital - Grey Bruce Health Services

Address:340 High Street,
Southampton, ON
N0H 2L0

Directions:Take Devonshire Road to ON-21 N
Turn left onto ON-21 N and proceed for 5.9km
Turn right onto High Street and proceed to destination (550m)
Destination will be on the left.

Consent*

I understand where the nearest hospital is*

First Aid & Reporting Accidents

If you or a co-worker have been injured while on the job site, it is your responsibility to let management know immediately. If you are unable to seek help due to your injury, please have a coworker or witness get in contact with our health and safety representative. If medical attention is needed, please call 911 first.

Health & Safety Representative: Chris Swanson (Cooper) - 519-375-1960

Consent*

I understand that it is my duty to report accidents and injury immediately*

Fire Safety & Fire Route

In the event of a fire, fire extinguishers are located in the basements of each house that is under construction and at the site office/trailer. They can be used at any time for emergency purposes.

Please find your way to the muster/meet up point located at the site office/trailer located on lot 1 of Phase 7 (corner of Mary Rose Avenue and Highland Street).

Consent*

I understand the Fire Safety Plan and know where the muster point is*

Proper Protective Equipment

All workers shall wear protective clothing, protective headwear and protective footwear, always while on site.

Reg 213 Section 20-26

Consent*

I understand that under Reg 213 Section 20-26, I am required to have a hard hat, steel toe boots and high visibility on at all times while on site.*

Hot Work Permits & Roof Access

Hot Work Permits

A hot work permit is required for any operation involving open flame or producing a spark. This includes but is not limited to brazing, cutting, grinding, soldering, pipe thawing, torch applied roofing and welding.

Hot work permits are required to be filled out daily and dropped off prior to starting any work. Permits can be dropped off at the construction office.

Roof Access Permit

A roof access permit is required to get access to all roofs. Before fill out a roof access permit you must obtain a valid working at heights certificate. All roofs require you to be tied off.

Consent*

I understand that is tis my responsibility to complete and drop off all permits to the correct location BEFORE starting work.*

Working at Heights

I understand that I MUST be tied off when required and have certified, up to date Working at Heights Training*

Yes, I understand I must be tied off when required and I have a valid Working At Heights Certificate

No, I do NOT have a valid Working At Heights Certificate

Ladders

All ladders must be a Grade 1A or Grade 1AA in the CSA standard Z11-12

Consent*

I understand that those are the only ladders to be used on site*

WHMIS

I have up to date WHMIS training and understand the hazards in my workplace*

Yes, my WHMIS is up to date

No, my WHMIS is NOT up to date

Health & Safety

Consent*

I have read and understand Health and Safety at work*

I have successfully completed the Ontario Worker Health and Safety Training in 4 Steps with the last year*

Yes

Housekeeping

All workers are responsible for the removal of their own material. If you require a bucket or machinery, please contact the office and someone will assist you. Back charges will be issued to workers that leave debris around the interior and exterior of the houses.

Consent*

I understand*

Drugs & Alcohol

Consent*

I understand there is a ZERO tolerance for drugs and alcohol*

Harassment

Walker Homes has zero tolerance for any violence, sexual or physical harassment.

Consent*

I understand*

Consent*

I know that safety starts with me*

Signature*

Please type your name

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Site Orientation Form

Site Contacts

Site Hours

Parking

Nearest Hospital - Grey Bruce Health Services

First Aid & Reporting Accidents

Fire Safety & Fire Route

Proper Protective Equipment

Hot Work Permits & Roof Access

Working at Heights

Ladders

WHMIS

Health & Safety

Housekeeping

Drugs & Alcohol

Harassment