Visitor Site Orientation Checklist

Visitor Site Orientation Checklist
HSE Orientation and Training Standard HSE-03-04
Company*
Orientation Date*

YearMonthDay
Date
Project Name/Number*
Visitor's First & Last Name*
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
YesNoN/A
Safety GlassesGlovesHearing ProtectionSafety FootwearDust MaskRespiratory EquipmentHard HatsFace ShieldsMono-GogglesFall ProtectionVestsOther
Part 2: Orientation Acknowledgment. This form will be retained on file at the project worksite location
Visitor's Signature*

Clear
STOP. Please hand phone/tablet to Nordic PCL employee for completion.
Escort's Name*
Escort's Signature*

Clear
Facilitator's Name*
Facilitator's Signature*

Clear
Should be Empty:

STOP. Please hand phone/tablet to Nordic PCL employee for completion.