Form HSE.VOR.

105-AGCC-16-01-00__
Visitor HSE Orientation Attendance Record

I acknowledge that I have attended the Visitor HSE Orientation. The following subjects were discussed and I have a clear understanding
of the company requirements:

1.0 Responsibilities
2.0 Personal Protective Equipment
3.0 First Aid
4.0
Emergency Assistance
5.0
6.0 Equipment and Procedures
7.0 Speed Limits and Access Restrictions
8.0 Environmental Protection
9.0 Reporting Incidents and Hazards
10.0 General Behavior
11.0
Discrimination and Harassment
Achieving World’s Best Practice Standards
NO,S Name (print) Employer Occupation Signature Date

Verified by:

Approved By

PE PM

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