Permit to Work Induction "*" indicates required fields First Name* Last Name* Email* I, the individual, confirm i have watched and understood the above video in full I understand and accept that my personal information is used exclusively for the purpose of recording completed inductions I understand and accept that each party shall comply with their respective obligations under the Privacy Act 2020. Neither Auckland Transport Limited, Auckland One Rail Limited, nor anyone acting on their behalf, intend to have access to personally identifiable information for commercial purposes, of those individuals engaged in providing services that are required to register by using this form for any reason. Such personally identifiable information will be used exclusively in relation to completion of the induction. Disclaimer* I acknowledge CAPTCHAContractor working on the network and depots will be subject to which of the following?* Compliance audits from AOR Asset, Management and Engineering Safety Audits from AOR Health and Safety Random Drug and Alcohol Testing All the above None of the above Who is responsible to provide contractor’s Rail Protection Officer (RPO)?* The contractor AOR KiwiRail AT All the Above None of the above Who will be responsible for choosing the Safe Place when working on the rail corridor?* AOR Stations Manager Contractor Site Supervisor / In charge Kiwi Rail RPO All the above None of the above Contractor’s PTW will not be suspended if there is an emergency that happened on AOR site which will affect their work activity.* True False What are the risks involved for people or members of the public in AOR rail network?* People who engage in a physical attack People might be intoxicated and not in their proper mind Self-harmer individuals Workers who act unsafely on the network All the above None of the above What are the important requirements working in AOR Station Platforms?* No work beyond the yellow platform edge tactiles during service hours Emergency public access/egress should not be restricted and hindered during service hours Contractor’s work activity noise should minimize impact on station public address Pedestrian flow management plan will be required if works impact platform areas and designated walkways All of the above None of the above Are contractors entitled to use the lifts to transport equipment and workers?* Yes, unless emergency Not allowed to all extent Yes, unless approval been given prior to use Workers are only allowed to use How many metres are considered safe in relation to the MAD zone?* 2meters for persons and tools .75meters for emergency rescue 8meters for scaffolding 4meters for plant All the above A & B only What are the contractor requirements on AOR Depots and Stabling yards?* Sign the visitor’s book or log into the site visitors electronic Kiosk (where available) on arrival and sign out when leaving the site. Entry into the site is by invite or swipe card access Report to the site AOR on duty Person in charge (PIC). No entry to the stabling yard until they have reported first to the Wiri Control Centre (Wiri Ops) found on the 1st floor of the Depot Facility Building. For EMU Maintenance facility, must first sign in with the EMU Maintenance Shift Manager Be aware of and adhere to the site safety rules and take note of the operational safety boards and to be familiar with Stabling Yards Joint Operation Plans When walking through the yard keep to the designated footpaths and stay inside the yellow painted lines, where marked All of the above None of the above AOR facilities are an alcohol and drug free workplace which means smoking and vaping are not permitted in facilities* True False NumberNameThis field is for validation purposes and should be left unchanged.
