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Fall Protection Planner Appointment Form

This document summarizes the appointment of a Fall Protection Planner for a construction project. It names the planner, their employer and the site. It lists 11 duties of the planner including ensuring compliance with fall protection regulations, compiling and implementing a fall protection plan, training employees, inspecting equipment and including roof work in planning. The planner and employer sign to acknowledge the appointment.

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Hamish Williams
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2K views1 page

Fall Protection Planner Appointment Form

This document summarizes the appointment of a Fall Protection Planner for a construction project. It names the planner, their employer and the site. It lists 11 duties of the planner including ensuring compliance with fall protection regulations, compiling and implementing a fall protection plan, training employees, inspecting equipment and including roof work in planning. The planner and employer sign to acknowledge the appointment.

Uploaded by

Hamish Williams
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Sample appointment of Fall Protection Planner form

OCCUPATIONAL HEALTH AND SAFETY ACT, 85 of 1993


Construction Regulation 8

APPOINTMENT OF FALL PROTECTION PLANNER

I, ___________________________(Employer), for
_____________________________(Company) do hereby appoint :
________________________(Employee) as the Fall Protection Planner for:
___________________________ at
_____________________________________(Site/Address).

Duties:
1. Ensure compliance with Construction Regulation 8.
2. Compile a Fall Protection Plan for the project.
3. Implement the Fall Protection Plan and amend where required.
4. Take steps to ensure all employees adhere to the plan.
5. Ensure risk assessments are conducted prior to commencing work in elevated positions.
6. Ensure persons required to work in elevated positions are physically and psychologically
fit.
7. Ensure all employees required to work in elevated positions are trained.
8. Ensure all fall arrest equipment is inspected and maintained.
9. Ensure the construction supervisor is issued the latest version of the Fall Protection Plan.
10. Ensure all checklists are kept up to date, with copies in the Health and Safety File.
11. Ensure roof work is included in the planning.

Signature:_______________________________________________
(for Employer)
Designation:_____________________________________________

Date:___________________________________________________

ACCEPTANCE OF APPOINTMENT

I______________________________ hereby accept and understand this appointment.

Signature:______________________ Date: _______________________________

Designation:_____________________________________

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