Sample appointment of Site Manager letter
COMPANY NAME & LOGO/LETTERHEAD
OCCUPATIONAL HEALTH AND SAFETY ACT, 85 of 1993
SECTION 16(2) – ASSISTANT TO THE CHIEF EXECUTIVE OFFICER APPOINTMENT
(Appointee’s Name)
I, (Appointer’s Full Name) the (Legislative reference of appointment) appointee of (Appointer’s Area)
hereby appoint you (Appointee’s Full Name) as the Section 16(2) (Assistant to the CEO) appointee
responsible for the area known as (Appointee’s Area).
In terms of this appointment, you are responsible for Occupational Health and Safety matters at the
aforementioned area. In order to ensure that you meet this responsibility you must familiarise yourself
with the Occupational Health and Safety Act and its Regulations. You are also required to ensure that all
statutory requirements are met at all times.
You may not further assign this duty.
Your appointment is valid from (Start Date) to (End Date).
You shall report (Time Period) directly to myself on all occupational health and safety matters arising out
of (Appointee’s Area).
……………………………… ……………………………………
(Appointer’s Full Name) Date
Kindly confirm your acceptance of this appointment by completing the following:
ACCEPTANCE
I, (Appointee’s Full Name) understand the implications of the appointment as detailed above and confirm
my acceptance.
………………………………. …………………………………..
(Appointee’s Full Name) Date
Sample Site Construction Supervisor form
OCCUPATIONAL HEALTH & SAFETY ACT, 85 OF 1993
Construction Regulation 6
SUPERVISION OF BUILDING/CONSTRUCTION WORK
I, …………………………………………………, designated as the
…………………………………………………… for ……………………………………………… do hereby
appoint you in terms of Section 6 of the Construction Regulations as
SUPERVISOR OF BUILDING WORK
Your area of responsibility will be …………………………………………………………………………...
Your duties will include:
1. Familiarise yourself with the relevant legislation.
, 2. Supervise the safe performance of building work and also in regard to health.
3. Cause every excavation to be inspected by a competent person once before each shift or
after any rain, and ensure that these inspections are recorded in a register.
4. Ensure that all workers understand the hazards attached to work performed by them.
5. Be in possession of proof that all workers have attended formal training regarding their job
hazards and the precautionary measures to be taken.
6. Report to your superior immediately all incidents and accidents that come to your attention.
7. In the case of building work taking longer than three months and in which the excavation is
more than 1m deep or requires a person to work at a height exceeding 3m above ground,
inform the Regional Director in writing, prior to starting work, as required in terms of Section 3
of the Construction Regulations.
8. Comply and ensure compliance with the Contractors Regulations GN1010 of 18/07/03 and
the relevant sections of the OHSA.
………………………………………….…. ..…………………
Signature of CEO/Employer Date
ACCEPTANCE
I, ………………………………………………………… hereby accept this designation and understand and
agree to comply with the requirements.
……………………………………… ..………………………………
Signature Date
Sample Assistant Site Construction Supervisor form
OCCUPATIONAL HEALTH AND SAFETY ACT, 85 OF 1993
Construction Regulation 6
APPOINTMENT OF ASSISTANT CONSTRUCTION WORK SUPERVISOR
I, ________________________________________ (Employer), for ______________________
(Company) do hereby appoint __________________________________________ (Employee) as the
Assistant Supervisor of Construction Work at
_______________________________________________________________________________
(Site/address).
Special Instructions/Information:
1. Assist the employer to comply with the Occupational Health and Safety Act, and especially the
Construction Regulations.
2. Endorse Safety Representatives’ reports/Minutes of the Health and Safety meeting.
3. Report and investigate any incident/accident/injury.
4. Ensure the terms of the “Agreement with Mandatory” as per Section 37(1)(2) of the Act are complied
with.
5. Ensure risk assessments are conducted within your area of responsibility and are regularly updated.
6. Assist in compiling Method Statements and the development of Safe Work Procedures.
Signature: ________________________________________
(for Employer)
Date: ________________________________________
Designation: ________________________________________
ACCEPTANCE OF APPOINTMENT
, I, __________________________________________________________ hereby accept and
understand this designation.
Signature: _____________________________________ Date: ___________________
Designation: ____________________________________
Sample Health and Safety Officer appointment form
OCCUPATIONAL HEALTH & SAFETY ACT, 85 OF 1993
Construction Regulation 6
HEALTH AND SAFETY OFFICER
I, _________________________ (Employer), for __________________________ (Company) do hereby
appoint:____________________ as the Health and Safety Officer for ____________________
________________________________ (site/address).
Duties:
1. Assist in compiling the SHE Plan.
2. Assist with risk identification, evaluation and development of safe work procedures.
3. Conduct or have conducted a risk and hazard analysis and take the necessary corrective action.
4. Ensure all accidents are properly recorded, reported and investigated.
5. Ensure Health and Safety Representatives are appointed.
6. Ensure Safety Meetings are held regularly and the results recorded.
7. Ensure Health and Safety Representatives conduct monthly inspections and submit the required
reports.
8. Ensure Contractors comply with the Health and Safety Specifications.
9. Assist with establishment of the Fall Protection Plan.
10. Where it is not possible to remove any remaining hazard/s you are to inform employees thereof
and what precautionary action is to be taken.
11. Ensure appropriate restoration of areas affected by construction.
12. Detail mitigating measures required to be taken, and the procedures for their implementation to
the Project Manager.
13. Establish the reporting system to be undertaken during construction and ensure effective
reporting to management on the deviations identified and required action to be taken.
14. Ensure EMP compliance.
15. Ensure monthly Safety, Health and Environmental reports are submitted to the Project Manager.
16. Carry out toolbox talks.
17. Ensure training needs are identified and implemented.
18. Assist with Induction training.
Signature:_______________________________________________
(for Employer)
Designation:_____________________________________________
Date:___________________________________________________
ACCEPTANCE OF APPOINTMENT
I,____________________________________ hereby accept and understand this appointment.
COMPANY NAME & LOGO/LETTERHEAD
OCCUPATIONAL HEALTH AND SAFETY ACT, 85 of 1993
SECTION 16(2) – ASSISTANT TO THE CHIEF EXECUTIVE OFFICER APPOINTMENT
(Appointee’s Name)
I, (Appointer’s Full Name) the (Legislative reference of appointment) appointee of (Appointer’s Area)
hereby appoint you (Appointee’s Full Name) as the Section 16(2) (Assistant to the CEO) appointee
responsible for the area known as (Appointee’s Area).
In terms of this appointment, you are responsible for Occupational Health and Safety matters at the
aforementioned area. In order to ensure that you meet this responsibility you must familiarise yourself
with the Occupational Health and Safety Act and its Regulations. You are also required to ensure that all
statutory requirements are met at all times.
You may not further assign this duty.
Your appointment is valid from (Start Date) to (End Date).
You shall report (Time Period) directly to myself on all occupational health and safety matters arising out
of (Appointee’s Area).
……………………………… ……………………………………
(Appointer’s Full Name) Date
Kindly confirm your acceptance of this appointment by completing the following:
ACCEPTANCE
I, (Appointee’s Full Name) understand the implications of the appointment as detailed above and confirm
my acceptance.
………………………………. …………………………………..
(Appointee’s Full Name) Date
Sample Site Construction Supervisor form
OCCUPATIONAL HEALTH & SAFETY ACT, 85 OF 1993
Construction Regulation 6
SUPERVISION OF BUILDING/CONSTRUCTION WORK
I, …………………………………………………, designated as the
…………………………………………………… for ……………………………………………… do hereby
appoint you in terms of Section 6 of the Construction Regulations as
SUPERVISOR OF BUILDING WORK
Your area of responsibility will be …………………………………………………………………………...
Your duties will include:
1. Familiarise yourself with the relevant legislation.
, 2. Supervise the safe performance of building work and also in regard to health.
3. Cause every excavation to be inspected by a competent person once before each shift or
after any rain, and ensure that these inspections are recorded in a register.
4. Ensure that all workers understand the hazards attached to work performed by them.
5. Be in possession of proof that all workers have attended formal training regarding their job
hazards and the precautionary measures to be taken.
6. Report to your superior immediately all incidents and accidents that come to your attention.
7. In the case of building work taking longer than three months and in which the excavation is
more than 1m deep or requires a person to work at a height exceeding 3m above ground,
inform the Regional Director in writing, prior to starting work, as required in terms of Section 3
of the Construction Regulations.
8. Comply and ensure compliance with the Contractors Regulations GN1010 of 18/07/03 and
the relevant sections of the OHSA.
………………………………………….…. ..…………………
Signature of CEO/Employer Date
ACCEPTANCE
I, ………………………………………………………… hereby accept this designation and understand and
agree to comply with the requirements.
……………………………………… ..………………………………
Signature Date
Sample Assistant Site Construction Supervisor form
OCCUPATIONAL HEALTH AND SAFETY ACT, 85 OF 1993
Construction Regulation 6
APPOINTMENT OF ASSISTANT CONSTRUCTION WORK SUPERVISOR
I, ________________________________________ (Employer), for ______________________
(Company) do hereby appoint __________________________________________ (Employee) as the
Assistant Supervisor of Construction Work at
_______________________________________________________________________________
(Site/address).
Special Instructions/Information:
1. Assist the employer to comply with the Occupational Health and Safety Act, and especially the
Construction Regulations.
2. Endorse Safety Representatives’ reports/Minutes of the Health and Safety meeting.
3. Report and investigate any incident/accident/injury.
4. Ensure the terms of the “Agreement with Mandatory” as per Section 37(1)(2) of the Act are complied
with.
5. Ensure risk assessments are conducted within your area of responsibility and are regularly updated.
6. Assist in compiling Method Statements and the development of Safe Work Procedures.
Signature: ________________________________________
(for Employer)
Date: ________________________________________
Designation: ________________________________________
ACCEPTANCE OF APPOINTMENT
, I, __________________________________________________________ hereby accept and
understand this designation.
Signature: _____________________________________ Date: ___________________
Designation: ____________________________________
Sample Health and Safety Officer appointment form
OCCUPATIONAL HEALTH & SAFETY ACT, 85 OF 1993
Construction Regulation 6
HEALTH AND SAFETY OFFICER
I, _________________________ (Employer), for __________________________ (Company) do hereby
appoint:____________________ as the Health and Safety Officer for ____________________
________________________________ (site/address).
Duties:
1. Assist in compiling the SHE Plan.
2. Assist with risk identification, evaluation and development of safe work procedures.
3. Conduct or have conducted a risk and hazard analysis and take the necessary corrective action.
4. Ensure all accidents are properly recorded, reported and investigated.
5. Ensure Health and Safety Representatives are appointed.
6. Ensure Safety Meetings are held regularly and the results recorded.
7. Ensure Health and Safety Representatives conduct monthly inspections and submit the required
reports.
8. Ensure Contractors comply with the Health and Safety Specifications.
9. Assist with establishment of the Fall Protection Plan.
10. Where it is not possible to remove any remaining hazard/s you are to inform employees thereof
and what precautionary action is to be taken.
11. Ensure appropriate restoration of areas affected by construction.
12. Detail mitigating measures required to be taken, and the procedures for their implementation to
the Project Manager.
13. Establish the reporting system to be undertaken during construction and ensure effective
reporting to management on the deviations identified and required action to be taken.
14. Ensure EMP compliance.
15. Ensure monthly Safety, Health and Environmental reports are submitted to the Project Manager.
16. Carry out toolbox talks.
17. Ensure training needs are identified and implemented.
18. Assist with Induction training.
Signature:_______________________________________________
(for Employer)
Designation:_____________________________________________
Date:___________________________________________________
ACCEPTANCE OF APPOINTMENT
I,____________________________________ hereby accept and understand this appointment.
