Moolarben Coal Operations Contractor Approval Form - Mechanical (Underground)
Please complete all mandatory fields in separate form for each inductee
Site Contact Details
Site Contact
*
Please Select
Steve Gleeson
Site Contact Email
example@example.com
Company Details
Company Name
*
Requester Name
*
First Name
Last Name
Requester Position
*
Requester Phone number
*
Please enter a valid phone number.
Requester Email
*
example@example.com
Date of Request
*
-
Day
-
Month
Year
Date
Reason for Induction
*
Inductee Details
Select a role for each area the inductee will be working in
Full Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Occupation
*
Contractor Category
*
Please Select
Cat 1 - Restricted to surface work e.g. administration, trainer in office, office worker, technical expert, consultants
Cat 2 - Surface routine work in normal environment
Cat 3 - Surface work in abnormal environment or non routine work or any Underground routine, non routine and abnormal work environment
Cat 4 - High risk works, major works, major services
WHSE Number
*
What role will the inductee be carrying out on site - Mechanical?
*
Moolarben -Underground - Apprentice (Mech)
Moolarben -Underground - Mechanical Trades Person
Moolarben -Underground Surface - Apprentice (Mech)
Moolarben -Underground Surface - Mechanical Engineer
Moolarben -Underground Surface - Mechanical Trades Person
What relevant qualifications does the inductee have for the nominated site role?
*
What experience does the inductee have to perform the planned tasks on site for the nominated role?
*
MANDATORY REQUIREMENT - Please upload a copy of the Letter of Competency (LOC) for the above applicant.
*
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Acceptable file formats are pdf, doc, docx, xls, rtf, or zip. Maximum file size in 500Kb
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Please upload any supporting documentation for the applicant mentioned above (e.g Trade papers, diplomas, SOA's)
*
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Mechanical and Electrical Trades will need to be approved and appointed by the Mechanical or Electrical Engineers on site
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IMPORTANT NOTE: This approval is only for the person named to attend the Moolarben Induction. ALL requirements under the persons selected job role must be met through the Avetta Contractor Booking Portal before induction authorisation will be considered
Acknowledgement
*
I acknowledge the above statement and have attached all required supporting documentation to this application.
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