EHS Manual Forms & Guidance Materials
On this page:
- Suggested Procedure for Designated Work Groups: how to elect an employee Health & Safety Representative
- Guidance Material: How to Renegotiate a Designated Work Group
- Hot Work Permits - Information and Sample
- Confined Space Entry Permits - Information and Sample
- Out of Service Tags - Sample
- Danger Tags and Lock Out Devices - Examples
See also (in the EHS Manual):
Suggested Procedure for Designated Work Groups: how to elect an employee Health & Safety Representative
The University register of elected employee Health & Safety Representatives (HSRs), which lists expiry dates for HSR Terms of Office, is available at http://www.unimelb.edu.au/ehsm/HSRs_list.pdf
The following templates and advice may be of assistance in running an election for an elected Health & Safety Representative in a Designated Work Group.
Members of a DWG are not required to accept this advice. Members of a DWG may agree to determine any election procedure, and any member of the DWG may seek advice on the conduct of an election from the General Manager EHS or delegate, WorkSafe or other representative.
Note: these templates assume you have one vacancy for a HSR and are able to create an election webpage. If you have a vacancy for a Deputy HSR or more than one vacancy, or will not be creating an election webpage, you will need to adapt the templates accordingly.
- Suggested Procedure for Designated Work Groups: how to elect an employee Health & Safety Representative [.pdf]
- Template: Call for Nominations for a HSR [.doc]
- Template: Nomination form [.doc]
- Template: Welcome Letter for a newly elected HSR [.doc]
- Template: Ballot Paper [.doc]
- Template: Voting Paper (inner) envelope labels [.doc]
- Template: Voter signature labels for outer envelope [.doc]
Guidance Material: How to Renegotiate Designated Work Groups
A Designated Work Group is a grouping of employees represented by an elected employee Health & Safety Representative. The EHS Unit maintains a list of the University's current DWGs and incumbent HSRs [.pdf].
From time to time, workplace or organisational changes may make it more difficult for HSRs to represent staff while a previously agreed DWG structure persists. Therefore Departments, Schools and Faculties may wish to adjust the grouping of staff into DWGs. The following guidance material advises what factors to consider, and gives a recommended protocol for renegotiating DWGs in a manner that is compliant with legislative and procedural requirements. A template for the letter to all staff recommended in the protocol is also provided.
To commence a renegotiation, you will need to contact the General Manager, EHS, as the GM EHS or nominee is the only management representative authorised to represent the University in DWG negotiations.
- EHS Guidance Material: How to Renegotiate Designated Work Groups [.pdf]
- Template: Proposal to Renegotiate Designated Work Groups [.doc] - to use this template, remove the background "TEMPLATE" watermark and edit or remove all text highlighted in yellow.
Hot Work Permits
Hot Work Permits are carbonised triplicate permits, whose use is described in the EHSM procedure: 11.30. New. Hot Work.
A sample illustration (in *.pdf format) is available by clicking the thumbnail at right.
Hot Work Permits are available by contacting the EHS Unit.
Confined Space Entry Permits
Confined Space Entry Permits are carbonised triplicate permits, whose use is described in the EHSM procedure: 11.16. New. Confined Spaces
A sample illustration (in *.pdf format) is available by clicking the thumbnail at right.
Confined Space Entry Permits are available by contacting the EHS Unit.
Out of Service Tags - Sample
Out of Service Tags are tags are used to withdraw unsafe plant and equipment from service, as described in the EHSM procedure: 11.28. New. Withdrawing Unsafe Plant and Equipment from Service.
A sample illustration is available by clicking the thumbnail at right.
Out of Service Tags printed on UV-resistant vinyl are available by contacting the EHS Unit.
Note: It is not compulsory to use this particular design of Out of Service tag. You can use any design that complies with the specifications in the EHSM procedure.
Danger Tags and Lock Out Devices - Sample
Danger Tags and Lock Out Devices are used for isolating equipment during cleaning, servicing, repairing or alteration, as described in the EHSM procedure: 11.27. New. Lock Out, Tagging and Isolation.
The following sample illustrations are available:
- Examples of Suitable Lock Out Devices [.pdf]
- Danger Tags: a sample illustration of the tags used by Property & Campus Services is available by clicking the thumbnail at right.
Danger Tags and Lock Out Devices should be supplied by the person completing the work.