TOOL BOX MEETING RECORD SHEET

DATE: TIME: LOCATION:

COMPANY: SUPERVISOR:

DESCRIPTION OF WORK TO BE UNDERTAKEN:

YES N/A
PERMIT TO WORK ISSUED, POSTED AT PLACE OF WORK & DISCUSSED WITH WORKERS
SAFE ACCESS/EGRESS ROUTE IDENTIFIED (INCLUDING ACCESS FOR EMERGENCY SERVICES)
TEMPORARY PLATFORM CHECKED AND IN GOOD ORDER (SCAFFOLD)
FALL PROTECTION MEASURES DISCUSSED (ANCHOR POINTS, BARRICADES ETC.)
FIRE PROTECTION MEASURES DISCUSSED
HOUSEKEEPING AND WASTE DISPOSAL DISCUSSED
EMERGENCY PROCEDURE DISCUSSED
TOILETS AND WELFARE FACILITIES IDENTIFIED
TOOLS AND EQUIPMENT IN GOOD ORDER AND FREE FROM DEFECT
PERSONNEL TRAINED IN THE USE OF THEIR EQUIPMENT
PPE IN GOOD ORDER AND FREE FROM DEFECT( ADDITIONAL REQUIREMENTS IDENTIFIED?)
MATERIALS STORAGE AND HANDLING DISCUSSED
HAZARDOUS MATERIALS IDENTIFIED AND DISCUSSED (MSDS AVAILABLE & ATTACHED)
LIST HAZARDS IDENTIFIED & CONTROLS DISCUSSED

QUESTIONS ASKED TO ENSURE UNDERSTANDING

QUESTIONS ASKED FOR AND ANSWERED
CONDUCTED BY: WITNESSED BY:
NAME:

COMPANY:

POSITION:

SIGNATURE:

ATTENDEES
I have understood this Tool Box Meeting and agree to fully comply with the information and instructions given. Should I
observe any act or condition that places myself or others at risk I will bring it to my Supervisor’s attention immediately.
NAME: BADGE NUMBER SIGNATURE