LIS OF

Doc/Rev # STL-VARUN-EHS-M-F05-R0 Ver-1 EHS Manual-Annexure-F05 Tool Box Talk (Record)

F

Location Details S.No.:

Activity Date:
Drg. Reference
AA. Useful General Topics (Please tick “ √ ” the topic covered in tool box or write it)
01. Housekeeping 08. Overhead Power transmission lines 15.Working at Height
02. Hand Tools 09. Crane Operation 16. Scaffolding
03. Power Tools 10. Transit Mixture / Concrete Pump 17. Diversions
04. Excavation 11. Dumpers Operation 18 Traffic
05. Loading / Unloading 12. Mobile Equipments 19 Others (Pl. specify)
06. Lifting & shifting 13. Permit to work 20
07. Electrical 14. Personnel Protective Equipment 21
BB. Equipments used at site
Name of equipment Nos. Name of equipment Nos. Name of equipment Nos.
1.Vehicle 7. Grader 13. Others (Pl. specify)
2.Bus 8. Transit Mixture 14. Tractor with Trolly
3.Dumper 9. Crane
4.Trailor 10 Front End Loader
5. Roller 11. Paver (Bitumen)
6. Dozer 12. Concrete Paver
CC. Critical Hazard & its control (To be written by concerned execution supervisor / engineer)
Critical Hazard Control Critical Hazard Control

DD. Attendance of persons participating on Tool box talks ( to include all staff, workmen & subcontractor employee)
Name Designation Sign Name Designation Sign

EE.(i)Tool box conducted by Tool box witnessed by

Name Name
Sign Sign
Date Date

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