Document No:SMPCL-IMD-F-054

Revision No.: 00
SUMMIT MEGHNAGHAT POWER COMPANY LTD. Effective Date: 10 Jan 16
TITLE: RECORD OF TOOLBOX TALK Page 1 of 2

Work Permit No:

Workplace: Date:

Name of Main Craft Person: Time:

Persons
present
Na Na Na Na
me me me me

Following topics may be covered after generating of Work Permit:

Basic personal protective equipment and clothing Overhead reaching can increase risk of MSI

Hearing protection Heavy tool belts pose MSI risk

Proper use of foam earplugs Preventing falls from heights

Putting on your respirator Anchors

Eye and face protection Fall restraint or fall arrest?

Basic fire precautions Hot work permit

Confined spaces Putting on a full body harness

Hand signals for hoist and crane operations Vertical lifelines

Overhead high-voltage electricity Personal shock absorbers and carabiners

Power tools and cords Inspection and use of safety belt

Overexertion can increase risk of MSI Locking out permanently connected or hard-
wired equipment
Compressed gas cylinders Overexertion can increase risk of MSI

Housekeeping Silica dust control when drilling concrete

Material Safety Data Sheets Safe use and setting up a ladder

Working safely with mobile equipment Avoiding hazards when working with roll-
off waste containers

Safe use of powered hand drills Safe use of powered hand belt sanders

Safe bending, lifting, and carrying Safe bending, lifting, and carrying

Scaffold requirements Safe use of abrasive tools

General welding and cutting Importance of Isolation before work


SUMMIT MEGHNAGHAT POWER COMPANY LTD.
TITLE: RECORD OF TOOLBOX TALK
Acknowledgements
By signing you are stating the following
I know the hazards:
1. You have been involved in the
Task Safety Environmental
Analysis and understand the
hazards and risk control actions
associated with each task you
are about to perform.
2. You understand the permit to
work requirements applicable to
the work you are about to
perform (if it includes permitted
activities).
3. You are aware that no tasks
or work (that is not risk-
assessed) is to be performed.
4. You also are aware of your
obligation to ‘Stop Work’
Note/Comment:
……………………………………………………….
Main/Craft Person
Name:
Date:
I arrived and departed fit for
duty:
5. You are physically and
mentally fit for duty.
6. You are not under the
influence of any type of
medication, drugs or alcohol that
could affect your ability to work
safely.
7. You are aware of your
responsibility to bring any
illness, injury (regardless of
where or when it occurred) or
fatigue issue you may have to
the attention of the Work Crew
Leader.
8. You signed out uninjured
unless you have otherwise
informed the Work Crew Leader.
Document No:SMPCL-IMD-F-054
Revision No.: 00
Effective Date: 10 Jan 16
Page 2 of 2
STOP WORK:
I will STOP the job any time
anyone is concerned or
uncertain about safety.
I will STOP the job if anyone
identifies a hazard or additional
mitigation not recorded.
I will be alert to any changes in
personnel, conditions at the
work site or hazards.
If it is necessary to STOP THE
JOB, I will reassess the task,
hazards and mitigations.