Information
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Title
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Work type
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Department
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Line Manager
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Team Leader
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Address (Workplace) and GPS Coordinates:
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Conducted on Date and Time
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Presenter Names
Presenter name
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Presenter Names and Title
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Worksite Project Manager
Supervisor
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Worksite supervisor
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Health and Safety Representative (HSR) if applicable
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First Aid Representatives
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1. SAFETY TOPICS RAISED FOR DISCUSSION WITH JOB INSTRUCTIONS
1.
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1.2 Roles and responsibilities allocated?
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1.1 Worksite consultation conducted at daily pre-start?
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1.3 Hazardous manual tasks and fatigue discussed?
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1.4 SWMS reviewed and checked for currency? Monitor and review at any stage during activity).
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1.5 Additional site hazards identified and controlled? (Using hierarchy of control).
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1.6 Emergency rescue plan in place (Discussed).
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1.7 First aid persons identified for worksite.
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Insert name of first aiders on site
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1.8 All worker to maintain awareness for hazards posing risks to workers and stop work if required to implement controls.
1.9 Other safety issues and control
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1.9 Other safety issues and control
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2. DAILY WORK INSTRUCTIONS
2.
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2. Instructions for daily work program
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Worker comments
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Follow-up Actions, Hazard and Risk Rating
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Control details and person responsible to action (If required)
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Name of person responsible and sign-off when signature action is completed.
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3. HIRAC and PERSON RESPONSIBLE
3.
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3. Hazard Identified and risk rating?
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Control details and person responsible to action (If required)
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Name of person responsible and sign-off when signature action is completed.
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4. WORKER COMMENTS
4.
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4. Worker comments
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4.1 Hazard Identified and risk rating?
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4.1 Control details and person responsible to action (If required)
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Name of person responsible and sign-off when signature action is completed.
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5. PREVIOUS SHIFT SAFETY CONCERNS and OTHER BUSINESS.
5.
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5. Previous shift concerns?
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Control details and person responsible to action (If required)
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Name of person responsible and sign-off when signature action is completed.
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6. PRESENTER SUMMARY COMMENTS, NAME, TITLE and SIGNATURE
6.
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Summary Comments
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Presenter Name, Title and Signature
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7. WORKER NAME, TITLE and SIGNATURE (All participating in toolbox talk)
7.
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Worker Name, Title and Signature
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8. VISITORS INDUCTED
8.
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Visitor formally inducted using Council Corporate Induction procedure
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Visitor Name, Title and Signature
