Title Page
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CMS WINDOW SYSTEMS RECORD OF TOOLBOX TALK
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PROJECT NO/PROJECT NAME
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Location
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DATE:
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Contractor (if Applicable)
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TOOLBOX REF:
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TOOLBOX TITLE:
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PRESENTED BY
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Document No. CMS HS 17/04
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TOOLBOX TALK - DECLARATION
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I, the undersigned, Have received a Toolbox Talk on the above topic to the date listed.
I fully understand my duties and responsibilities and acknowledge that failure to comply with the foregoing procedures may result in disciplinary action being taken against me which may include permanent exclusion from this and/or any other CMS Site. -
PLEASE ADD PICTURE OF SIGNED TOOLBOX TALK, OR ALTERNATIVELY USE BELOW.
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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NAME: EMPLOYER:
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Select date
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Add signature
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NAME: EMPLOYER:
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Select date
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**PLEASE ADD TOTAL OF PERSONS GIVEN TOOLBOX TALK**
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TOTAL PERSONS
- 1 PERSON
- 2 PERSONS
- 3 PERSONS
- 4 PERSONS
- 5 PERSONS
- 6 PERSONS
- 7 PERSONS
- 8 PERSONS
- 9 PERSONS
- 10 PERSONS
- 11 PERSONS
- 12 PERSONS
- 13 PERSONS
- 14 PERSONS
- 15 PERSONS
- 16 PERSONS
- 17 PERSONS
- 18 PERSONS
- 19 PERSONS
- 20 PERSONS
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ARE ALL SECTIONS COMPLETE
