Shift Details

Safety Incidents/Issues

Work Completed Summary (Planned vs. Actual)

Work Completed During Shift




Contractors On-Site


(Company, Trade, No's)

Plant On-Site


(Company, Type, No's)

TU Representative On-site

Visitors and Discussion

Contractor Toolbox Talk Location

Delays or problems with Progress

Quality issues with completed work

Changes to plan for next shift

Comments/Additional Notes

Attach Images
Maps (Work Locations)
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.