OI-L4-300-ME-17 REV.

01 04/ 2013 PAGE 1 OF 1

TOOLBOX TALK
FORM
Date : Conducted by:
(Name & Signature:
Location: Country / City:

Equipment / Instrument involved: Activity performed:

Topic covered:

Slip , Trip and Fall PPE Hazard / risk Identified

Housekeeping Helmet
Fire hazards Shoes
H2S Eye Glasses
Unguarded moving parts Protective Clothing
PTW Respirator
Confined space Life Jacket
Control of Energy / LOTO Full Body harness
Work at Height Gloves
Manual Handling Personal Gas Monitor Any Other topic Discussed:
MSDS Escape Gas Mask
Chemical hygiene Electrical Hazards
Emergency services Electro Static Hazards
Risk Assessment Noise Hazards
Correct Tools & Equipment Working Out Doors
Crystal Incident reporting Compressed Gas Cylinder
Environment & Waste Management First Aid

Attendance
# Name Position LOB / Function Signature
1

10