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Daily ToolBox Meeting Form
Please input all fields marked with *
Job Name & Description
(Define Scope of Work for the day):
Document Control No
(TB-Date-Initials):
TB-
Employee Leading the ToolBox:
Name of AA / Project Oversight:
Date:
Pre-Stat Review:
Risk Assessment:
Does an SOP exist for the job?
Yes
No
SOP#:
If NO, the TESA is substitute SOP
Job Level risk assessment complete?
Yes
No
RA#:
Task Level risk assessment complete?
Yes
No
TSEA#:
Have RAs and TSEAs reviewed and validated on site by workforce members?
Yes
No
Have newly identified risks been documented on TSEA?
Yes
No
NA
Has a member of the workforce conducting each task participated in the TSEA review?
Yes
No
Have all members of the workforce confirmed understanding of the work scope, hazards, and risk controls?
Yes
No
Have everyone reviewed the Emergency Response Plan?
Yes
No
Have equipment checks been completed, documented and reviewed?
Yes
No
NA
SIMOPS or Multi-Crew Activity?:
Yes
No
Describe:
Management of Change (MoC):
Does the work activity required an MoC?
Yes
No
Describe:
If YES, has the Moc been authorized by BP management?
Yes
No
(If NO, Stop Work and consult BP management)
Work Permits:
Identify any permitted actiivities: Permit #
No Permits Issued
Permit Type:
IA Name:
Permit Type:
IA Name:
Permit Type:
IA Name:
Daily Safety Discussion:
Topics Discussed:
Will any conditions change the muster point for today?
Yes
No
Where?
Acknowledgements
By signing you are stating the following:
I know the hazards:
1. You have been involved in the Task Safety Enviromental 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 you obligation to
'Stop Work'
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.
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 on the TSEA.
I will
be alert to any changes in personnel, conditions at the work site or hazards not covered by the original TSEA.
If it is necessary to
STOP THE JOB,
I will reassess the task, hazards and mitigations, and then amend the TSEA as needed.
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