PRE-JOB SAFETY MEETING FORM AB

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PRE-JOB SAFETY MEETING FORM AB Powered By Docstoc
					TRUCKING SAFETY WORK PERMIT REPORT
PRE-JOB SAFETY MEETING DATE (dd/mm/yy) LOCATION PILOT VEHICLE REQUIRED



MONTHLY SAFETY MEETING



TRIP #

TIME (24 HR)

SUPERVISOR PROVINCE/STATE CITY/TOWN

YES  NO  COMPANY NAME

PILOT VEHICLE INSTRUCTIONS ______________________________________________________________________________________________ ______________________________________________________________________________________________ YES  NO  COMPANY NAME

CRANE REQUIRED

ITEMS DISCUSSED ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________

HAZARDS IDENTIFIED ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ CORRECTIVE ACTION ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ SUB-CONTRACTORS NAME (PRINT NAME)

RISK RATING (IDENTIFIED) HIGH = 3 ___

MEDIUM = 2 ___ LOW = 1 ___

RISK RATING (CORRECTION) HIGH = 3 ___

MEDIUM = 2 ___ LOW = 1 ___

COMPANY NAME – UNIT # (Use reverse side if needed)

SUPERVISOR X OWNER OPERATOR/DRIVER NAME

SAFETY MANAGER X UNIT #

LIST EMERGENCY CONTACT NUMBERS BELOW ______________________________________________________________________________________________ ______________________________________________________________________________________________
Return (White) copy to office – (Golden Rod) copy to Supervisor – (Pink) leave in book RETURN COMPLETED WHITE COPY IN TRIP ENVELOPE


				
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posted:7/25/2009
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