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STATE OF CALIFORNIA•DEPARTMENT OF TRANSPORTATION <br /> SAFETY MEETING REPORT <br /> PM-S-0110(REV.0512009) <br /> ;TION AND DISTRIBUTION: <br /> u 1. First-line supervisor conducts meeting,Completes,and sign form. <br /> Note:See Chapter 2, <br /> ❑ 2. First-line supervisor retains and posts one copy. Safety Meetings,in <br /> ❑ 3. First-line supervisor sends original to second-line supervisor for review. the Ca/tmns Safety <br /> ❑ 4. Second-line supervisor reviews,signs original,and returns to first-line supervisor to file. Manua/for details. <br /> ❑ 5. Additional routing to: <br /> DATE OFFICE!CREW/PROJECT NAME COST CENTER <br /> 06/13/2016 Stockton Maintenance East Crew 10-2638 <br /> PRINT NAME OF EMPLOYEES(Add additional sheets if required) <br /> Jesus G.Zuniga L/� �— Edmann Gonzal Robert Lawrence <br /> Mike Boda TL� Mark Taylor p� uis Perez <br /> Gerardo RodriguezJuvenal Hurtado Z�ZQ Mike Correia <br /> Tyrone Marshall l / Christine Davis Dennis Daniela' ��;-/ <br /> SAFETY TOPICS DISCUSSED, <br /> SPILL PREVENTION CONTROL AND COUNTERMEASURES PLAN <br /> FRA,FRO,SIN Training <br /> Pump station shut off valves <br /> FUEL and DIESEL fill up station boxes <br /> HAZMAT labeling,hazmat shed <br /> SAFETY SUGGESTIONS/COMMENTS <br /> clean up all spills immediately. <br /> SUPERVISOR'S COMMENTS <br /> always clean up spilled absorbent and dispose of properly.clean up any absorbent thats on the ground. <br /> clean up and inspect periodically the diesel fuel and e85 fill up stations clean spilled fuel and install new pads if needed. <br /> Ensure the hazmat placard is filled up properly,we have classes and there is a demo picture on the hazmat building to assist you. <br /> any 55 gallon barrel we use to put absorbent pads must be labeled. <br /> place waddles back in place after they have been removed. <br /> FIRST-LINE SUPERVISOR SIGNATURE DATE SECOND-LINE SUPERVISOR SIGNATURE DATE <br /> s <br /> 06/13/2016 06/13/2016 <br /> tGGESTED OPISFOR DISCUSSIONafe work habits ❑ Maintenance,Chapter 8 ❑ Respirator safety ❑ Safety vest <br /> ❑ Safe work conditions ❑ Traffic controuflagging ❑ Confined spaces ❑ Body protection <br /> ❑ Codes of Safe OperatingNVork Practice ❑ Sliplirip/fall hazards ❑ Hard hats ❑ Foot protection <br /> `7 First aid treatment ❑ Protective vehicles ❑ Safety glasses <br /> ADA Notice For individuals with sensory disabilities,this document is available in altemate formats. For information call(916)654-6410 or TDD(916)6543880 or write <br /> Records and Forms Management 1120 N Street,MS-89.Sacramento,CA 95814 <br />