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HEALTH AND SAFETY PLAN (HASP) Tailgate Safety Meeting Form Site Name & Number: ATC Project Number: Work Being Performed: Date & Time of Meeting: Name of Presenter: NOTE: On the initial day of the project, the Project Manager or designee should conduct a visual inspection of the project site (using the Site Safety Checklist) prior to the Tailgate Safety Meeting. This inspection should include a review of project site equipment, hazards, and specific job tasks, activities or operations to be performed for that day. These specific items must be covered during the Tailgate Safety Meeting. For subsequent days, any changes to the site or operations must be covered in the Tailgate Safety Meeting. In addition, "Task-Specific" Job Safety Analysis (JSA) for the tasks/activities at the project site must be integrated into the HASP and Tailgate discussions. Itemize the Specific Topics Discussed (if more space is needed use the back of this page): CI Are all employees okay? 0 Are all employees physically able to perform their job duties? 0 "Shared Learning" items? 0 Has PPE been checked? ClEmergency evacuation area identified? 0 Asked for Sub interactions or questions? CI Client Requirements - By checking the box to the left, the Presenter of the Tailgate Meeting acknowledges that all Client- specific requirements have been completed for both ATC and Subcontractor employees. Participants (if needed, list additional participants on back of this page): Print Name Signature Company Date A Tailgate Safety Meeting must be conducted and documented at the beginning of each workday when two or more ATC employees and/or Subcontractor representatives are present on site. Employees, client representatives and subcontractors who arrive at the site after the Tailgate Safety Meeting has been conducted must be briefed on the topics and acknowledge by signing this form. The JSA must be completed at the beginning of each day when one or more ATC employees and/or subcontractor