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• <br /> TAILGATE MEETING FORM <br /> ' Project Name Date <br /> Project Number Presented by <br /> ' Check the Topics/information Reviewed <br /> ❑safety glasses,hard hat,safety boots ❑slips trips and falls 0 daily work scope <br /> ❑site safety plan review and location ❑directions to hospital ❑emergency protocol <br /> ❑equipment and machinery famillanzabon ❑anticipated visitors ❑parking and laydown <br /> ❑employee Right T"nowfMSDS k>cation ❑electrical ground fault ❑hot work permits <br /> ❑open plts excavations and site hazards ❑public safety and fences 0 strains and sprains <br /> ❑vehicle safety and driving/road conditions ©excavator swing and loading ❑noise hazards <br /> ❑portable tool safety and awareness ❑orderly site and housekeeping 0 no horseplay <br /> ❑overhead utility locations and clearance ©smoking in designated areas ❑heat and cold stress <br /> ' ❑first aid salely,and PPE k>cabon ❑leather gloves for protection ❑backing up hazards <br /> ❑sharp obtact rebar and scrap metal hazards ❑effects of iiia nlghl before ©accidents are costly <br /> ❑safety is everyone s responsibility ❑vibration related injuries ❑dust and vapor control <br /> ❑talex gloves innertnitrile gloves outer ❑fire extinguisher locabons ❑refueling procedures <br /> ' *excavation/treri ping inspectionsldocumentabon ❑eye wash station locations ❑confined space entry <br /> ❑full face respirators with proper cartndges ❑decontaminabon procedures ❑flying debris hazards <br /> ❑upgrade to level c at:FOOD(_ eV)>_ppm <br /> ' 11 work stoppage at FIDIRD(____eV)>r ppm,% LEL>10% <br /> Discusslon/Comments/Follow-up Actions <br /> NAME SIGNATURE COMPANY <br /> 1 <br /> 1 <br /> lrtsiruCtions <br /> Conduct a daily safely meeting pnor to beginning each day s site acs vrt es <br />' . Compie4e form by cheGung off specific topics and/or hazards <br /> ■ obtain signalures Imm all GTI slab and GTI subcontractors <br /> IL Follow-up on any noted rterns and document resolulion of any action nems <br />