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Toolbox Meeting Form

This document outlines the hazard identification and risk management process for a work activity. It contains three sections: Section 1 involves identifying potential hazards from different energy sources. Section 2 involves assessing specific risks related to the task such as lifting, manual handling, working at heights, etc. Section 3 involves breaking the task into steps and identifying controls for each hazard. The summary confirms that all risks have been identified and appropriate controls put in place before commencing the work. Personnel must review the risks, wear PPE, follow procedures and stop work if hazards change.

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Benjamin Aregbesola
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© Attribution Non-Commercial (BY-NC)
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Download as PPT, PDF, TXT or read online on Scribd
964 views

Toolbox Meeting Form

This document outlines the hazard identification and risk management process for a work activity. It contains three sections: Section 1 involves identifying potential hazards from different energy sources. Section 2 involves assessing specific risks related to the task such as lifting, manual handling, working at heights, etc. Section 3 involves breaking the task into steps and identifying controls for each hazard. The summary confirms that all risks have been identified and appropriate controls put in place before commencing the work. Personnel must review the risks, wear PPE, follow procedures and stop work if hazards change.

Uploaded by

Benjamin Aregbesola
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Section 4

Hazard /Risk Management


Can all personnel in the group answer YES to the following questions? If yes, Tick the box
Are all the steps required to carry out each task in today's activity reviewed in the TBM risk assessment, (the TBM Task hazard analysis)? Are all the hazards identified in each step included in the SECTION 3 of this JHA-TBM form? Have control measures been identified for each hazard? Are action parties for implementing each control measures identified, and ALL the controls in place? Are the appropriate HSE tools/equipment available, adequate, functional and in the right place? Have all the work party received the required trainings, and are wearing appropriate PPE for the tasks to be performed? Are all the relevant procedures, permits, etc communicated to and understood by the work party? Have the other people on this site, adjacent and/or impacting sites been informed of this job and the content of the permit?. Are all the work party aware that any changes in the work plan should be communicated to everyone involved in the work? Is the work party aware of the emergency measures and equipment locations, such as egress, alarms, portable fire fighting equipment and spill kits? Is the worksite clean, tidy and in a manner fit to commence the work activity and is time allowed for cleaning after the days work? Have all isolations been identified, implemented and checked by supervisor and workparty, if applicable? Have all working at height and confined space risks, access /egress route been addressed?? Is the work site safe to start work, all isolations confirmed, Gas test done and warning signs in place? Are past incidents, including HIRs, nearmisses and Learning from incidents (LFIs) related to this job discussed and applicable learning understood?

Section 2
Hazard /Risk Identification
Will the work involve any of the following? Y N
Use of lifting equipment. If yes is the lifting plan developed and available on site? Has the lifting plan been read and understood by the lifting party Manual handling - moving or carrying objects/tools with significant risk of injury? if yes, is the manual handling assessment done? Working with or near an object/equipment that may move or potentially dangerous (e.g rotating part, live plant) Working with equipment or connections under pressure Working in a confine space Working in an area with poor visibility (lighting or tight) or weather Working in an area where personnel can trip, slip or fall Personnel who are new (to the operation/team) or yet to undergone the required trainings Potential for in/flammable liquid and/or gas (e.g Crude oil, fuel, condensate) Potential for environmental impact (Spill, waste, emission) peculiar to the job location Concurrent operations and potential conflict with adjacent work places or work parties

Y N

Section 1 Toolbox Meeting Risk Identification Card


Facility/Project:. Location:. Task: Date/Time:.. PTW No: Attendee: member of work party
Names/Signature Names/Signature

Potential Hazards from Energy sources:


Motion Energy Sources Chemical Energy Sources (incl. dangerous goods or substances hazardous to health/environment) Radiation Energy Sources Electrical Energy Sources (Static or current) Pressure Energy Sources Biological Energy Sources Heat/Cold Energy Sources Gravity Energy Sources - (Incl. dropped objects, working at height or over side)

1 -------------------------2 -------------------------3 -------------------------4 -------------------------5 -------------------------6 -------------------------7 -------------------------8 -------------------------9 -------------------------10 --------------------------

11 12 13 14 15 16 17 18 19 20

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

If the answer to any of these questions is NO, then the hazards must be re-assessed in section 3 The supervisor should confirm the understanding of the group by asking open questions on the above points

If yes, the work may be hazardous and care should be taken to ensure the work is done safely
Remember you are responsible for your safety and that of the others, know the hazards, use the right tool, wear the right PPE and comply with all the HSE requirements.

TBM Leader:____________________________ Reviewed by: Permit Holder : ___________________and/or Contractor Supervisor : _________________ Asset Holder Site Supervisor:_____________ Action required: Update Work method statement: Yes/No ___ Update Plans/Procedures/JHA:Yes/No _____ Feedback/Others: _____________________ ______________________________________ ______________________________________

AT THE END OF EACH WORKING SHIFT, THE WORK AREA MUST BE LEFT IN A CLEAN AND TIDY MANNER

Section 3
(This section should be used to summarise the key points of the relevant risks identified during the teams discussion)

Tool Box Meeting Task Hazard Analysis


Hazard/Threat
(Review each step to find out what could go wrong?)

Task to be carried out: (The task should be a part/section of the job planned for the day)
Task Breakdown
(Break the tasks into basic steps, use active verbs)

Controls
(How can the hazard be prevented from being released?)

Responsible Person To take Action

Controls in Place

Yes

No

Step 1:

Step 2:

Step 3:

Step 4:

Step 5: Step 6:

Step 7:

Step 8:

Step 9:

Step 10:

Remember sources of energy : Motion, Chemical, Radiation, Electrical, Gravity, Heat/Cold, Biological, Pressure
Know your Emergency Response procedure, Emergency Telephone number ______________, and the Location of nearest Telephone:________________ *IN THE EVENT OF AN ACCIDENT: STOP THE JOB, INFORM YOUR SUPERVISOR, CONTACT CSR/MEDIC, GIVE 1ST AID IF REQUIRED*

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