P HYSICAL P LANT
TOOLBOX / TAILGATE MEETING REPORT
15 minutes/week OR
Time:
30 minutes/2 weeks
Date:
year/month/day
Duration:
Work Unit/Shop:
Topics:
Discussion/Concerns:
Future Topic:
Next Meeting:
Time:
Date:
Recorder:
Please Print Name
Signatures:
Manager:
Worker Rep:
(Please Print Name)
(Please Print Name)
Work Unit/Shop Sign-in Sheet to be on reverse side of this sheet or attached.
Send Copy To:
Physical Plant Safety Coordinator,
– Co-Chairs of Local Area Safety Committee
– Work Unit Files
– Shop/Work Unit Safety
Board