HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Site / Station Name Location
Program Project Manager
Month Permit Holder
COMPULSORY TOPICS
Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Project Detail / Progress
Target of Completion
12 Life Saving Rules
Shell Golden Rules
(Comply, Intervene, Respect)
Shell Goal Zero –
No harm, no leak
(Competence, Assurance, Culture)
Blue Board Training
Permit Holder Signature
COMPULSORY TOPICS
Date 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Project Detail / Progress
Target of Completion
12 Life Saving Rules
Shell Golden Rules
(Comply, Intervene, Respect)
Shell Goal Zero –
No harm, no leak
(Competence, Assurance,
Culture)
Blue Board Training
Permit Holder Signature
ADDITIONAL TOPICS FOR ACTIVITY RELATED
Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Working at Height
Lifting / Critical Lift
Confined Space
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Excavation
LOTTO
(Electrical / Pressure)
Hot Work
Chemical Handling
Personal Protective
Equipment (PPE)
Housekeeping
Traffic Management
Emergency Response &
Evacuation Route
Others:
1.
2.
3.
Permit Holder Signature
Comments:
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
ADDITIONAL TOPICS FOR ACTIVITY RELATED
Date 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Working at Height
Lifting / Critical Lift
Confined Space
Excavation
LOTOTO
(Electrical / Pressure)
Hot Work
Chemical Handling
Personal Protective
Equipment (PPE)
Housekeeping
Traffic Management
Emergency Response &
Evacuation Route
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Others:
1.
2.
3.
Permit Holder Signature
Comments:
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Toolbox Attendance
Permit CBRE / Date
Name CIDB
Validity 6HRT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Total Attendee
Permit Holder Authorisation
Toolbox Attendance
Permit CBRE / Date
Name CIDB
Validity 6HRT 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
HSE-CHECKLIST-TB-REV00
Toolbox / Pre-Task Talk Form
Total Attendee
Permit Holder Authorisation
● Toolbox / Pre-Task Briefing is not Safety Briefing. The topic should cover work activity related, target of achievement, quality control, hazards, and risk control
measure to ensure smooth operation.
