APS Infrastructure Tailboard Form

Tailboard Conducted By:

People in attendance

Communicator

Fatigue Monitor

Please read out loud

1. Maintain a questioning attitude

2. Use the Self Check Technique STAR: Stop, Think, Act, Review

3. Contact your supervisor or Operations if you recognize conditions that are out of process, procedure or parameters

4. Intiate timely corrective actions for safety or equipment concerns.

5. Understand risk to personnel and equipment; DO NOT proceed when uncertain!

6. Changes in work scope shall NOT be performed without an understanding of potential changes to risk. Additional job briefing is required for changes to work scope.

7. Maintain a high standard for housekeeping.

Key Questions

What are the likely Human Error Situtations?

What are the Hazard / Worst case secenarios?

What safe work practices will we rely on?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Site Phone #

Area CodePhone Number

What is your Evacuation Plan in case of Emergency?

Any additional Requirements?

What items of PPE will be needed for this Job?

Are there any additional PPE Items Required?

Reasons for Post Job Critique?

Were there any problems with this Assignment?

What can be done to improve this Task?

Any additional Comments/ Details

Signature of the Person Completing this Tail board form

Pre Tailboard Questions

Fundamentals

Contact information

Evacuation PLan

CIP Regulatory Awareness

RISK Review

PPE Items Needed Prior to work Start

Post Job Critique

Areas for Improvement?