Information

  • Job Name and Number

  • Plan Number and Creator

  • Activity

  • Conducted on

  • Prepared by

  • Location
  • Foreman

Crew Review

SHEMS MMR

  • Check box if you participated in the job site SHEMS Monthly Management Review Meeting OR Project Safety Leadership Team Meeting

  • Comments regarding the review meeting.

  • Photo of sign in sheet

Crew Review

  • 1. Are all of the Crew members signed off on the DHA<br>and participating in the review process?

  • 2. What Safety and Environmental topics did you discuss today during your DHA?

  • 3. Have all relevant inspections and permits for<br>the activity been completed? (Hot work permit,<br>confined space, soil erosion and sediment control, AWP, etc.)

  • 4. What triggers from the CWP were discussed and why were they relevant today?

  • 5. What ongoing safety hazards and potential environmental impacts were discussed with the crew (in association with the activity, work area or job site)?

  • 6. Are there any safety or environmental issues that<br>were discussed (either verbally or written on the DHA)<br>that have not been addressed?

  • Who did you talk to about getting them addressed?

  • 7. Do you feel that the CWP that you have currently and<br>adequately addresses the scope of work & all risks that<br>are relative to your current activities? (What improvements<br>could be made to the CWP)?

  • Any Improvements for CWP?

  • 8. Did crew participate in stretch and flex today?

  • 9. Does the crew have plans such as an inspection or testing today?

  • Has this been reviewed with the crew?

  • 10. Is the crew aware of the procedures in the emergency action plan including in the event of an environmental release? (Are all tools materials and equipment readily available)?

  • 11. Are all appropriate signatures on the CWP? (specifically the Risk Acknowledgment sheet)

Observations

  • PPE

  • Housekeeping

  • Scaffold and ladders

  • Power/Hand tools:

  • Vehicle/Equipment inspection

  • Eye Wash Stations

  • Rebar Exposure

  • HazCom (Labels, Containment, SDS)

  • Fire/Hot work safety

  • Electrical

  • Lock out/Tag out

  • Rigging

  • Excavation

  • Demolition

  • Confined space

  • Fall Protection/Fall Arrest systems

Sign Off

  • Foreman's Signature

  • Auditor's signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.