SAFE WORK METHOD STATEMENT

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1 COMPANY DETAILS: Company Name Address CLIENT DETAILS: Principal contractor Contact name Phone no. Mobile: Phone no. Mobile: Works manager Contact no.: Project/owner name Work activity Scope of work covered by this SWMS Work location The Sample Safe Work Method Statement (SWMS) outlines the precautions to be taken to ensure the health and safety... INSTRUCTIONS FOR SWMS A safe work method statement (SWMS) must be prepared for any and all high risk construction work to be undertaken prior to the work commencing. All high risk construction work must be carried out in accordance with this SWMS. This SWMS must be kept and be available for inspection until the high risk construction work to which this SWMS relates is completed. If the SWMS is revised, all versions should be kept. If a notifiable incident occurs in relation to the high risk construction work in this SWMS, the SWMS must be kept for at least 2 years from the date of the notifiable incident. High risk construction work activities (Check any that are applicable to this site) (A SWMS is required for all high risk work activities) Demolition of a load-bearing structure Work on a telecommunications tower Work in or near a shaft or trench with an excavated depth over 1.5m; or in a tunnel Work involving the use of explosives Work on or near chemical, fuel or refrigerant lines The disturbance of or likely disturbance of asbestos Tilt-up or precast concrete Work in an area in which there are artificial extremes Work on or near energised electrical installations or services Work carried out in or near a confined space PERSONAL PROTECTIVE CLOTHING AND EQUIPMENT (PPE) REQUIRED (Required PPE is highlighted). Ensure all workers have required PPE before any work requiring the PPE is commenced. Work in an area that may have a contaminated or flammable atmosphere of temperature Work on, under or near water or other liquid that involves a risk of drowning Site-specific considerations NOTE: This is a generic SWMS. A generic SWMS may be prepared and used for high risk construction work activities that are carried out on a regular basis; however, the generic SWMS must be reviewed by the person carrying out the work to take into account the hazards and risks for the specific workplace and amend the SWMS as necessary for the site where the work is to be carried out, and complete details such as names and qualifications of workers who will carry out the work. All amendments to the SWMS must conform to regulatory requirements and be recorded on the SWMS. Workers and their health and safety representatives (if any) should be consulted before the generic SWMS or toolbox talks. Details of consultation with workers and instruction in the SWMS must be recorded on the SWMS for that project or site. All workers are required to sign-off on the SWMS before the work is commenced.

2 SWMS approved by Name: Sign.: Person responsible for ensuring compliance with SWMS Implementation of SWMS Date issued: How will the SWMS be communicated to workers? Inductions Pre-start meetings Review of SWMS How and when will SWMS control measures be reviewed? Person responsible Name: Sign.: Person responsible Name: Sign.: Have workers been consulted about this SWMS? Yes No Details of licenses, competencies and qualifications of persons who will carry out work Workers consulted Signature Date Class Type/description Worker s name Number All workers must sign below before commencing work covered by this SWMS: I have been instructed in and fully understand the content of this SWMS Worker s name Signature Date Worker s name Signature Date RISK CALCULATOR Expected likelihood of an incident occurring Risk level and management actions required Likely outcome of an incident Unlikely Likely Very likely Risk Level Action required to control risk Serious injury or death; major environmental impact High risk Urgent action required to control risk Time off work, major damage; moderate environmental impact First aid injury, minor damage; negligible or minor environmental impact LOW Medium risk Ensure listed controls are implemented LOW LOW LOW Low risk Monitor task and existing controls Untrained workers All persons working on a construction site must hold a General Construction Induction (GCI) card. Refer to SWMS Inductions and Training (Construction Work)

3 Site establishment and security Site protocols Unauthorised entry to site Carry out site-specific inductions for all workers. All workers must be competent in the tasks carried out. Vehicles, plant and equipment must only be operated by licensed or competent persons. Refer to SWMS Inductions and Training (High Risk Work) Safety of other persons Provide safe access for persons past work site. Keep pedestrian paths clear of obstacles, trip or slip hazards, and holes, etc., on footpath. Ensure that occupants and other persons are clear before allowing plant or vehicles to cross footpath. Site amenities Ensure that adequate amenities for the health and hygiene of workers are available. Provide amenities if unable to access household amenities. Locate chemical toilets in locations where they will not create nuisance odours. Provide adequate supplies of consumables (soap, toilet paper and paper towels) for workers. Chemical toilets are to be serviced weekly. First aid Injury to workers Untrained workers All persons operating mobile plant for which a high risk license is not required must be trained in the safe use of the plant. Operators should have successfully completed a recognised training course provided by a RTO and have been assessed as competent in the operation of the plant. Plant must not be used for any other purpose that for it was designed and intended.

4 Electric shock Refer to SWMS for the specific plant being used. Collision Keep clear of mobile plant in operation. Use traffic control where risk of collision is present. Safety of scaffolds Exemption Mobile tower scaffolds from which a person or object can fall more than 4 metres must be erected, altered and dismantled by or under the direct supervision of a licensed scaffolder. Safety of scaffolds (continued) Electrocution Ensure that unauthorised access to scaffolds is prevented when scaffolds have to be left unattended. Remove ladders to discourage entry by children. Consult with property owner or occupier to ensure that access prohibition is understood and to assist in ensuring that unauthorised access to scaffold is not attempted. Underground services Hazardous manual tasks Strains, personal injury Identify any underground services and their locations before commencing excavation work. Use non-destructive excavation methods to locate all services before excavation is commenced. Report any damage to underground services immediately and leave excavation open for inspection. Refer to SWMS Location of Underground Assets. Protection of persons and property Provide dust control where dust generated during work could spread to adjoining areas. Sweep up dust and vacuum area to remove dust. Wipe down wails and surfaces with damp cloth before vacating area.

5 Protection of persons and property (continued) Noise Use of chemicals Slips, trips and falls Prevent access into areas where hazardous materials (e.g., asbestos, synthetic mineral fibres, etc.) may be present. Ensure that areas are decontaminated and cleaned thoroughly before allowing re-entry or re-occupancy of the area. Vehicles and plant Do not leave tools, materials or equipment in areas where they could be accessed by persons at risk. Secure area where risks are present when area is unattended. Return all areas where occupation will occur to a safe condition at completion of work. Ensure that all materials are stored in a manner to prevent access to hazardous substances, rough or sharp edges, or falling objects. Securely cover materials where practicable. Slips, trips and falls of persons Review No Signature Date