Insert name SAFE WORK METHOD STATEMENT FORM REPRESENTATIVE RESPONSIBLE FOR PREPARATION OF THE SAFE WORK METHOD STATEMENT AND THE DATE SIGNED Signature Date Description of the work to be undertaken Installation of Balustrade Work Site / Office Step by step sequence involved in doing the work (attach additional page if more room is needed to list steps) General planning Workers Presentation to the site Hazardous materials Risk and rating for each step Safety / Environmental Risk Rating Task specific injuries due to inexperience, inadequate consultation or failure to provide appropriate equipment. Slips and foot injuries, injuries to the head Workers using and exposing themselves and the public to risk Safety Controls that will be in place to minimise these hazards/risks eg. the installing of 1.8m cyclone fencing/warning signs/wear respiratory protection/eye protection/isolate electrical services/wear ear muffs. 1 Induct all employees and management, conduct TNA, comply with the required use of all PPE and follow the directions of safety committees and management. 2 Appropriate footwear and head protection must be worn 2 Store all flammable material in safe storage area nominated by the Builder All employees and management are required to read company MSDS Follow all safety recommendations Wear PPE, i.e. gloves, goggles Outdoors Work Transports tools and equipment to work site Exposure to Ultra Violet Light, glare. Skin cancer; sunburn, eye damage. Manual handling causing strains and sprains; injuries such as back damage. Operating Vehicles causing injuries MSDS Kept in Company Safety Pack 2 Workers to wear appropriate clothing, sun glasses and sun screen. 2 Workers will use appropriate manual lifting techniques and utillise mechanical lifting equipment
Access to the site Digging and manual labour Perform heavy physical labour including continuous arm and leg movements. The use of hand and power tools Area around work area cluttered with stored materials and/or rubbish poor housekeeping. Strains and sprains; injuries such as back damage. Insufficient rest periods between jobs. Repetitious Electric shock or electrocution, 2 Keep all areas clear clutter and rubbish. Good housekeeping 2 Correct manual handling procedures to be used Stack material closer to job area. Swap about at repetitious tasks Ensure sufficient rest periods between jobs. 2 Operator will be trained in the use of equipment. All equipment will be checked and tagged. Equipment faulty or damaged will not be used. Clear water around electrical equipment. Earth Leakage Switch will be used on mains supply or portable generator will be used. Extension lead will be secured above work Electrical Equipment Registrar Kept in Company Safety Pack Use of power saw Serious cuts from contact with saw blade 2 All Power saw blade must have guard s and blades in good working condition Power saw Eye damage from 2 All employees must wear appropriate PPE for the task sharp plywood splinters Angle grinder Serious cuts 2 The Angle grinder disk must be guarded and the cutting disk must not be overly worn or damaged Tagged monthly Angle grinder Sparks causing burning and eye damage 3 Wear PPE do not wear combustible material have fire extinguishers available Use Explosive Tool Injury from Shrapnel 3 Operator must hold appropriate competencies Hearing and eye protection must be worn Signs must be displayed Noise Hearing damage 5 If able engineer solution to reduce noise level with quieter tool or temporary sound absorption screen or barrier Wear PPE for the required task Cleans work site by sweeping Dust by cleaning causing breathing difficulties and exposure to silica 2 Wear dust mask where required PPE Employee issue Kept in Company Safety Pack
Task Lighting Use of a Forklift to move materials. Use of step ladders for access Work at Height Insufficient lighting to see hazards Struck by Forklift. Falls Ladder shifts causing a fall Persons falling or dropping tools and equipment causing injuries or death 2 All workers are to ensure appropriate task lighting at work site, contact supervisor for assistance. 2 All operators are to be competent Forklift must use buzzer and flashing light when fitted 1 Use only strong, unpainted, undamaged ladders long enough for the job The base of the ladder is to be approximately one fourth of the ladder's length from verticals The ladder should extend a minimum of one metre beyond the landing place Make sure the ladder is tied off and cannot slip Face the ladder and hold onto the side rails when climbing up or down. Clean mud and greasy substances from boots before using ladders Do not carry tools or materials in your hands when climbing up or down. Do not use electrically conductive ladders around live power cables 1 All work must be preformed using appropriate access to the work area. No persons should work without fall protection. Only competent persons to erect scaffold over 4 meters in height All scaffold must comply with Australian Standards for Scaffolding (AS1576)
Passing tools and material Secure work areas Wearing fall protection equipment Removing hand rails and installing balustrade Tools and material falling on persons below Materials falling to ground injuring persons Injuries due to incorrect fitting or use of fall protection equipment Persons falling causing death or injury 3 Do not throw tools and materials always ensure area below is secured from persons entering any potential drop areas 3 All areas beneath work location to be taped off restricting access while work above is preformed 3 All persons must be instructed in fitting and use of fall protection equipment 2 All workers are to wear fall protection devices and be connected to approved safety line system when preforming duties in areas without appropriate mechanical fall protection during installation process Penetrations, hand rails and kick boards Falls and objects dropping 3 All areas of potential risk for falls or objects dropping must be fitted with hand rails, kick boards and penetrations must be covered and covers must be fixed appropriately (dynabolts) with the covering marked as penetration cover (yellow painted stripes) Oxyacetylene equipment Burns or fire 3 Regulators, hoses, torches and bottles must be in good working condition. All equipment must be fitted with gas fuses located on the regulators. Bottles must be secured in a truck and fire extinguisher must be present. PPE including goggles, gloves and apron shall be worn. Hot work must be isolated from persons accidentally making contact and sustaining burns. List all Codes of Practice, Legislation, Standards applicable to the work and details of where these are kept OH&S Act & Regs 2000/2001 Code of Practice for Formwork Code of Practice Electrical Practices for Construction Work Code of Practice for the Control of Hazardous Substances Code of Practice for Manual Handling
RISK ASSESSMENT RECKONER HOW BAD IS IT LIKELY TO BE? ++ Very likely: could happen at any time HOW LIKELY IS IT TO BE THAT BAD? + Likely: Unlikely: could happen some time could happen, but very rarely Very unlikely: could happen but probably never will Kill or cause permanent 1 1 2 3 disability or ill health Long term illness or serious 1 2 3 4 injury!!! Medical attention and several 2 3 4 5 days off work!! First aid needed! 3 4 5 6 (Adapted from WorkCover NSW HAZPACK Worksheet) Please identify the risk involved and place the rating number in the Rating Column on page 1. The numbers show you how important it is to do something. i.e. ratings 1-3 are to be considered high risk, 4-6 are low risk. Environmental risks are to be listed on page 1 but a rating is not required for these risks.
Provide a description of what training is given to people involved with the work List the names and qualifications of those responsible for training them Identify the plant and equipment that will most likely be used on site eg. ladders, scaffolds, grinders, electrical leads, welding machines, fire extinguishers, manual handling aids List the details of the inspection and maintenance checks that will be or have been carried out on the plant and equipment Signatures of staff who have read and understand the work activities described in the Safe Work Method Statement List the names of person(s) responsible for supervising/inspecting work Person(s) responsible for site supervision of the work, inspecting and approving work areas, compliance with SWMS, protective measures, plant, equipment and power tools Name: Position: Signature: