Safe Work Method Statement

Project Name: Sandvik Asia Pvt Ltd

Company Name: Architects Evolution Activity/Trade: Carpentry Work

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Vehicle movement at site Improper horn M  Vehicle & Driver license should be check. Project
Over speed  Speed limits should be only 10 Kmph while entering manager/
Untrained drive Project in
in gate.
charge.
Pinch point, STF  Stopper must be use.
Over load  Vehicle parking should be designed near entry gate.
 PPEs. safety helmet, safety shoes should be wear
driver while entry in material gate.
 Safety induction should be conducted.
 Horn should be proper.
 ID Card must be carried.
 Seat belt & side mirror should be proper.
 Ensure no use of mobile phone while driving.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Mobilization of Man power Unskilled person, personal injury, M  Medical& physical fit workers shall be deploying for Project
property damage manager/
this activity.
Project in
 Health check-up must be done prior to enter the site. charge.
 Safety induction & site safety rules & regulation shall
be done prior to enter the site.
 Mandatory & required PPEs shall be used by all
workers.
 Gate pass for all the worker & staff shall be provided.
 Tool box talk shall be conduct before start the
activity.
 Take work permit before start the activity.
 Job specific training must be conducted.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Material Handling Improper Handling H  Work permit must be taken prior to start the Project
Fall of material  Ensure Training on manual material shifting to manager/
Fall of person Project in
workers by concern supervisors.
charge.
Improper Communication  Ensure all the person will properly have trained.
Minor injuries  Ensure PPE`s like hand Gloves, shoulder pad.
Serious injury
 Keep safe access & egress clean, neat & tidy

 Proper stacking of materials

 Use of appropriate PPEs such as nose mask, safety
goggles, rubber hand gloves, safety shoes, helmet,
etc.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Storage of material Placing near access M  Ensure the material should be placed on the safe Project
Falling hazard area. manager/
Project in
Improper communication  Ensure no material should be stacked in access.
charge.
Personal Injuries  Material storage related safety poster should be
Improper illumination display at location.
 Keep safe access & egress clean, neat.

 Fire extinguisher must be display in storage area.

 Proper illumination should be available in store area.
 PPEs- Safety helmet, Shoe, Shoulder pad, Hand
gloves.
 Do not stack material in access.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Use of power tools [Drill Improper use of Electrical tools H  All workmen trained to spot and report any defective Project
machine, Cutter machine, Fly particles plugs, discolored sockets or damaged manager/
hammer machine etc.] Defective power tools cable/equipment to manager. Project in
charge.
Non guarded rotating parts  Use licensed electricians for electrical work.
Eye injury  Make sure socket outlets are protected by a safety
Respiratory diseases switch.
Electrical shock  Keep electrical equipment away from water and
Electrical short circuit other liquids.
 Make sure turning off the equipment will not harm
another worker.
 Make sure all moving parts have stopped before
touching the machine.
 Identify and turn off (or disconnect) all sources of
energy.
 PPEs like – Safety shoe, Helmet, Hand gloves etc.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Aluminum framing work M  Only trained, authorized staff allowed to work at Project
Fall of material, man from height height. manager/
Project in
Unsafe tools  Use of fall prevention mechanism such as safety net,
charge.
Slip, trip Falling hazard safety harness, etc. wherever required.
Incorrect methods of Manual Task  Use of appropriate PPEs such as safety shoes, hard
hats, etc.
• Securing or safe keeping, as appropriate, of
working tools, material, equipment, etc. to be used
while working.
 Training / briefing of workmen on working at height
and use of all the above.
 Inspect the scaffolding/ladder before using it to
ensure that no parts are broken, cracked, or missing.
 Train workers in the safe use of equipment/devices.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

M  Use of appropriate PPEs such as safety shoes, hard Project

Aluminum Profile hats, etc. manager/
• Securing or safe keeping, as appropriate, of Project in
Defective power tools charge.
working tools, material, equipment, etc. to be used
Untrained/ unskilled workers
while working.
Defective hand tools
 Training / briefing of workmen on working at height
Slip, trip & fall.
and use of all the above.
Cut injury
 Inspect the scaffolding/ladder before using it to
Falling partition
ensure that no parts are broken, cracked, or missing.
 Train workers in the safe use of equipment/devices.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

M  Use of PPEs such as nose mask, cotton hand gloves. Project

 Keep safe access & egress clean, neat & tidy manager/
Project in
Door Fixing  Proper stacking of partition and at door locations
charge.
 Make sure all moving parts have stopped before
Fall of material, man from height
touching the machine.
Unsafe tools
 Identify and turn off (or disconnect) all sources of
Slip, trip Falling hazard
energy.
Incorrect methods of Manual Task

M  PPEs like – Safety shoe, Helmet, Hand gloves etc. Project

 Training / briefing of workmen on working at height manager/
Laminate Paneling Slip, trip & fall. Project in
and use of all the above.
Cut injury Unsafe tools charge.
 Inspect the scaffolding/ladder before using it to
Incorrect methods of Manual Task
ensure that no parts are broken, cracked, or missing.
 Train workers in the safe use of equipment/devices.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

M  Work permit must be taken prior to start the work. Project

 Ensure Training on manual material shifting to manager/
Project in
workers by concern supervisors.
Fall of material, man from height charge.
Pelmet Fixing  Keep safe access & egress clean, neat & tidy
Unsafe tools
 Proper stacking of partition and at appropriate
Slip, trip Falling hazard
locations
Incorrect methods of Manual Task
 Scaffolding or ladder should be check before use.
 Do not use handmade tools .

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Ply Paneling Untrained/ unskilled workers H  Use of PPEs such as nose mask, cotton hand gloves, Project
Defective hand tools face shield, hard hat manager/
Project in
Slip, trip & fall.  Keep safe access & egress clean, neat & tidy
charge.
Cut injury  Proper stacking of partition and at appropriate
Falling partition locations
Handling of Partition.  Scaffolding or ladder should be check before use.
 Do not use handmade tools
 Only trained, authorized staff allowed to work at
height.
 Securing or safe keeping, as appropriate, of working
tools, material, equipment, etc. to be used while
working.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

M  Use of PPEs such as nose mask, cotton hand gloves. Project

 Keep safe access & egress clean, neat & tidy manager/
Project in
Loose Furniture Fixing  Proper stacking of partition and at appropriate
Unsafe tools charge.
locations
Slip, trip Falling hazard
 Adequate supervision ensured by providing a
Incorrect methods of Manual Task
dedicated site supervisor / safety officer or frequent
site visit by supervisor / safety officer.
 Proper stacking of materials

Fixing of Aluminum framing Handling of Partition M  Use of PPEs such as nose mask, cotton hand gloves, Project
Defective power tools face shield, hard hat manager/
Project in
Untrained/ unskilled workers  Keep safe access & egress clean, neat & tidy
charge.
Defective hand tools  Proper stacking of partition and at appropriate
Slip, trip & fall. locations
Cut injury  Scaffolding or ladder should be check before use.
Falling partition  Do not use handmade tools

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Working at height Fall of person H  Work at height Training should conducted before Project
Fall of material starting job. manager/
Project in
Slip and trip hazard.  Only trained, authorized worker allowed to work at
charge.
Minor injuries height
Serious injuries  Use of fall prevention mechanism such as safety
harness, etc. wherever required.
 Use of fall protection devices such as temporary
work platforms or scaffolding, wherever possible.
 Use of appropriate PPEs such as safety shoes, hard
hats, hand gloves etc.
 Securing or safe keeping, as appropriate, of working.
 tools, material, equipment, etc. to be used while
working.
 Training / briefing of workmen on working at height
and use of all the above.
 Inspect the scaffolding/ladder before using it to
ensure that no parts are broken, cracked, or missing.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

 Climb with both hands. If you need a tool or .

materials, climb first and then have someone pass
the item to you
 Make sure you place the scaffold on a firm, level
surface.
 Mid rail, top rail & toe guard must be provided.
Carpentry Work Inadequate supervision of work / area M  Adequate supervision ensured by providing a Project
Hearing problem dedicated site supervisor / safety officer or frequent manager/
Poor illumination site visit by supervisor / safety officer. Project in
charge
Electrical shock  Site safety inspection to be done at regular intervals.
Slip and trip
Fire hazard

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Vinyl Flooring Installation Slip, trip & fall. M  Work permit must be taken prior to start the work. Project
Cut injury Unsafe tools  Ensure Training on manual material shifting to manager/
Project in
Incorrect methods of Manual Task workers by concern supervisors.
charge
Electrical shock  Keep safe access & egress clean, neat & tidy
Fire hazard  Do not use handmade tools.
Cut & joint cables should be avoided from the site
 Electrical cable should overhead.
 Co2 type fire extinguisher should be available near
workplace.
Cutter machine Hearing problem H  Suitable hearing protectors provide for all workman. Project
Drill machine Poor illumination  Staff trained in risks of noise exposer. manager/
Project in
Breaker machine Electrical shock  Staff trained in systems of work to reduce noise
charge
Hammer machine Slip and trip exposer.
Fire hazard  Eliminate or replace noisy equipment.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

Distribution board used at site. Untrained/ unskilled workers H  Ensure license holder electrician should be allowed. Project
Defective hand tools  All electrical work should be done by electrician only. manager/
Project in
Poor illumination  Ensure TBT conducted before starting the activity.
charge
Electrical shock  Cut & joint cables should be avoided from the site
Slip and trip and ELCB/RCCB should be provided on Sub D. B’s.
Fire hazard  Proper illumination should be providing.
 PPEs- Safety shoe, rubber hand gloves etc.
 Co2 type fire extinguisher should be available near
workplace.

Temporary Electrical cable Unsafe Electrical cable joints H  Cut & joint cables should be avoided from the site Project
laying. Unsafe Electrical cable laying and ELCB/RCCB should be provided at site. manager/
Voltage fluctuation  Welding machines and grinding cables should not be Project in
charge
Electrical Shock mingling with each other.
Electrical Short circuit  MCB/ELCB should be provided on the main panel to
Fire hazard avoid the short circuit.
 Electrical cable should overhead.
 Co2 type fire extinguisher should be available near
workplace.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Person
Procedure (in steps) Possible Hazards Risk Control Measures
who will
(Break the job down into steps. (Identify the hazards associated with each Rating (Describe what action or procedure will be taken to eliminate or
Each step should accomplish some step. Examine each to find possibilities that (See minimise the risk of injury or damage. Use the Hierarchy of ensure this
Controls below as a guide happens
major task and be in logical could lead to an accident or potential harm below)
sequence.) arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
7.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
 Safe Work Method Statement

Personnel Summary
SUPERVISOR’S DETAILS

Supervisor’s Responsibilities: In addition to the above, the supervisor is to provide training in the use of this SWMS, issue PPE and provide training in the same, supervise the
work, ensure conformity with this SWMS, amend the SWMS when additional hazards are found (and if applicable, ensure all workers receive a
tool-box talk to discuss the control measures for the additional hazards).

DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: All workers must have successfully completed industry induction training

WORK ACTIVITY TRAINING: All workers need to have been trained in the activities outlined in this safe work method statement.

SITE INDUCTION: All workers are to be site inducted by the Principal Contractor, prior to commencing work on site.

OTHER: (List other training undertaken by workers): (eg: Confined Space, Manual Handling, Traffic Control etc)

PERMITS or LICENCES REQUIRED to undertake this work (ie. Certificates of Competency, Confined Spaces etc):

N.B. - Copies of the above must be shown to the Principal Contractor during site induction.

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

All work to comply with the location H&S Acts and Regulations and amendments, Workplace Injury Management & Workers Compensation Acts

Additional Codes and Standards applicable to this trade:

 Safe Work Method Statement

We agree that we have been consulted in the hazards and control measures and agree to complete the work in accordance with our Safe Work
Method Statement (SWMS).
We have been provided with training in all tasks outlined in our SWMS and in the Codes of Practice applicable to our work.

Employee / Worker Signature Date Employee / Worker Signature Date

1. 8.
/ / / /
2. / / 9. / /
3. / / 10. / /
4. / / 11. / /
5. / / 12. / /
6. / / 13. / /

Reviewed by: Signature: Date:

(Principal Contractor’s Representative)

Any changes, additions or deletions made to this SWMS are to be covered with the above personnel and the Principal Contractors representative at a
Toolbox meeting (Record date and time of Toolbox meeting below):

Date: Time:
Comments:

A copy of the Toolbox Meeting must be attached to this SWMS.