Sample-SWMS
Sample-SWMS
Business Address:
Permits Will permits be required? ☐ Yes ☐ No (Refer to local site requirements on permit conditions) (Please tick relevant permits)
Lift Plan
Work Box Excavation/Penetration Working at Heights Powerline Corridor
Activities that
Activities that require Activities that require Activities that require Activities within 10m
☐ require non- ☐ use of a work box with ☐ excavation or penetration ☒ working near an ☐ (30ft) powerline
standard or a crane into walls unprotected edge corridor
significant crane lifts
Fixed Floor & Guard
Land Disturbance
Rail Removal
Activities that require
☐ Activities that require ☐ the clearing of land or ☐ Other Permits:
removal of fixed floor,
vegetation
guardrail, and walls
Fatality Risk (Please tick any of the following activities that will be undertaken as part of the task. Refer to group procedures for specific requirements)
Surface Confined Light
Lifting Working at Plant
☐ ☐ Mobile ☐ Space ☐ Vehicle ☐ ☐ ☐ Aviation
Operations Heights Isolation
Equipment Entry Operation
Line of Fire (Mark areas of body exposed to ”line of fire”) Personal Protective Equipment (In addition to mandatory site PPE please tick required PPE)
Hearing
☒ Manadatory PPE ☒ Hard Hat ☐ Protection
High Other:
Splash Buoyancy Fall
☐ Whole Body ☐ Suit ☐ Vest ☐ Voltage ☒ Arrest
Equipment
Project Name: Double click to add project name. This SWMS covers the general hazards associated with Working in Ceiling Spaces.
Project Address: Double click to add project address.
involves a risk of a person falling more than 2 meters. is carried out on or near pressurised gas mains or piping.
is carried out on a telecommunication tower. is carried out on or near chemical, fuel, or refrigerant lines.
involves demolition of an element of a structure that is load bearing. is carried out on or near energised electrical installations or services.
involves demolition of an element related to the physical integrity of a structure. is carried out in an area that may have a contaminated or flammable atmosphere.
involves structural alteration or repair that requires temporary support to prevent collapse. is carried out on, in or adjacent to a road, railway, shipping lane or other traffic corridor.
is carried out in or near a confined space. is carried out in an area of a workplace where there is any movement of powered mobile plant.
is carried out in/near a shaft or trench deeper than 1.5m or tunnel involving use of explosives. is carried out in areas with artificial extremes of temperature.
is carried out in or near water or other liquid that involves a risk of drowning. involves diving work.
Ensure workers are trained and have relevant qualifications and experience to complete the
tasks required.
All workers are appraised for licences or certification of competency before work can
commence.
2.Site Personnel Site safety induction to be completed for all construction personnel including check of
induction/arrival to unaware of site- qualifications, an evacuation plan, identification of site-specific hazards, trade activities and
site specific hazards amenities. If identified hazards or activities will affect planned works, they must be
and unfamiliar added to this document with relevant control measures at time of induction.
with work area All personnel including subcontractors must have completed the General Construction
or unqualified Induction Training and hold a current card or certification.
A site-specific induction must be conducted for ALL project workers. Workers must sign a
Site Induction Register that includes:
o Site specific hazards and work to be carried out.
o Location of amenities and first aid facilities.
o Safety controls and revised Safe Work Method Statements (SWMS).
o Correct use and maintenance of appropriate PPE.
o Emergency and evacuation procedures.
3.PPE (Personal Excessive noise PPE must be suitable for the nature of the work or hazard and must be suitable size and fit for
Protective levels - damage the individual.
Equipment) to hearing PPE must be maintained, repaired, or replaced and must be clean and in serviceable
condition.
Ensure all workers are issued with and wear the recommended PPE as necessary for safety
Dust and fumes on the worksite and specific to the relevant task.
Avoid using any PPE which is damaged, defective, or unclean. NEVER start work until
appropriate PPE has been obtained.
4.Working at heights Falls from A minimum of two competent personnel is to be present when working at height.
heights Provide edge protection to prevent objects falling off work surfaces.
Make sure fall arrest systems are in place when working at heights.
Falling objects Only competent persons must install all systems.
To prevent access to areas where objects may fall, barricades may be used.
Unauthorised On sites where falling objects may occur, wearing hardhats is recommended.
persons Erect signage below the overhead work warning of potential Hit by Falling Objects.
entering site Ensure all access ladders, steps and ramps are safe and secure.
Always maintain a safe distance from electric catenary wires.
Personnel injury Always wear appropriate footwear, hardhats when working below work at heights.
Ensure personnel have appropriate training.
Provide safe means of raising, lowering, and storing tools and materials.
Refer to Working at heights SWMS.