Contractor OHS Non Conformance Report: Safe Work Method Statement
Contractor OHS Non Conformance Report: Safe Work Method Statement
Completion of
Confined Space Yes N/A (n/a should only be selected
High risk job description
Entry Permit? when not working in a confined space)
Gloves Face mask Eye protection Welding mask Appropriate Hearing protection Protective clothing
footwear
What are the tasks involved? What are the hazards and risks? How will hazards and risks be controlled?
Describe the steps required to perform the Against each step list the potential hazards that List the control measure required to eliminate
task in the sequence they are carried out. could cause injury/damage when the task step is or minimise the risk of injury arising from the
performed. identified hazard, see Contractor Hazard
Identification and Control Table.
Central Office Use Only Issue Date: June 2013 Last Reviewed: November 2017 Next Review Date: November 2019
No: DET ESWB-24-4-4 Authorised By: Manager, ESWU
THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED Page 1 of 3
Contractor OHS Non Conformance Report
I have provided site specific risk controls to manage the hazards identified above and will comply with the controls listed above.
Contractor:
I understand the risk controls listed above to be implemented to manage the identified hazards associated with the works to be undertaken.
Central Office Use Only Issue Date: June 2013 Last Reviewed: November 2017 Next Review Date: November 2019
No: DET ESWB-24-4-4 Authorised By: Manager, ESWU
THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED Page 2 of 3
Contractor OHS Non Conformance Report
Control levels
1. Eliminate any risk to health or safety.
2. Reduce the risk to health or safety by any one or any combination of the following:
Substituting a new activity, procedure, plant, process or substance
Engineering controls, such as mechanical or electrical devices.
3. Use administrative controls, such as changing the way the work is done.
4. Provide appropriate personal protective equipment.
5. All contractors should be briefed on the SWMS before commencing work. Ensure all contractors know that work is to immediately stop if the SWMS
is not being followed.
6. Observe work being carried out. If controls are not adequate, stop the work, review the SWMS, adjust as required and re-brief the team.
7. Retain this SWMS for the duration of the high-risk work.
Central Office Use Only Issue Date: June 2013 Last Reviewed: November 2017 Next Review Date: November 2019
No: DET ESWB-24-4-4 Authorised By: Manager, ESWU
THIS DOCUMENT IS UNCONTROLLED WHEN PRINTED Page 3 of 3