Business Name:

Business Address: ABN/NZBN:

CONCRETE PILING SAFE WORK METHOD STATEMENT (SWMS)

Business Contact: Phone #: Principal Contractor (PC):
Responsible person (for monitoring SWMS and work): Job address:
Signature: Date: PC Phone #: Date SWMS provided to PC:
Contact Phone #: Contact Phone #:

THIS WORK ACTIVITY INVOLVES THE FOLLOWING HAZARDOUS WORK AND ENVIRONMENTAL IMPACTS

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Electrical equipment Elevated levels Slips, trips and falls Hazardous substances Silica dust:
Hot Work Hazardous manual tasks Outdoor work Remotely &/or isolated work ?

PL
Noise and vibration Native vegetation & weeds Air quality Waste Vehicle movement
Fuels, oils & chemicals Terrestrial fauna Waterways & soils Cultural heritage ?

THIS WORK ACTIVITY INVOLVES THE FOLLOWING “HIGH-RISK CONSTRUCTION WORK” (HRCW - IDENTIFIED IN THE JOB TASK COLUMN)
Confined spaces Mobile plant movement Demolition of a load-bearing structure Asbestos disturbance

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Using explosives Diving work Artificial extremes of temperature Tilt-up or pre-cast concrete
Pressurised gas distribution mains or piping chemical, fuel or refrigerant lines energised electrical installations or services
SA
Structures or buildings involving structural alterations or repairs that require temporary support to prevent collapse
Involves a risk of a person falling from 2m or more, including work on telecommunications towers
Working at depths greater than 1.5 Metres, including tunnels or mines Work in an area that may have a contaminated or flammable atmosphere
Work carried out adjacent to a road, railway or shipping lane, traffic corridor In or near water or other liquid that involves the risk of drowning
FOOT HEARING HIGH HEAD EYE FACE HAND PROTECTIVE BREATHING SUN SAFETY Do not wear rings,
PROTECTION PROTECTION VISIBILITY PROTECTION PROTECTION PROTECTION PROTECTION CLOTHING PROTECTION PROTECTION HARNESS watches or
jewellery that may
become
entangled. Long
and loose hair
must be tied back.

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CONCRETE PILING © SafetyCulture All Rights Reserved ISSUE DATE: REVISION DATE: Page 1 of 14
 Business Name:

Business Address: ABN/NZBN:

LIKELIHOOD INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC

SCORE ACTION
ALMOST CERTAIN 3 - HIGH 3 - HIGH 4 - ACUTE 4 - ACUTE 4 - ACUTE
LIKELY 2 - MODERATE 3 - HIGH 3 - HIGH 4 - ACUTE 4 - ACUTE 4A - ACUTE DO NOT PROCEED.
POSSIBLE 1 - LOW 2 - MODERATE 3 - HIGH 4 - ACUTE 4 - ACUTE 3H - HIGH Review before commencing work.
UNLIKELY 1 - LOW 1 - LOW 2 - MODERATE 3 - HIGH 4 - ACUTE 2M - MODERATE Maintain control measures.
RARE 1 - LOW 1 - LOW 2 - MODERATE 3 - HIGH 3 - HIGH 1L - LOW Record and monitor.
MOST LEAST
HIERARCHY OF CONTROLS EFFECTIVE EFFECTIVE

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RESPONSIBLE
JOB TASK HAZARDS RISK CONTROL MEASURES PERSON

PL
1. Planning Contact with 4A Ÿ Identify the presence of all underground, aboveground or overhead utilities or services at the Supervisor
utilities/services proposed excavation site:
o Dial Before You Dig (Telephone Service 1100) as a minimum
o Site surveys, drawings and plans
Ÿ If identified, ensure the location, clearance distances, alignments and other relevant information
shown on utility drawings for the work.

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Ÿ All details clearly marked on these documents.
Exposure to 4A Ÿ Training and information provided to workers on RCS should include:
silica dust o Information on the health effects associated with respirable crystalline silica dust (Provide
workers with a copy of ‘Health Monitoring for Exposure to Hazardous Chemicals - Guide for
SA
workers’: Safe Work Australia)
o Identification of RCS dust through Material/Safety Datasheet (M/SDS) or labels
o Dust exposure prevention
o Checking controls are working and using them
o When and how to use any respiratory protective equipment provided and what to do if
something goes wrong (Including worker respirator fit and check processes)
2. Arrival on-site Personal injury, 3H Ÿ The vehicle should be positioned in a safe location, clear of traffic/vehicles/pedestrians during Supervisor to
& assess property equipment delivery and materials removal (deploy physical barriers, caution signs as necessary) check the site
onsite damage &/or Ÿ Do not park illegally and conduct
conditions environmental Ÿ Identify and obey all safety-related signage (check site entry requirements) JSA where
incident Ÿ Report to Site Supervisor necessary
Ÿ Ensure site-specific induction undertaken
Ÿ Assess mobile phone reception
Ÿ The worksite is exactly as detailed in Terms of Agreement or contract
Ÿ Complete a JSA specifying the control measures of unanticipated hazards.
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 Business Name:

Business Address: ABN/NZBN:

RESPONSIBLE
JOB TASK HAZARDS RISK CONTROL MEASURES PERSON
Slips, trips and 3H Ÿ Where protrusions are small enough to present a trip hazard, e.g. bolt heads: ensure protrusions followed
falls clearly marked by the use of signage, hazard tape/netting or other means to remain highly visible
by others entering the area.
16. HRCW Unauthorised 3H Ÿ If acceptable, remove or add barricades Supervisor to
On access Ÿ Ensure machine is parked in a safe, level area, clear of unstable or sloping ground confirm all
completion Ÿ Store the key in a safe place (restrict unauthorised access). workers have
signed out
Inhalation of 3H Ÿ Use, maintain and store any respiratory protective equipment provided per instructions.

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silica
Workers to
Security breach 3H Ÿ All personnel sign-out on Site Register.
comply with
Vehicle/people 4A Ÿ Stay to designated access and egress routes controls

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impact Ÿ Maintain awareness of surroundings at all times.
17. Emergency Ÿ Injury 4A Ÿ For police, fire or ambulance call ‘000.’ Ÿ Refer to your SWMS Supervisors
response Ÿ Fatality Ÿ Follow site emergency and evacuation procedures implementing and workers
Ÿ Environmenta Ÿ A communication system is available, e.g. a mobile phone or radio instructions for further ensure
l damage Ÿ Check for dangers to self before helping others specific emergency controls

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Ÿ Maintain control of the area and stabilise the situation responses. followed
Ÿ Apply first aid to the injured worker
Ÿ Complete an incident report.
OVERALL RISK RATING AFTER CONTROLS 1 - LOW 2 - MODERATE 3 - HIGH 4 - ACUTE
SA
PLANT & EQUIPMENT HAZARDOUS SUBSTANCES SUPERVISORY ARRANGEMENTS
Electrical tools and leads Tested and tagged quarterly List hazardous substances taken on-site Audits
and have the SDS on-site.
Hand tools - Meet AS/NZS Regular visual inspection 1. Spot Checks
Ladders - Meet AS/NZS Inspected and tagged out if damaged 2. Reporting systems
3.
Mobile plant-specify Inspected and tagged out if damaged 4. Suitably qualified supervisors for job
? 5. Direct on-site supervision
6.
? 7. Remote site: communication
? 8.
systems/schedule
9.
? 10.
? 11.

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