Scribd
Upload
0 views

Safe Work Method Statement Standard Format

The document is a Safe Work Method Statement (SWMS) outlining safety protocols for various hazardous work activities, including coring, demolition, and structural work. It details required personal protective equipment (PPE), potential hazards, risk assessments, and compliance measures. Additionally, it specifies the responsibilities of personnel involved in ensuring adherence to safety standards and the review process for the SWMS.

Uploaded by

skytechengineers.ali01
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
0 views

Safe Work Method Statement Standard Format

The document is a Safe Work Method Statement (SWMS) outlining safety protocols for various hazardous work activities, including coring, demolition, and structural work. It details required personal protective equipment (PPE), potential hazards, risk assessments, and compliance measures. Additionally, it specifies the responsibilities of personnel involved in ensuring adherence to safety standards and the review process for the SWMS.

Uploaded by

skytechengineers.ali01
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 22

Safe Work Method Statement

Project Name:
Company Name:
Engineer Name:
Trade:
Description of work
Hazardous Work Activity:
(Put "Yes" & " No" associated with the relevant work activity)

Coring / Chasing / Cutting (no electrical power in the area)

Roof Access

Demolition / Strip-Out Works (that does not involve disturbing a load bearing structure)

Demobelization

Fire Services

Structural Work (all structural works including steel posts, beams and concrete works)

Works in contaminated or flammable atmospheres / areas.

Hydraulics work (all mains, waste water, sewerage, storm water and hydraulic supply)

Mechanical Work (all works related to air conditioning and lift services; pumps, pipes and ductwork related to other services str

Tick the additional Personal protective equipment (PPE) requirements for the job apart from Safety shoe, Hard hat, H

Safety Goggles Hearing Fall arrest Hand Gloves Welding Helmet Coverall Suit
Hazardous materials: Are hazardous materials to be used(Yes/No)?
Mention Specific controls required as per MSDS:
Permit required (Put Below "Yes", "No")
Permit to work Confined spaces
Hot-work permit Night work permit
Person responsible for ensuring compliance with SWMS:
What measures are in place to ensure compliance with the SWMS?
Person responsible for reviewing the SWMS control measures:
How will the SWMS control measures be reviewed?
(SWMS control measures to be reviewed (and revised if
necessary) if work tasks / methods change or unexpected
issues arise)

Review date:

Safe Work Method Statement


Potential Hazards / Risk
Description of Work Activity
(What might go wrong?)
Slips and trips, unfamiliarity with site layout, fatigue, dehyd
vehicular accidents, medically unfit or ill workers, unskilled
working without medical check-up or site induction.

Manpower Mobilization at Site


Safe Work Method Statement
Potential Hazards / Risk
Description of Work Activity
(What might go wrong?)
Safe Work Method Statement
Workers
I understand and agree to adhere to the contents
ID No Name of Worker
ü
û
Project Address:
Company Address:
Contact No:
Work Location:

Energised electrical installation / services.

Electrical Work including cable tray installation and cable laying etc.

Working at heights (risk of falling more than 2 metres).

Use, transport or storage of chemical, fuel or refrigerant lines.

Works near to or use of moving mobile plant.

Works in or near a confined space.

Tilt-up or precast concrete work.

Works involving traffic corridors or other non-pedestrian traffic.

Works carried out on a tower.

k related to other services structural work)

Safety shoe, Hard hat, Hi-Vis Jacket.


Mention other Job Specific PPE if any;

Coverall Suit
sed(Yes/No)?

Excavation Permit
Height Work Permit
SWMS Monitoring Record

Reviewed during weekly / regular contractor meetings


Reviewer's signature:

Inherent Risk
Hazards / Risk Possi
ht go wrong?) Likelihood Consequences Risk before controls (How do
site layout, fatigue, dehydration,
it or ill workers, unskilled labor,
p or site induction.
Hazards / Risk Inherent Risk Possi
ht go wrong?) Likelihood Consequences Risk before controls (How do
Workers briefed on the hazard associated for the activity and control measures on safe execution
o adhere to the contents of this method statement. I have attended the briefing that explained the safe way to execute the activity
Worker Signature ID No Name of W
Structural alterations / repairs with a potential for structural collapse.

Demolition of a load-bearing element of a structure.

Works in or near a 1.5+ metre shaft / trench (excavation).

Works in or near a tunnel.

Works in areas exposed to extreme temperature.

Works in or near water or other liquids with a risk of drowning.

Construction diving work.

Use of explosives.

Works on or near pressurised gas / piping.

Other (specify)

Emergency arrangement details

Fire/evacuation First Aid Pollution/spill


Is MSDS Available ?

LOTO
Other
Date of SWMS review:

Date SWMS received by reviewer:


Reviewed when scope of work changes

Site Inspection observations

Residual Risk
Possible Control measures.
(How do you stop it going wrong?) Likelihood
Possible Control measures. Residual Risk
(How do you stop it going wrong?) Likelihood
trol measures on safe execution.
d the safe way to execute the activity as per recommended control measures.
Name of Worker Worker Signature
Residual Risk
Consequences Risk after controls
Residual Risk
Consequences Risk after controls
Worker Signature
Х Х
√

Yes
Y No
N
ü
û

You might also like