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  • Safe Work Method Statement Worksheet

    Remember: Each SWMS should be site specific. Include all workers in the development of the SWMS. All workers should sign off to verify that they understand all the requirements of this Safe Work Method Statement.

    Use of Master Builders Generic Safe Work Method Statements

    Disclaimer:

    The Master Builders Association of Victoria expressly disclaim all and any liability to any person in respect of anything, and of consequence of anything done or omitted to be done by any or such person in reliance, whether wholly or partially on this generic safe work method statement.

    Rules for the use of Master Builders generic SWMS

    1. This generic SWMS is provided as a sample. It is not to be used by a builder or subcontractor for the purpose of managing safety on their projects. It can be used as a template to enable builders and subcontractors to produce their own SWMS. Master Builders have carbon copy pads available for sale to enable builders/subcontractors to produce their own SWMS.

    2. Employers intending to use this SWMS as a template for their own SWMS must ensure they consult with their employees,

    including their Health and Safety Representatives, prior to its introduction.

    3. Builders and subcontractors must ensure that their SWMS is relevant to the project at hand. Generic SWMS should not be used unless precautions have been taken to ensure that the document adequately addresses the hazards and risks relevant to each particular project.

    4. Builders and subcontractors intending to use this sample SWMS as a template for their own generic SWMS, without making

    any changes to the detail, must ensure that they adhere to and implement all of the relevant risk controls.

    5. The range of generic SWMS provided by Master Builders are not sufficiently broad enough to cover all hazards or risks encountered by builders and subcontractors. It does not cover the full list of requirements for which SWMS are specifically required under the OHS Construction Regulations. It is important that the builder or subcontractor undertake their own hazard identification and risk control process relevant for each particular task.

    It is highly recommended that persons who are responsible for preparing and reviewing SWMS undertake training so as to understand the process of identifying and controlling risks in the workplace.

  • Safe Work Method Statement Worksheet

    Remember: Each SWMS should be site specific. Include all workers in the development of the SWMS. All workers should sign off to verify that they understand all the requirements of this Safe Work Method Statement.

    Tasks

    List the tasks required to perform the activity in the sequence they are

    carried out.

    Hazards and Risks

    What can harm you - Hazards? What can happen - Risks?

    Risk control measures

    List the control measures required to eliminate or reduce the risk of injury and detail how the control measures will be put in place.

    Who is responsible?

    Write the name of the person responsible (supervisor or above) to implement the

    control measures identified.

    Site induction. Meeting regarding safety and job procedures

    Various Staff will be inducted prior to the commencement of work on all sites. Regular toolbox meetings are also required to discuss issues and review SWMS and procedures for amending as necessary for improvement.

    Inspection for underground services

    Potential that work activities come in contact with possible underground services such as power, gas, water, communication cables etc.

    Ensure relevant service providers have been contacted including dial before you dig, to identify where these services are. The building contractor is to notify and mark these service locations before piling works commence. An excavation permit from the builder may be required.

    Inspection of overhead services.

    Potential that work activities come in contact with overhead services such as power lines, communication cables etc.

    Ensure service providers have been contacted to arrange any permits if necessary. Building contractor is to notify and provide a specified no working zone to contractor if working under power lines etc.

    Traffic management on adjacent roads and upon entry and exit to the site.

    Injury / death to the public. Property damage including damage to vehicles.

    Ensure appropriate and adequate traffic management measures have been established. Workers to be inducted into the traffic management plan so they are familiar with the entry/exit points, site speed limit, etc.

    Providing a clear and safe work area (site setup)

    Injury to the general public. Temporary fencing to be provided by principal contractor with signage as Construction site keep out along boundary fences and gates.

    Providing a clear and safe work area (site setup)

    Injury to personnel and damage to property and equipment / vehicles on site

    Ensure piling work activities are isolated and segregated from other activities on site. All vehicles and property not involved in piling activities should be isolated from the work area.

    Company Name

    Site Name

    Safe Work Method Statement

    No ______ Page of

    Contractor Activity Piling Permit to Work Requirement

    Yes No

  • Safe Work Method Statement Worksheet

    Remember: Each SWMS should be site specific. Include all workers in the development of the SWMS. All workers should sign off to verify that they understand all the requirements of this Safe Work Method Statement.

    Incorporating appropriate safety wear

    The hazard risk increases substantially when the appropriate safety apparel is not worn.

    All staff must wear the appropriate safety wear including: hard hat, safety vest, eye and ear protection, safety boots and gloves. Long sleeved shirts and long pants will be worn if required. Sunscreen 30+ is also to be used if working outdoors.

    Machinery and equipment plant condition check

    Injury from plant failure A machinery and equipment pre-start check is to be done each day before work commences. The checklist to be completed is supplied within the operators hire book. All defects to be rectified and recorded before commencement of work. Ensure all plant has been risk assessed and serviced/maintained at the required hour reading.

    Off loading of drilling equipment from vehicles and set up of drill rigs

    Damage to property and equipment. Injury to personnel including: crushing, striking, strains, back injuries. Lifting chains break. Falling loads. Excavator tilting over.

    Work is to be done by qualified and experienced personnel. Off loading area is clear of hazards. All personnel not involved to keep well clear. No loads are to travel or be suspended over personnel. Ensure the load is within the SWL of the machinery and is secured. Lifting chains to be in working order and rated / tagged. All PPE to be worn. No manual lifting of heavy loads. Machinery to be used on a stable ground.

    Rigging of machines Contact with onsite personnel or machinery

    Piling rigs not allowed to work outside nominated areas. Piling personnel only within restricted area. Rig machinery as per manufacturers manual.

    Spotter to be used at all times to observe power lines/services and other machinery and personnel.

    Machine collapse Select firm, level work area for rigging. Rig machine as per manufacturers manual. Suitably qualified personnel or trainee under supervision only to rig machine.

    Falling from height Fall protection for heights over 2m. EWP to be used when applicable. Ensure a high risk work licence is held if used over 11 metres in height. Harness used where applicable as a last resort. All persons wearing harnesses must be trained in correct use.

    Drilling / bored piers Entanglement, falling, tripping, crushing, striking. Excavator tilting over and or colliding with objects / personnel. Machinery / drilling noise.

    Work to be done by qualified and experienced personnel. All operators to hold current excavator ticket or supervised by ticketed operator. No loads are to travel or be suspended over personnel. Clear spoil from vicinity of pier. Drill offsider to be in full view of machine operator at all times.

  • Safe Work Method Statement Worksheet

    Remember: Each SWMS should be site specific. Include all workers in the development of the SWMS. All workers should sign off to verify that they understand all the requirements of this Safe Work Method Statement.

    Unauthorised personnel to keep well clear of all activities. Machinery to be used on stable ground. All PPE to be worn. All personnel to keep clear of all rotating plant. Shovelling around a hole is only to occur when the Kelly bar is down the hole. Spotter to ensure all onsite personnel keep clear of the spin-off area.

    Handling drilling equipment while in operation

    Hands caught in drill tools during changeover

    Use palms rather than fingers when guiding locking pins into position. Wear gloves where practicable. Keep tight tolerances on equipment joints

    All personnel to work within full view of plant operator. Only qualified and experienced operator or trainee under supervision to operate drill rig. Only ticketed, competent operator or supervised trainee to drive bobcat. All onsite personnel to maintain safe working distance from bobcat during operation. Never walk behind bobcat during operation.

    Removal of spoil from drill rig using bobcat

    Bobcat hitting/running over personnel. Collision with other onsite traffic.

    Bobcat operator to communicate and make eye contact with drill rig operator or offsider prior to entering slew radius to remove bored spoil. All onsite vehicles to be fitted with flashing orange lights and reversing beepers.

    Placement of hole covers Pinched fingers, strains, back injuries Hole covers to be used between drilling and pouring concrete. No manual lifting of heavy loads. PPE to be worn at all times. Machinery or two people to be utilised for the large hole covers.

    Hole inspection Falling Hole cover to be in place when the hole is inspected and tested if required

    Placement of reinforcement cage

    Personnel, objects, equipment being struck, falling load, pinched fingers, lifting chains / slings breaking. Excavator tilting over.

    Work to be done by qualified and experienced personnel. Licenced dogman to perform all chaining works. Swing area for excavator to be clear of personnel. The load to be within the MRC of the machine. No loads are to travel or be suspended over personnel. All personnel to wear PPE. Lifting chains / slings to be tagged / rated and in working order. Machinery to be used on stable ground. Load to be secured. Chain register to be maintained.

    Placement of concrete including vibrating

    Striking, pinched fingers, concrete splashing in the eyes, strains, back injuries, contamination of waterways and environment.

    All PPE to be worn. No lifting of heavy loads. The use of the excavator may be required to lift the vibrator. Refer to Concrete Pumping SWMS. Cleaning of the concrete chute to be washed in an area that will not contaminate any waterways, drains, and or the surrounding environment etc. Tremie pipes used where required.

  • Safe Work Method Statement Worksheet

    Remember: Each SWMS should be site specific. Include all workers in the development of the SWMS. All workers should sign off to verify that they understand all the requirements of this Safe Work Method Statement.

    Receiving and sending deliveries to and from the work area

    Ground collapses, personnel run over, colliding with objects, machinery and equipment. Services above and below ground being struck.

    Delivery driver to be directed by our spotter. Delivery truck to have flashing light and reverse beeper activated. No personnel or items to be in the path of the truck.

    Oxycutting, welding and grinding

    Radiation burns, foreign objects in the eyes, welders flash, hot metal, possible fire.

    Refer to SWMS for Use of Grinder. Ensure Flashback arrestors in place on bottles and handset if required. Have fire extinguisher in place at all times. Bottles to be secured onto a trolley. Ensure welding shield in place as applicable. Watch for fire outbreaks, remove flammable materials if required. Do not wear polyester fluoro vests as they are highly flammable. A Hot Work permit may be required.

    I have read and understood the content of this Safe Work Method Statement

    Approved By

    Date

    Workers name Signature Workers name Signature