Safe Work Method Statement (SWMS) : Signature Date
Safe Work Method Statement (SWMS) : Signature Date
Organisation Details
Organisation Name: Contact Name:
ABN: Contact Position:
Address: Contact Phone No.:
Project Details
Project: Area:
Activity: Client:
SWMS prepared by: Name This SWMS • The use of UV protection, including long pants, long sleeve shirts, wide brim sun
makes hat and sunscreen while working under exposed sunlight;
Signature mandatory: • Seat belts to be worn when operating all vehicles;
• Prohibition of alcohol/non-prescription drug use at work site;
•
Date
Hazard identification and risk assessment: • Class 1 (high risk): the hazard has the potential to kill or disable permanently;
• Class 2 (medium risk): the hazard has the potential to cause serious injury or illness, which will temporarily
cause a disability;
• Class 3 (low risk): the hazard has the potential to cause a minor injury which will not cause a disability.
Resources/Trades involved:
Plant and equipment used:
Maintenance checks:
Occupational Health and Safety or • Codes or Standards Applicable to •
Environmental Legislation: the Works:
4. •
6. • •
7. • •
8.
Position and name Qualifications and Personnel, duties and responsibilities (supervisory staff and Training
experience others)
PROJECT MANAGER: and • The Site Manager is responsible for safety on the project. • General Induction, Construction
SITE DIRECTOR Induction Certificate
Duties include:
• Implementing the company Occupational Health, Safety, • Manual Handling Certificate
Environment and Rehabilitation procedures; • First Aid Certificate.
• Carrying out a design review with the Principal Contractor’s
project team to assist in the identification of further risk
reduction control measures;
• Stimulating a high level of safety awareness at all times;
• Identifying safety training needs;
• Leading by example;
• Ensuring safe equipment and plant is provided and
maintained;
• Insisting on correct and safe work practices at all times;
• Assisting in the identification and preparation of safe work
procedures;
• Reviewing safety reports and inspections and initiating
rectification where necessary;
• Insisting on correct and safe work practices at all times;
• Participating in accident/incident investigations.
OPERATIONS MANAGER: The Operations Manager is responsible for work area site • General Induction, Construction
management issues and assisting in safety management. Induction Certificate
• First Aid Certificate
Duties include:
• Implementing the company Occupational Health, Safety,
Environment and Rehabilitation procedures;
• Carrying out a design review with the Principal Contractor’s
project team to assist in the identification of further risk
reduction control measures;
• Stimulating a high level of safety awareness at all times;
• Identifying safety training needs;
• Leading by example;
• Ensuring safe equipment and plant is provided and
maintained;
• Insisting on correct and safe work practices at all times;
• Assisting in the identification and preparation of safe work
procedures;
This SWMS has been developed through consultation with our employees and has been read, understood and signed by all employees undertaking the
works:
Print Name: Signature: Date:
Consequences
Insignificant Minor Moderate Major Catastrophic
Minor injury requiring first Single injury requiring Single serious injury or Single fatality, multiple Multiple deaths from a
aid but no lost time or a few medical treatment resulting illness requiring injuries or major incapacity single event or serial deaths
Likelihood incidents which do not
result in injury
in some lost time or a large
number of incidents
hospitalisation and
rehabilitation due to a single
or series of single fatalities
or major injuries due to a
over one year or cumulative
and delayed disability due
resulting in minor injuries cause at one location single cause at one location to a single cause at one
location
Almost certain
Likely to occur E
H H E E
about once a month
Likely
Expected to occur E
M M H E
once every year
Possible
Will be Expected to E
L M M H
occur once every 10
years
Unlikely
Will be expected to E
L L M H
occur once every
100 years
Rare
Will be expected to H
L L M H
occur once every
1000 years or less
Level of Risk
E: Extreme risk; immediate action required M: Moderate risk; management responsibility must be specified
H: High risk; senior management attention needed L: Low risk; manage by routine procedures