Safe Work Method Statement Template

5T EXCAVATOR AND SKID STEER LOADER COMBO ON SITE | SAFE WORK METHOD STATEMENT (SWMS)
TASK OR ACTIVITY: 5T EXCAVATOR AND SKID STEER LOADER COMBO ON SITE

Business Name: [Company Name] ABN: [ABN] SWMS#
Business Address: [Company Address]
Contact Person: Phone: [Phone] Email:
THIS SAFE WORK METHOD STATEMENT IS APPROVED BY THE PCBU OF THE PROJECT
Under the Work Health and Safety Regulation (WHS Regulation), a person conducting a business or undertaking (PCBU) is required to ensure that a safe work method statement (SWMS) is prepared before
the proposed work starts.
Full Name: Double click to add name. (Note: Double click all grey fields to electronically edit).
Signature: Title: Double click to add title. Date: 25 May 2022
Details of the person(s) responsible for ensuring implementation, monitoring and compliance of the SWMS as well as reviews and modifications of the SWMS.
Full Name: Double click to add name. Title: Double click to add title. Phone: Double click phone.
ALL PERSONNEL PARTICIPATING IN ANY ACTIVITY ON THIS SWMS MUST NAME AND DATED SIGNATURE OF ALL RELEVANT PERSONNEL WHO HAVE BEEN CONSULTED AND
HAVE THE FOLLOWING COMMUNICATED COMMUNICATED TO IN THE DEVELOPMENT AND APPROVAL OF THIS SWMS
Safety meetings or toolbox talks will be scheduled in accordance with legislative NAME SIGNATURE DATE
requirements to first identify any site hazards, secondly to communicate those
hazards and then to further take steps to either eliminate or control each hazard. Double click to add name. 25 May 2022
If an incident or a near miss occurs, all work must stop immediately. Depending Double click to add name. 25 May 2022
on the severity of the incident, a meeting will be called with all workers to amend
the SWMS if required. The meeting may also be an educational opportunity. Double click to add name. 25 May 2022
Any changes made to the SWMS after an incident or a near miss must be Double click to add name. 25 May 2022
approved by the Person Conducting Business or Undertaking and
communicated to all relevant personnel. Double click to add name. 25 May 2022
The SWMS must be kept and be available for inspection at least until the work is Double click to add name. 25 May 2022
completed. Where a SWMS is revised, all versions should be kept. If a notifiable
incident occurs in relation to which the SWMS relates, then the SWMS must be
kept for at least two years from the occurrence of the notifiable incident. Double click to add name. 25 May 2022
Version 2.5 Authorised by Review # Date of Issue: Review Date: 1

CLIENT OR PRINCIPAL CONTRACTOR DETAILS
Client: Double click to add client or Principal Contractor. SCOPE OF WORKS
Project Name: Double click to add project name. Provide a detailed description of the specific work being carried out (otherwise
known as a scope of works).
Project Address: Double click to add project address.
Project Manager: Double click to add project manager.
Contact Phone: Double click to add contact phone.
Project Manager Signature:
Date SWMS supplied to Project Manager: 25 May 2022
ANY HIGH-RISK CONSTRUCTION WORK BEING CARRIED OUT
involves a risk of a person falling more than 2 meters. is carried out on or near pressurised gas mains or piping.
is carried out on a telecommunication tower. is carried out on or near chemical, fuel or refrigerant lines.
involves demolition of an element of a structure that is load-bearing. is carried out on or near energised electrical installations or services.
involves demolition of an element related to the physical integrity of a structure. is carried out in an area that may have a contaminated or flammable atmosphere.
involves, or is likely to involve, disturbing asbestos. involves tilt-up or precast concrete.
involves structural alteration or repair that requires temporary support to prevent collapse. is carried out on, in or adjacent to a road, railway, shipping lane or other traffic corridor.
is carried out in or near a confined space. is carried out in an area of a workplace where there is any movement of powered mobile plant.
is carried out in/near a shaft or trench deeper than 1.5m or tunnel involving use of explosives. is carried out in areas with artificial extremes of temperature.
is carried out in or near water or other liquid that involves a risk of drowning. involves diving work.
ANY HIGH-RISK MACHINERY OR EQUIPMENT NEARBY
Forklift Crane/s Hoist/s Excavator Backhoe/Loader Boom Lift EWP Genie Lift
Trencher Drilling Rig Trucks Formwork Bobcat Flammable Gas Fuel Dozer
High Voltage Mulcher Tilt-up Panels Roller Scissor Lift Tractor Other - Double click here to enter details.

RISK MATRIX
LIKELIHOOD INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC HEIRARCHY OF CONTROLS

SCORE ACTION
ALMOST 3 3 4 4 4
CERTAIN HIGH HIGH ACUTE ACUTE ACUTE Elimination
2 3 3 4 4 4A DO NOT Remove the hazard.
LIKELY
MODERATE HIGH HIGH ACUTE ACUTE ACUTE PROCEED
Substitution
1 2 3 4 4 3H Review before
POSSIBLE Replace the hazard.
LOW MODERATE HIGH ACUTE ACUTE HIGH work starts.
Ensure control
1 1 2 3 4 2M Engineering
UNLIKELY measures in
LOW LOW MODERATE HIGH ACUTE MODERATE
place. Isolate the hazard.
1 1 2 3 3 1L Monitor and
RARE Administrative
LOW LOW MODERATE HIGH HIGH LOW keep records.
Change the work.
Notes on Hierarchy of Controls: Elimination methods are the most effective and preferred when controlling a hazard. Substitution is
the second most effective method of controlling a hazard. Engineering by isolation is the third most effective, while Administrative
PPE
Controls by changing the work is the fourth most effective method. PPE (Personal Protective Equipment) is the least effective
method.
PERSONAL PROTECTIVE EQUIPMENT (PPE)

FOOT HAND HEAD HEARING EYE RESPIRATORY FACE HIGH-VIS PROTECTIVE FALL SUN HAIR/JEWELLERY
PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION CLOTHING CLOTHING PROTECTION PROTECTION SECURED
Select the appropriate PPE above suitable for the equipment used or the job task being performed (if applicable).
Note: A SWMS must be reviewed regularly to make sure it remains effective. A SWMS must be reviewed (and revised if necessary) if relevant control measures are revised. The
review process should be carried out in consultation with workers (including contractors and subcontractors) who may be affected by the operation of the SWMS and their health and
safety representatives who represented that work group at the workplace.
When a SWMS has been revised, the person conducting a business or undertaking must ensure all:
1. persons involved in the work are advised that a revision has been made and how they can access the revised SWMS;
2. persons who will need to change a work procedure or system as a result of the review are advised of the changes in a way that will enable them to implement their duties
consistently with the revised SWMS; and,
3. workers that will be involved in the work are provided with the relevant information and instruction that will assist them to understand and implement the revised SWMS.

RESPONSIBLE
JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR
PERSON
INITIAL RESIDUA
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS NAME OF PERSON
RISK L RISK
Establish the following on-site policies, procedures and systems in consultation

with the Principal Contractor while being sure to establish:
- Health and Safety guidelines and site rules

- Emergency plans and evacuation procedures
- Worker inductions
- Toolbox talks (safety meetings)
- Establish supervision of site and workers
A lack of planning, consultation with Double Double Double click to add
- Check all workers qualifications, permits and competencies
workers and stakeholder input may Click - Click name of
1. Planning and Preparation - Ensure all workers are medically sound
lead to injury, property damage and/or Enter Enter responsible
- Ensure any communication equipment is functioning correctly
environmental impact. Risk Risk person.
- Hazard reporting procedures in place
- Incident reporting procedures in place
- Traffic Management Plans implemented where required
- Exclusion zones
- Site plans in place
- All Safe Work Method Statements, Risk Assessments and/or JSA’s completed
- Electrical NO GO ZONES identified, discussed and documented
- Underground Services – Gas, water, sewerage, electrical etc identified
Thoroughly assess the work site/area conditions and make sure that:
- There is adequate phone reception. Ensure emergency communication is

possible
- Risk assessment of site or work area conducted
- Suitable access and adequate space to conduct the work safely
A lack of a thorough assessment of Double Double Double click to add
- Site specific induction conducted (first aid, emergency and evacuation etc)
the on-site conditions may lead to Click Click name of
2. Assessment of site conditions - Consult with all stakeholders on potential hazards and risks etc
injury, property damage and/or Enter Enter responsible
- Identify and consult with Health and Safety Representatives
environmental impact. Risk Risk person.
- Consultation with all relevant workers and personnel for SWMS details
- If working at night, ensure there is adequate lighting
- Site amenities established
- Identify all mobile and high-risk plant and machinery
- Check that surface levels are suitable for the work being carried out
- Hot or cold conditions – ensure the environment temperature is assessed
Make sure all workers have the appropriate qualifications required before
starting work. If White Cards are required, retain copies of all cards, licenses
and qualifications of personnel. All personnel must:
Double Double Double click to add
A lack of personnel competency may
3. Training and worker Click Click name of
lead to injury, property damage and/or - Be trained and/or have received instructions on this SWMS including all safety
qualifications Enter Enter responsible
environmental impact. and emergency procedures.
Risk Risk person.
- Be qualified, knowledgeable and competent in all delegated
tasks/responsibilities
- Be fully aware and understand the scope of work

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Work must not be conducted near powerlines. 3m above, either side and below
power lines are NO GO ZONES.
Check that:
- There are no overhead power lines, including high or low voltage conductors
Electricity - There are no Single Wire Earth Return cables (SWER)
Underground services - There are no service cables, communication cables or electrical transformers
Click Click name of
Slips, trips and falls
Enter Enter responsible
Environmental impacts Identify and document the maximum range of equipment, including the
Risk Risk person.
proximity of any loads or machinery to any energy sources. Be sure to follow all
regulatory guidelines in relation to working near electrical sources.
(Ensure the use of a spotter when working within 3-6.4m)
Never conduct work within 10m radius of a SWER transformer. For work within
Minimum Clearance Zones, contact the power supplier.
Before conducting any excavations, contact Dial Before You Dig and contact
the relevant department/s for plans and required documentation.
Make sure all underground services have been identified, and that all
4. Work area setup Double Double Double click to add
information is accurate and complete as to the location of the underground
Click Click name of
Underground services service/s. Be sure to use an authorised licensed contractor when testing areas
for underground services.
Risk Risk person.
Use caution when working within the vicinity of gas mains. Be sure to tag all
services with high visibility equipment for all personnel to avoid potential
incidents when coming within the vicinity of exposed underground services.
When working outdoors ensure that all personnel:
- Are dressed with protective clothing, preferably long-sleeved shirts.

- Wear a wide brim hat where possible.
- Use SPF 30+ sunscreen.
Double - UV glasses that comply with Australian Standards. Double Double click to add
Click - Are supplied with drinking water. Click name of
Environmental
Enter - Have access to shaded areas. Enter responsible
Risk - Conduct work in the cooler areas depending on the time of day. Risk person.
- Never conduct work in extreme weather.
- If working at night, ensure adequate lighting is provided.
- Are provided consistent breaks if working in hot weather.
- Are wearing adequate warm clothing and gloves if working in cold weather.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Always keep watch for moving plant, equipment, machinery and vehicles. Be
sure to also listen for any reversing alarms and beepers.
If possible, always work within the area of vision of a plant operator and avoid
working in the blind spot of a machinery operator as much as is reasonably
practicable.
5. Delivery of materials and Click Click name of
Collision with vehicles or machinery
equipment Enter Enter responsible
Avoid standing between two moving vehicles, or the rear of a vehicle and a
Risk Risk person.
structure, such as a building.
Always follow designated pathways/walkways when there are deliveries to site

or machinery operating within the vicinity, and be sure to maintain exclusion
zone instructions when required.
When conducting work in public areas, on main roads, neighbourhood

kerbsides or where pedestrians are likely to pass by:
- Produce a Traffic Management Plan to manage vehicle or pedestrian traffic

risks.
Public safety Click Click name of
6. Temporary Traffic Control - Ensure all traffic controllers have the necessary qualifications and experience.
Collision with vehicles and machinery Enter Enter responsible
- Ensure that all traffic control processes meet ASNZS 1742.3-2009.
Risk Risk person.
- Make sure all approvals and permits are attained from relevant government
bodies.
- Ensure pedestrians are directed by clearly marked paths, free of risk to safety.
- Always wear high visibility clothing when working near traffic.
Immediately advise site shed/supervisor of arrival on site.

Observe speed limit at all times (all signage).
Make sure that flashing light/beeper is on.
Collisions with other plant or persons
Place spotter where practical/available.
Contact with overhead power lines
Wear high-visibility PPE at all times.
Poor site conditions (caused by rain) Double Double Double click to add
Check work area before entry and acknowledge other items of plant on site and
7. Arrive on site Click - their proximity to path of entry. Click name of
Falling from cabin (if asked to exit
cabin by site supervisor)
Risk If necessary, stop operation of plant while moving in the vicinity. Risk person.
Slips and trips
Check area before entry.
Get official clearance height from site manager.
Assess site conditions.
Move obstacles where practical/appropriate.
Clean mud from roadway.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Unless site conditions are improved, do not enter site until safe.
Never drive with door open.
Make sure seatbelt is secured until vehicle is completely stopped.
Never jump – use the steps on truck.
Use the assistance handle when exiting truck.
Where practical, make sure obstacles are removed.
Where possible, avoid muddy areas.
Wear safety boots in good condition.

Slips and trips when moving to Where possible, avoid muddy areas.
induction area
Proximity to mobile plant on site –
scissors lift Wear high-visibility PPE at all times.
Proximity to high-risk work being Click - Assess the path of travel before leaving the present area. Click name of
8. Site induction at site
carried out on site: Enter Take notice of plant on site and be careful of where you are walking. Enter responsible
1. Lasers Risk Risk person.
2. Explosive power tools Observe site signage (e.g.: laser in use, explosive power tool in use, welding in
3. Welding in area progress, etc.)
Wearing all required PPE is essential (e.g. hard hat, high visibility, safety boots,
long sleeves – where required).
Follow all directions from site supervisor/s.
Make sure the grip tapes on ladder treads are in good condition.
Slip off ladder attached to the tipper
body Always maintain three points of contact at all times.
Entanglement with equipment on truck Make sure safety boots are in good condition and have good grip on soles.
Slips and falls while amongst Double Clean mud off the treads before stepping on them. Double Double click to add
9. Climbing into back of truck to
access plant and equipment on equipment on truck Click - Work steadily and do not rush. Click name of
truck body. Enter Enter responsible
Fall from back of truck while Make sure all plant and attachments are secured on the truck at the end of
Risk Risk person.
accessing equipment each use so they are not unstable when walked on.
Use available hand grips on the machine while moving around them.
Never jump across machines, hop down then re-climb on new obstacle.
Always park truck so there is minimum distance from tail gate to ground.
10. Unloading excavator from Double Double Double click to add
Machine failure
back of truck to the ground. Click - Click name of

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Slipping off ramps used to load Enter Make sure that all maintenance on excavator is up to date – both scheduled Enter responsible
excavator on truck Risk and inspection based. Risk person.
Proximity to other plant in the loading Make sure all hoses are properly fitted and not leaking.
area
Make sure beeper and flash light are working properly.
Make sure operator is competent and licensed for using an excavator.
Make sure the ramps are fitted properly to the truck.
Make sure the ramps and attachment points have so signs of excessive wear
and are in safe working condition.
Make sure that excavator tracks have adequate tread and are in good
condition.
Use only minimum speed to approach and move down the ramps.
Check work are before entry and acknowledge other items of plant on site and
their proximity to path of entry.
If necessary, stop operation of plant while moving in the vicinity.
Always use machines to move attachments around the job site – do not use
hands.
If it is impossible to use the machine, try to use a smaller machine on site or
another means.
Lifting machine attachments by hand:
1. Buckets When attachments have to be handled manually, use as many persons as
2. Hoses available and practical to lift attachments.
11. Manual handling of materials 3. Security screens Double Double Double click to add
Keep Quick Hitch Pin in place at all times and in sight of operator.
and attachments where 3. Pins Click - Click name of
mechanical aids are not practical. Enter Always use proper tools for each application. Enter responsible
Maintenance on machine while at site
Risk Risk person.
Use lever bars in place of brute force.
Lifting of materials e.g. reo cages
If available, use hydraulic or pneumatic aided tools.
Do not strike spanners with the palm of hand.
If replacement parts exceed 20kgs, use handling aid to move them.
Always try to get the machine serviced preferably in a workshop rather than on
site.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK

Where practical/possible, have a spotter in place to assist both excavator and
other plant operators.
If necessary, clear the work area of all workers before entering site.
Collisions with other plant between
loading area and job site. Make sure that all maintenance on excavator is up to date – both scheduled
and inspection based.
Collisions with persons between
loading area and excavation area. Make sure all hoses are properly fitted and not leaking.
Machine failure Make sure beeper and flash light are working properly.
Moving excavator near a batter or Make sure seatbelt is working properly.

drop off: Double Double Double click to add
12. Moving excavator from Visually inspect excavator before taking up any operation.
1. Machine rollover Click - Click name of
loading area to job site. 2. Machine sliding over edge Enter Make sure adequate bunting is in place before the area is approached. Enter responsible
Risk Risk person.
Moving excavator on slippery or Maintain a safe distance from the edge, as far away as practical.
unstable ground
Inspect the batter/drop off before approaching.
Dust from moving excavator around
site Where possible/practical, have a spotter in place to assist the operator.
Make sure the operator is competent in operating the excavator.
Exposure to noise
Sun exposure Proceed only at speeds appropriate to the conditions.
Make sure tracks are in good condition and have adequate tread.
If the ground is too slippery to work on, spread some dry material on area.
If area is found to be too slippery, and it cannot be repaired, cease work and
return after conditions improve.
Operator must wear a dust mask when dust levels become uncomfortable.
Operator must shut door on air cab,
If practical wet down the work area.
Place temporary roads to reduce dust.
Operator must use hearing protection at all times when using the machine.
When practical, operator must shut the door on air cab.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Make sure the muffler on the machine is maintained and is adequate.
Using sunblock is necessary.
Rotate workmen regularly.
Keep the door closed on air cab.
Make sure the machine is turned off before exiting cabin.

Always place bucket firmly on ground in a closed position before exiting cabin.
Make sure all attachments are in safe working condition, all hoses are secure
and not leaking.
Never allow any person to be within 1m of boom of excavator radius while
machine is in switched on condition.
Without exception, allow only competent and ticketed operator only to operate
the machine.
Where practical, use exclusion zones to keep unauthorised persons out of work
Entanglement with attachments (mud area.
bucket) of excavator Observe speed limit at all times (all signage).
Entanglement with hydraulic moving Make sure that flashing light/beeper is on.
boom arm of excavator
Collision with other mobile plant
Double Wear high-visibility PPE at all times. Double Double click to add
13. Excavation/removal of oil from Collision with other persons Click - Click name of
behind kerb line with excavator. Enter Check work are before entry and acknowledge other items of plant on site and Enter responsible
Working near batters/drop offs (edges
Risk their proximity to path of entry. Risk person.
of cut where spoil is excavated away)
Dust inhalation
Exposure to noise other plant operators.
Exposure to the sun
Make sure adequate bunting is in place before the area is approached.
Maintain a safe distance from the edge, as far away as practical.
Where possible/practical, have a spotter in place to assist the operator.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Make sure the machine is turned off before exiting cabin.

and not leaking.
Never allow any person to be within 1m of boom of excavator radius while
Entanglement with hydraulic moving
boom arms. Without exception, allow only competent and ticketed operator only to operate
the machine.
Collisions with other mobile plant.
Where practical, use exclusion zones to keep unauthorised persons out of work
Collisions with other persons area.
Working near batters/drop offs Observe speed limit at all times (all signage).
Dust inhalation Make sure that flashing light/beeper is on.
Exposure to noise Double Place spotter where practical/available. Double Double click to add
14. Moving spoil from point of Click - Click name of
excavation to truck loading area. Exposure to sun Enter Wear high-visibility PPE at all times. Enter responsible
Persons caught between truck body Risk Risk person.
and excavator their proximity to path of entry.
Entanglement with attachments (mud If necessary, stop operation of plant while moving in the vicinity.
bucket)
Entanglement with hydraulic moving other plant operators.
boom arm
Loading trucks near batters/drop offs

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Set up exclusion zones in loading area to keep unauthorised persons away
from vicinity.
Operator must sound horn of machine to alert truck driver and other persons of
his approach.
Make sure the flashing light is working properly.
Make sure the motion beeper is working properly.
Approach the body of the truck at minimum speed.
Without exceptions, allow only competent and ticketed operators to load trucks
with an excavator.
Entanglement with hydraulic moving Make sure the machine is turned off before exiting cabin.
boom arms.
Collisions with other mobile plant.
Collisions with other persons and not leaking.
Working near batters/drop offs Never allow any person to be within 1m of boom of excavator radius while
Dust inhalation
Double Without exception, allow only competent and ticketed operator only to operate Double Double click to add
Exposure to noise the machine.
15. Loading spoil into tip truck. Click - Click name of
Exposure to sun Enter Where practical, use exclusion zones to keep unauthorised persons out of work Enter responsible
Persons caught between truck body Risk area. Risk person.
and excavator Observe speed limit at all times (all signage).
Entanglement with attachments (mud Make sure that flashing light/beeper is on.
bucket)
Entanglement with hydraulic moving
boom arm Wear high-visibility PPE at all times.
Loading trucks near batters/drop offs Check work are before entry and acknowledge other items of plant on site and

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
other plant operators.
from vicinity.
his approach.
with an excavator.
Slipping off ramps
Make sure that all maintenance on excavator is up to date – both scheduled
Persons caught between excavator and inspection based.
16. Loading excavator from and truck body Double Double Double click to add
ground up onto truck ready for Click - Click name of
Make sure all hoses are properly fitted and not leaking.
floating off site. Proximity to other plant in the truck Enter Enter responsible
loading area Risk Make sure beeper and flash light are working properly. Risk person.
Make sure operator is competent and licensed for using an excavator.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Make sure the ramps are fitted properly to the truck.
Make sure the ramps and attachment points have so signs of excessive wear
and are in safe working condition.
Make sure that excavator tracks have adequate tread and are in good
condition.
Use only minimum speed to approach and move down the ramps.
from vicinity.
his approach.
with an excavator.

Collisions with other plant or persons Make sure that flashing light/beeper is on.
Contact with overhead power lines Place spotter where practical/available.
Poor site conditions – caused by rain Wear high-visibility PPE at all times.
Falling from the cabin Double Double Double click to add
Click - Check work are before entry and acknowledge other items of plant on site and Click name of
17. Leaving site
Slips and trips Enter their proximity to path of entry. Enter responsible
Risk If necessary, stop operation of plant while moving in the vicinity. Risk person.
Heavy rain
Thunder and lightning Check area before entry for presence of overhead power – get official
clearance height from site manager.
Strong winds
Assess site conditions.
Move obstacles where practical/appropriate.

RESPONSIBLE
PERSON
INITIAL RESIDUA
RISK L RISK
Clean mud from roadway.
Unless site conditions are improved, do not enter site until safe.
Never drive with door open.
Make sure seatbelt is secured until vehicle is completely stopped.
Never jump – use the steps on truck.
Use the assistance handle when exiting truck.
Where possible, avoid muddy areas.
Cease all work if site condition becomes too wet to work on safely.
Cease all work immediately if operator cannot see properly because of heavy
rain. Do not start wok if heavy rain prior to arrival makes site unsafe.
If an electrical storm hits while on site, operator must switch off machine and
remain in cabin until storm has passed.
If site becomes too unsafe to remain in cab, operator should move to the
closest safe place. If winds become strong enough that operator deems site
unsafe, operator must switch off machine and remain in cabin until it is safe.
If the winds persist for extended periods or operator is in danger, then operator
must move to the closest safe area as quickly as possible.
Clean up all work areas thoroughly and ensure there are no offcuts, debris or
waste materials left within the vicinity of the work area. If machinery will be
Slips, trips and falls
parked at the worksite area, be sure to park the plant, machinery or vehicle in a
safe place, if possible, under cover and out of the weather and ensuring to
remove all keys, spare keys and valuables. Always lock the plant, machinery or
equipment after use.
Moving machinery or mobile plant and
equipment
After using work equipment, always use gloves while cleaning down the tools
and machines, in order to avoid cuts, lacerations and burns from hot material
Click Click name of
18. Completion of job such as hot metal, fragmented discs or tool parts. Be sure to inspect the piece
Cuts, lacerations and burns Enter Enter responsible
of equipment for any damage, and if damaged be sure to attach lockout tags
Risk Risk person.
and document the requirements in an equipment maintenance register.
Always be sure to disconnect any power sources before beginning to roll

Electrical contact
electrical leads, in order to avoid any electric shock caused by faulty leads. If
heavy equipment requires storing or packing away, be sure to use lifting aids,
or request assistance from another worker or any other available personnel.
Musculoskeletal disorder
Never attempt to lift heavy items alone. Ensure all work areas are left tidy, and
free from hazards.

EMERGENCY RESPONSE – CALL 000 FOR EMERGENCIES
Ensure to have an Emergency Management Plan in place as well as adequate numbers of trained first aid staff with easy access to fully stocked first aid kits, rescue equipment, material safety data sheets,
adequate access to emergency communication equipment and fire-fighting equipment suitable for all classes of fire and ignition sources.
LEGISLATIVE REFERENCES
RELEVANT LEGISLATION AND CODES OF PRACTICE. DELETE THE LEGISLATIVE REFERENCES IN ANY STATE THAT ARE NOT APPLICABLE
Queensland & Australian Capital Territory Victoria

Work Health and Safety Act 2011 Occupational Health and Safety Act 2004
Work Health and Safety Regulations 2011 Occupational Health and Safety Regulations 2017
Legislation QLD: https://www.worksafe.qld.gov.au/laws-and-compliance/work-health-and-safety-laws Legislation VIC: https://www.worksafe.vic.gov.au/occupational-health-and-safety-act-and-
Codes of Practice QLD: https://www.worksafe.qld.gov.au/laws-and-compliance/codes-of-practice regulations
Legislation ACT: https://www.worksafe.act.gov.au/laws-and-compliance/acts-and-regulations Codes of Practice VIC: https://www.worksafe.vic.gov.au/compliance-codes-and-codes-practice
Codes of Practice ACT: https://www.worksafe.act.gov.au/laws-and-compliance/codes-of-practice
New South Wales Western Australia

Work Health and Safety Act 2011 Western Australia has received assent, keep up to date with progress:
Work Health and Safety Regulations 2017 Legislation Western Australia: https://www.commerce.wa.gov.au/worksafe/modernisation-work-
Legislation NSW: https://www.safework.nsw.gov.au/legal-obligations/legislation health-and-safety-laws-frequently-asked-questions-faq
Codes of Practice NSW: https://www.safework.nsw.gov.au/resource-library/list-of-all-codes-of-practice
Northern Territory Safe Work Australia Links

Work Health and Safety (National Uniform Legislation) Act 2011 Law and Regulation (All States): https://www.safeworkaustralia.gov.au/law-and-regulation
Work Health and Safety (National Uniform Legislation) Regulations 2011 Model Codes of Practice: https://www.safeworkaustralia.gov.au/resources-publications/model-
Legislation NT: https://worksafe.nt.gov.au/laws-and-compliance/workplace-safety-laws codes-of-practice
Codes of Practice NT: https://worksafe.nt.gov.au/forms-and-resources/codes-of-practice
Model Codes of Practice
South Australia
Work Health and Safety Act 2012 (SA) - Managing noise and preventing hearing loss at work
Work Health and Safety Regulations 2012 (SA) - Confined spaces
Legislation for SA: https://www.safework.sa.gov.au/resources/legislation - Labelling of workplace hazardous chemicals
Codes of Practice for SA: https://www.safework.sa.gov.au/workplaces/codes-of-practice#COPs - Managing risks of hazardous chemicals in the workplace
- Welding processes
Tasmania - First aid in the workplace
Work Health and Safety Act 2012 - Managing the risk of falls at workplaces
Work Health and Safety (Transitional and Consequential Provisions) Act 2012 - Hazardous manual tasks
Work Health and Safety Regulations 2012 - Managing the risk of falls in housing construction
Work Health and Safety (Transitional) Regulations 2012 - Managing electrical risks in the workplace
Legislation for TAS: https://worksafe.tas.gov.au/topics/laws-and-compliance/acts-and-regulations - Demolition work
Codes of Practice for TAS: https://worksafe.tas.gov.au/topics/laws-and-compliance/codes-of-practice - Excavation work
- Work health and safety consultation, cooperation and coordination
Details of permits, licenses or access required by regulatory bodies (add or delete as required): - Managing the work environment and facilities
- How to manage work health and safety risks
- Permits from local council - Managing risks of plant in the workplace
- Authorisation to commence work - Construction work
- Any required documents.

SIGNATORIES OF THE SAFE WORK METHOD STATEMENT
The signed and dated personnel listed below have cooperated in the consultation and development of this Safe Work Method Statement which has been approved by the Person/s Conducting a Business or
Undertaking (PCBU). In signing this Safe Work Method Statement each individual acknowledges and confirms that they have read this SWMS in full, having raised any questions for items on this Safe Work
Method Statement that require clarification, and confirms that they are competent, skilled and knowledgeable for the task assigned to them. Every person acknowledges that they have received the relevant
training and qualifications where required, before carrying out any work contained in this Safe Work Method Statement. By signing this Safe Work Method Statement each individual agrees to work safely, to
follow any safe work instructions which are provided, and agrees to use all Personal Protective Equipment where appropriate.
Worker Name Position Signature Date Time Supervisor
Double click to enter name. Double click position. Date: 25 May 2022 7:22 AM Double click supervisor name.
SAFE WORK METHOD STATEMENT MONITORING AND REVIEW
The SWMS must be reviewed regularly to make sure it remains effective and must be reviewed (and The SWMS must be monitored regularly for the effectiveness of ensuring hazard controls are
revised if necessary) if relevant control measures are revised. The review process should be carried out in effective in reducing the risk of incidents, keeping the workplace safe for all personnel. The
consultation with workers (including contractors and subcontractors) who may be affected by the operation person responsible for monitoring the effectiveness of the Safe Work Method Statement should
of the SWMS and their health and safety representatives who represented that work group at the employ a multi-faceted approach which includes but is not limited to:
workplace.
1. Spot Checks.
When the SWMS has been revised the PCBU must ensure that all persons involved with the work are 2. Consultation with workers, contractors and sub-contractors.
advised that a revision has been made and how they can access the revised SWMS, including all persons 3. Internal audits on a continual basis.
who will need to change a work procedure or system as a result of the review are advised of the changes in
a way that will enable them to implement their duties consistently with the revised SWMS. All workers that An approach of continuous improvement, promptly recording inconsistencies or deficiencies,
will be involved in the work must be provided with the relevant information and instruction that will assist followed up by immediate corrective action and consultation with all relevant personnel ensures
them to understand and implement the revised SWMS. that the PCBU is consistently developing ever-improving systems of safe work principles.
REVIEW NUMBER 1 2 3 4 5 6 7
NAME Double click.
INITIALS Double click.
DATE

SAFE WORK METHOD STATEMENT REVIEW CHECKLIST
This Safe Work Method Statement Review Checklist is to be followed and used upon initial development of the SWMS to help ensure that all steps have been adequately taken before work commences.
Think of this document as an internal audit review checklist before commencing work, and may form part of a Toolbox Talk (safety meeting) and may be used as an opportunity for education and training.
ITEMS WHICH MUST BE INCLUDED IN THE SWMS COMPLETED TO BE DONE COMMENTS
The company details have been entered, including the project name and address.
Names and signatures of all relevant personnel consulted during the development of the SWMS.
Name, signature, position and date signed of the person approving the SWMS.
Specific personnel and qualifications, experience is noted in the SWMS.
Provides a step-by-step process of tasks required to carry out the activity or task.
Adequate risk assessment of any identified hazards has been completed.
Foreseeable hazards are identified and documented for each step.
Any hazards listed in any site risk assessments have been added to the SWMS.
SWMS initial risk (IR) column as well as residual risk (RR) columns completed.
Check control measures added to the SWMS are the most effective selections.
Responsible person is assigned and listed on the SWMS for the implementation of control measures.
Permit requirements specified, such as Hot Work, Electrical Work, Work at Heights etc.
SWMS identifies plant and equipment to be used.
Details of inspection checks required for any equipment listed are noted on the SWMS.
Describes any mandatory qualifications, experience, training or skills required to perform the work.
Applicable personal protective equipment is selected on the SWMS.
Lists any required permits or licenses.
Reflects and documents any legislative references and/or Australian Standards.
Identifies any hazardous substances used with specific control measures in line with any SDS.
REVIEWED BY Double click to enter name. DATE REVIEWED
SIGNATURE DATE COMPLETED

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5T EXCAVATOR AND SKID STEER LOADER COMBO ON SITE | SAFE WORK METHOD STATEMENT (SWMS)

TASK OR ACTIVITY: 5T EXCAVATOR AND SKID STEER LOADER COMBO ON SITE

Business Address: [Company Address]

Contact Person: Phone: [Phone] Email:

Signature: Title: Double click to add title. Date: 25 May 2022

Version 2.5 Authorised by Review # Date of Issue: Review Date: 1

Client: Double click to add client or Principal Contractor. SCOPE OF WORKS

Project Manager: Double click to add project manager.

Contact Phone: Double click to add contact phone.

Project Manager Signature:

Date SWMS supplied to Project Manager: 25 May 2022

ANY HIGH-RISK CONSTRUCTION WORK BEING CARRIED OUT

involves, or is likely to involve, disturbing asbestos. involves tilt-up or precast concrete.

ANY HIGH-RISK MACHINERY OR EQUIPMENT NEARBY

Version 2.5 Authorised by Review # Date of Issue: Review Date: 2

LIKELIHOOD INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC HEIRARCHY OF CONTROLS

PERSONAL PROTECTIVE EQUIPMENT (PPE)

Version 2.5 Authorised by Review # Date of Issue: Review Date: 3

Establish the following on-site policies, procedures and systems in consultation

- Health and Safety guidelines and site rules

- There is adequate phone reception. Ensure emergency communication is

Version 2.5 Authorised by Review # Date of Issue: Review Date: 4

(Ensure the use of a spotter when working within 3-6.4m)

When working outdoors ensure that all personnel:

- Are dressed with protective clothing, preferably long-sleeved shirts.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 5

Always follow designated pathways/walkways when there are deliveries to site

When conducting work in public areas, on main roads, neighbourhood

- Produce a Traffic Management Plan to manage vehicle or pedestrian traffic

Immediately advise site shed/supervisor of arrival on site.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 6

Where practical, make sure obstacles are removed.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 7

Version 2.5 Authorised by Review # Date of Issue: Review Date: 8

Observe speed limit at all times (all signage).

Moving excavator near a batter or Make sure seatbelt is working properly.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 9

Make sure the machine is turned off before exiting cabin.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 10

Make sure the machine is turned off before exiting cabin.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 11

Version 2.5 Authorised by Review # Date of Issue: Review Date: 12

Version 2.5 Authorised by Review # Date of Issue: Review Date: 13

Observe speed limit at all times (all signage).

Version 2.5 Authorised by Review # Date of Issue: Review Date: 14

Always be sure to disconnect any power sources before beginning to roll

Version 2.5 Authorised by Review # Date of Issue: Review Date: 15

Queensland & Australian Capital Territory Victoria

New South Wales Western Australia

Northern Territory Safe Work Australia Links

Version 2.5 Authorised by Review # Date of Issue: Review Date: 16

Worker Name Position Signature Date Time Supervisor

SAFE WORK METHOD STATEMENT MONITORING AND REVIEW

Version 2.5 Authorised by Review # Date of Issue: Review Date: 17

ITEMS WHICH MUST BE INCLUDED IN THE SWMS COMPLETED TO BE DONE COMMENTS

Specific personnel and qualifications, experience is noted in the SWMS.

Adequate risk assessment of any identified hazards has been completed.

Foreseeable hazards are identified and documented for each step.

SWMS identifies plant and equipment to be used.

Applicable personal protective equipment is selected on the SWMS.

Lists any required permits or licenses.

Reflects and documents any legislative references and/or Australian Standards.