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Inspection

Take or Attach Photo of Site

Job Title

Description of Work (overview list of planned activities)

Supervision of Task

Click '+' and add personnel in charge of task supervision (e.g site supervisor, safety officer, foreman, etc.)

Employee

Name

Role

Contact No.

Employees Involved
Employee

Name of personnel

Role

Methodology

In this section, provide step-by-step instruction as to how the work activity should be safely carried out and completed

Sequence of Operations

Plant & Equipment to be used

Specific Staff Training

Select the type of hazard associated with the planned activities below

Associated Hazard
Hazard

Please specify

Control Measures

PPE (select the required ppe)

Please specify

Emergency Procedures

Name of Person with Health & Safety Responsibility

Emergency Contact Details (include mobile no.)

First Aid Provision - in the event of an emergency, the following procedures should be executed:

Welfare Requirements

Services to be Supplied by Others

Completion

Other Information & Comments

Prepared by (provide name & signature)
Reviewed by (provide name & signature)

Method Statement Briefing Record

Briefing delivered by

Position

Date

We (the undersigned) have read and understood the attached method statement and will comply with the specified requirements and control measures. If the work activity changes or deviates from that originally envisaged, we will seek further advice and request an amended method statement.

Employee
Name & Signature

Construction Method Statement Template Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 169

A construction method statement template is a tool used by the construction industry to manage work and ensure that necessary precautions are set and communicated to workers involved. A construction method statement is an essential requirement for HSE (Health & Safety Executive) regulations.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

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Inspection

Take or Attach Photo of Site

Job Title

Description of Work (overview list of planned activities)

Supervision of Task

Click '+' and add personnel in charge of task supervision (e.g site supervisor, safety officer, foreman, etc.)

Employee

Name

Role

Contact No.

Employees Involved
Employee

Name of personnel

Role

Methodology

In this section, provide step-by-step instruction as to how the work activity should be safely carried out and completed

Sequence of Operations

Plant & Equipment to be used

Specific Staff Training

Select the type of hazard associated with the planned activities below

Associated Hazard
Hazard

Please specify

Control Measures

PPE (select the required ppe)

Please specify

Emergency Procedures

Name of Person with Health & Safety Responsibility

Emergency Contact Details (include mobile no.)

First Aid Provision - in the event of an emergency, the following procedures should be executed:

Welfare Requirements

Services to be Supplied by Others

Completion

Other Information & Comments

Prepared by (provide name & signature)
Reviewed by (provide name & signature)

Method Statement Briefing Record

Briefing delivered by

Position

Date

We (the undersigned) have read and understood the attached method statement and will comply with the specified requirements and control measures. If the work activity changes or deviates from that originally envisaged, we will seek further advice and request an amended method statement.

Employee
Name & Signature