IBR - SWMS Review Form

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Safe Work Method Statement – Review Form

• Site/Project:

• SWMS No:

• Subcontractor Company Name (NA if not applicable):

• Work Activity Description:

• Submitted by:

• Review required by (date):

  Date

• WHERE ‘NO’ HAS BEEN MARKED YOU MUST EXPLAIN THE DIFFERENCES USING THE FOLLOWING COMMENTS SWSM DEFICIENCIES SECTION

SAFE WORK METHOD STATEMENT REVIEW CHECKLIST

WHERE ‘NO’ HAS BEEN MARKED YOU MUST EXPLAIN THE DIFFERENCES USING THE FOLLOWING COMMENTS SWSM DEFICIENCIES SECTION

• Is the SWMS on the PCBU’s letterhead including their ABC/ACN, address and phone number?

  Yes

  No

  N/A

• Is the SWMS approved by an appropriate Supervisor/Manager?

  Yes

  No

  N/A

• Does the SWMS clearly describe the work as a High-Risk Construction Activity per jurisdiction and legislative requirements?

  Yes

  No

  N/A

• Is the SWMS Site/Project Specific and not generic?

  Yes

  No

  N/A

• Does the SWMS specify hazards& describe the risks in relation to the High-Risk Construction Activities – not grouped together?

  Yes

  No

  N/A

• Is there evidence that the SWMS was developed in consultation with workers conducting the activity?

  Yes

  No

  N/A

• Does the SWMS describe the measures to be implemented to control the risks associated with the High-Risk Construction Activities (including emergency response and rescue plans as required)?

  Yes

  No

  N/A

• Does the SWMS include the details of the equipment to be used for the activity – plant and equipment?

  Yes

  No

  N/A

• Does the SWMS include qualifications/competencies/tickets & training for persons undertaking the work?

  Yes

  No

  N/A

• Does the SWMS list the Legislative, Code of Practice and Standards applicable for this task?

  Yes

  No

  N/A

• Applicable required permits relating to the work are identified? i.e. Working at Heights; Hot Works Permit etc

  Yes

  No

  N/A

• Does the SWMS indicate the monitoring and review process i.e. Monthly and who by?

  Yes

  No

  N/A

• Are environmental hazards & risks captured and appropriate controls addressed?

  Yes

  No

  N/A

• Is there a Risk Matrix included on how risks were assessed and based on?

  Yes

  No

  N/A

• Does the SWMS implement the hierarchy of control to be As Low As Reasonably Practicable? (Elimination, substitution, isolation, engineering, administrative, or personal protective equipment, in descending order)

  Yes

  No

  N/A

• Does the SWMS identify the role/persons accountable/responsible for the controls identified?

  Yes

  No

  N/A

• Does the SWMS take into account workplace specific circumstances that may affect the High-Risk Construction Activities (including how changes are risk assessed and workers consulted)?

  Yes

  No

  N/A

• Are hazardous chemicals identified (Safety Data Sheets must be submitted with the SWMS? [NB: Can not be more than 5 yrs from date of issue]

  Yes

  No

  N/A

• Does the SWMS identify the mandatory PPE requirements for the risks identified?

  Yes

  No

  N/A

• SWMS DEFICIENCIES - ACTION REQUIRED OR GENERAL COMMENTS

• Name of Contractor Rep

IBRA Review

• Accepted?

  Yes

  No

  N/A

• Name:

• Signature:

  Sign

• Date:

  Date

• Project Leader / Construction Manager must review and approve all SWMS where residual scores remain high