Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Safe Work Method Statement -

    This document is to be used by property management personnel or contractors undertaking repairs to buildings and other associated repairs to equipment and plant on the school campus

General Information

  • Company Name

  • Company Address
  • Name of Responsible Person

  • Commencement Date

  • Signature

Task Information

  • Description of the work?

  • Specific work location?
  • What are the hazards associated with the work?

  • Take photo's of any major hazards

  • Select the general control measures for the task here

  • List all site specific control measures here?

  • Select the plant and equipment required for the task?

  • Take pictures of certified plant labels here

  • Select the personal protective equipment (PPE) required for the task?

Permits

  • Select the permits required for the task here?

Photo's

  • Add photo's to show how the area/task has been made safe before work commences

Briefing and Acknowledgement

  • I hereby confirm that I have been briefed on the above information and will comply with all the controls listed in the Safety Work Method Statement

  • Person(s) undertaking the work please sign here

  • Signature(s)
  • Signature

  • Date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.