Safe Work Method Statement (SWMS)

• Job Number

• Location
  Address

• Job Description

• Prepared by

SWMS Document Details

• What measures have been put in place to ensure control measures in this SWMS are implemented, monitored and reviewed?

  Select

• Person responsible for monitoring and reviewing this SWMS?

• Names of people consulted during the preparation of this SWMS

High Risk Construction Activities

• Select the relevant High Risk Activities that is being covered by this SWMS

  Select

• NOTE: If activity isn't listed as a High Risk Construction Activity - a SWMS is not required.

Risk Matrix

• This Risk Matrix is to be used to determine risk rating prior to control measures and again after control measures are applied. Any rating of "High Risk" is unacceptable and requires further control measures applied.

  
Job Activity/Task

• Activity / Task

  Select

• If Other - Describe the Activity/Task

• Potential Hazards & Risks

  Select

• If Other - List Potential hazards & Risks

• Risk Rating

  Select

• Control Measures

  Select

• If Other - List additional Control Measures

• Residual Risk Rating

  Select

• Person Responsible

Relevant Legislation & Competencies

Additional Comments (Optional)

• Additional Comments (Optional)

Hazardous Chemical

• Name of Chemical & Storage Location

• Issue Date of Safety Data Sheet

• Additional Comments (Optional)

Signatures

• Name & Signature

  Sign

• Date of Signature

  Date