Title Page

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Safe Work Method Statement

  • Instructions & Risk Rating Guide
    -------------------------
    1. Refer to this guide when answering the "Consequence or Impact of Hazards without controls" in the sections below
    2. Select the relevant risk rating with and without controls. Try again if you select the wrong answer
    3. Confirm you have reviewed this SWMS form and assessed the hazard by providing your digital signature

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Step 1 - Assess the site for safety issues

Slips/ Trips/ Falls

  • Possible Hazard:
    - Slips/ Trips/ Fall
    -----------------------------
    Safety Controls:
    - Determine safe approach to site to be assessed.
    - Take care to identify trip hazard / unstable surfaces.
    - Do not work on unstable surfaces or steep slopes.
    -----------------------------
    Personal Protective Equipment:
    - Boots with ankle support and steel toecaps

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  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Strains and sprains

  • Possible Hazard:
    - Strains and sprains
    -----------------------------
    Safety Controls:
    - Standard tools and equipment are light-weight and do not require repeated / repetitive tasks.
    - For non-standard equipment weighing greater than 30kg a two-person lift is required.
    - Identify potential hazards and take steps to minimise injuries
    -----------------------------
    Personal Protective Equipment:
    - Lifting equipment/ aids as required
    - Use of two person crews for non-standard fauna surveying

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  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Step 2 - Shared sites/ Roadsides/ Rail corridors

  • Possible Hazard:
    - Vehicle / Equipment impact injuries – crush injuries, hearing damage, airborne particulates
    -----------------------------
    Safety Controls:
    - Ensure personnel have appropriate reflective clothing, helmets, ear-defenders and safety glasses.
    - Determine safe work zones in consultation with site manager.
    - Remain within identified safe work zones.
    -----------------------------
    Personal Protective Equipment:
    - High Visibility
    - Helmets
    - Hearing Protection
    - Eye Protection

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  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Step 3 - Environmental Conditions

Weather

  • Possible Hazard:
    - Sunburn / Hypothermia
    -----------------------------
    Safety Controls:
    - Ensure personnel have appropriate PPE for environmental conditions.
    -----------------------------
    Personal Protective Equipment:
    - Waterproof clothing, hats, gloves, sunglasses, sunscreen, gloves, long pants.

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  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Wind

  • Possible Hazard:
    - Falling branches
    -----------------------------
    Safety Controls:
    - Do not assess trees in high winds.
    - In moderate wind conditions clearly identify a safe approach distance.
    - Do not stand directly under deadwood / hanging broken branches.
    -----------------------------
    Personal Protective Equipment:
    - Helmets

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  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Bushfire

  • Possible Hazard:
    - Burns, smoke inhalation
    -----------------------------
    Safety Controls:
    - Outside of Metropolitan areas check fire before traveling to the site.
    - Do not undertaken works in areas with total fire bans.

  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Step 4 - Work

Duration of work

  • Possible Hazard:
    - Fatigue / Dehydration
    -----------------------------
    Safety Controls:
    - Ensure personnel take standard breaks and additional rest periods where required.
    -----------------------------
    Personal Protective Equipment:
    - Ensure adequate drinking water and food is available onsite.

  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Suitability of work

  • Possible Hazard:
    - Slips, trips, falls, manual handling injury.
    -----------------------------
    Safety Controls:
    - Personnel under the influence of alcohol and / or drugs are not permitted to work.
    - Personnel who are fatigued and / or in ill health are not permitted to work.
    -----------------------------
    Personal Protective Equipment:
    - Support individual and provide assistance to seek appropriate medical attention

    Screen Shot 2017-08-07 at 1.51.48 pm.png
  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Step 5 - Structures and Night works

Built structures

  • Possible Hazard:
    - Loose debris / hazardous substances
    -----------------------------
    Safety Controls:
    - Confirm with site manager building is suitable for access.
    - Confirm with site manager what hazards are present / potentially present.
    -----------------------------
    Personal Protective Equipment:
    - Do not undertake work if structure is unsound or there is a risk of exposure to hazardous substances.

  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Night works

  • Possible Hazard:
    - Trips, slips and falls.
    - Contact injury objects / surfaces.
    -----------------------------
    Safety Controls:
    - Use of head torches mounted on helmets. All personnel to carry secondary hand torch and spare batteries.
    - Reflective strips on clothing.
    - Obstacles / trip hazards to be clearly identified with reflective tape / barriers during daylight hours.
    -----------------------------
    Personal Protective Equipment:
    - Head torch.
    - Hand torch.
    - Spare batteries for both torches.
    - Reflective strips on clothing.

  • Risk rating without controls

  • Wrong answer try again!

  • Risk rating with controls

  • Wrong answer try again!

Sign off - Safe Work Method Statement

  • Add person

  • Person
  • All people below who have provided signatures confirm that they have read and understand this Safe Work Method Statement

  • Name and role

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.