Contractor WMS Form Template - Download as DOC by mnp19709

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									    OCCUPATIONAL HEALTH AND SAFETY TEMPATE

    Work Method Statement (Contractors)
    Contractor Details:
    Contractor Company Name:                                                                                                                           ABN:
    Company Address:
    Name of Key Contact Representative:                                                                                       Contact Details:

    Work Method Statement Details:
    Work Site / Location:                                                                                        BAC Site Contact: (name)
    Work Activity Title:                                                                                                                Proposed Work Date:
    WMS Author/s: (name/s)                                                                                                              Development Date:
    Related Permit To Work Number: (if applicable)                                                               Related Work Approval Number: (if applicable)
    Related Overarching Safe Work Plan:         Yes                    No
Task Tasks                                            Hazards                                    Controls                                               Responsible Party                     Risk Analysis*
 No. List in sequence, the tasks involved in the      List the hazards relating to each task     For each identified hazard, list the controls to be    List the role, competency, prescribed With controls in place
         work activity.                               using the WHSQ Risk Management Code        implemented based on the hierarchy of controls.        occupation title, etc. responsible for
                                                      of Practice 2007 as a guide as required.   Also include reference to specific work permits as     the controls (e.g. worker, supervisor,
                                                      Consider any environmental issues where    required.                                              foreperson, plant operator,            LL      CL      Risk
                                                      applicable.                                                                                       electrician, dogger, etc).




*     Refer to the WHSQ Risk Management Code of Practice 2007 as a guide as required, (LL = Likelihood Level, CL = Consequence Level, Risk = Risk Level Assessed).
Note: Although more than one page of the above may be required, the Monitoring, Approval & Communication sections must also be completed as part of the WMS development & implementation process.

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OCCUPATIONAL HEALTH AND SAFETY TEMPATE

Work Method Statement (Contractors)
Method for Monitoring / Reviewing Controls:
Detail how the controls will be monitored and reviewed during the work activity. Include reference to any inspections or checks and the responsible party/s who may undertake the monitoring.




WMS Approval: (Approved Contractor Supervisor / Manager)
I have reviewed the above WMS content and approve the proposed work activity to commence once applicable communication has been undertaken with relevant persons.



    Name of Approved Contractor Person (First & Last)                                     Signature                                             Date                           Time

WMS Communication: (tick one of the following)
        This section not required as this work activity is linked to a PTW and WMS communication is to be tracked via a PTW Sign On/Off Sheet.
        This section is required as this work activity is not linked to a PTW.
Name                                                                                 Signature                                                              Date
The detail and requirements of the above WMS have been communicated to me and I fully understand the hazards and control measures to be implemented as part of this activity.




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