WORK METHOD STATEMENT
Contractor Company Name: ABN:
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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WORK METHOD STATEMENT
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: (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 Approving 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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