Appendix 2 Saple work method statement by alendar

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									Appendix 2: Sample work method statement
 Work method statement                                ABN


 High risk construction activity                      Working on, or adjacent to, a road

If	your	work	procedure	or	activity	identifies	the	need	to	work	on,	or	adjacent	to,	
a	road,	then	it	is	a	high	risk	construction	activity,	and	you	will	need	to	develop	a	
work	method	statement.

The	following	is	a	generic	work	method	statement.	It	cannot	be	used	as	a	work	
method	statement	onsite,	unless	the	project-specific	section	has	been	completed.

It	must	be	reviewed	prior	to	undertaking	the	activity,	and	all	site-specific	details	
must	be	documented.

 Control measures          How to use control measures          Monitor and review           Responsible
                                                                                             officer

 1. Road work signs will   A road works signing layout will     Daily inspections to         Supervisor
    be erected prior to    be developed.                        be carried out and
    work commencing.                                            documented in project
                                                                records.
                           All signs will be in accordance      Signing layout to be         Project
                           with the MUTCD Part 3.               approved before work         Manager
                                                                commences.


 2. All workers will       Blue cards will be sighted and       All training records to be   Supervisor
    have general safety    recorded for all workers.            checked.
    induction training
    (blue card) and
    a site-specific
    induction before
    starting work.

                           All workers, including sub-          Safety audits to include     Safety
                           contractors, will be given a site-   check on training and        Coordinator
                           specific induction.                  induction records.

                           Site-specific induction records
                           will be kept for all inductions.
Control measures          How to use control measures         Monitor and review           Responsible
                                                                                           officer

3. Traffic controllers    All traffic controllers will        All traffic controller       Supervisor
   to be used as          be certified by Queensland          identity cards are to be
   required.              Transport.                          checked and recorded.


                          Traffic control will be conducted
                          in accordance with the
                          approved procedure.


4. Work zone and          Work zones will be delineated       Traffic Management           Project
   separation             in accordance with the Traffic      Plan to be reviewed and      Manager
   distances to be        Management Plan.                    approved before work
   delineated.                                                commences.
                          All workers will remain within      Supervisor to constantly     Supervisor
                          the work zone, unless traffic       check on workers and
                          has been stopped by traffic         take appropriate action.
                          controllers.
                          Note: In the site-specific
                          section, detail traffic control
                          devices, such as barriers.
5. All workers will       All workers will wear high          Supervisor to constantly     Project
   wear appropriate       visibility clothing, safety         check and take               Manager/
   personal protective    footwear, wide brim hat and         appropriate action for       Supervisor
   clothing and           any other equipment identified      breaches.
   equipment.             in the risk assessment.


6. All control measures                                       Signs will be checked        Supervisor
   detailed above will                                        before work starts
   be monitored and                                           each day and at regular
   reviewed regularly                                         intervals during the day.
   during the work.
                                                              These inspections are to     Supervisor
                                                              be recorded.
                                                              Daily pre-start meetings     Supervisor
                                                              will be held to ensure all
                                                              workers are informed of
                                                              control measures.
                                                              Any failure of a control     All
                                                              measure will be reported
                                                              to the supervisor
                                                              immediately for action.
Tick relevant boxes to indicate all occupational licences and certificates employed for this activity on
this project.


 Cranes or hoists    
 Loadshifting equipment:
     Backhoe             Excavator           Roller              Grader                Dozer
     Forklift            Skid steer          Front end           Scraper
                           loader               loader
 Riggers:
     Advanced            Intermediate        Basic
 Dogger     
 Scaffolder:
     Advanced            Intermediate        Basic


Approved by Manager:                       _____________________            _____ /_____ /_____
(Safety and Risk Management)                     Signature                         Date




 Project:                           Project Manager:

 Control measures          How to use control measures        Monitor and review            Responsible
                                                                                            officer

 Describe the work         Either use a control measure       If using a project-specific   Supervisor
 activity where working    from the generic section           control measure, the
 on, or adjacent to, a     (page 28 and 29), or develop       method of monitor
 road is required          a project-specific control         and review must be
                           measure.                           documented, as well as
                                                              the responsible officer.



Project-specific details
The following instructions are in addition to the standard work method statement instructions above
and are specific to this project only. This section must be developed after a project-specific risk
assessment has been conducted, and must take into account all hazards associated with the activity.
For further assistance or information, contact your local Safety Coordinator/Officer.
For generic work method statements, the only section that can be edited is the project-specific details.
If instructions in the generic section are not being followed, this should be outlined in the
project-specific details and an alternative method must be documented.

Approved by Manager:                       _____________________            _____ /_____ /_____
(Safety and Risk Management)                     Signature                         Date

								
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