OHS FORM 005 SAFE WORK METHOD STATEMENT (SWMS)

Document Sample
OHS FORM 005 SAFE WORK METHOD STATEMENT (SWMS) Powered By Docstoc
					              OHS FORM 005 SAFE WORK METHOD STATEMENT (SWMS) – also known as Job Safety Analysis (JSA)
                                               This SWMS has been developed and authorised by:
                                               Name:

Company Name:                                  Position:                                         Date:

ABN:                                           Signature:                                        Phone:

                                                                                                 Mobile:

DESCRIPTION OF WORK ACTIVITY:               Concrete Placement (General)

Trades involved with undertaking this Work Activity:

    This SWMS is submitted to: (principle contractor)
COMPANY:

CONTACT NAME:                                                   PHONE NUMBER:

SITE ADDRESS:                                                   PROJECT DESCRIPTION:

    This SWMS was review by: (principle contractor)
NAME:                                                                POSITION:

SIGNATURE:                                                           DATE:

PHONE NUMBER:                                                        MOBILE NUMBER:

Person responsible for OHS on the contractor’s behalf:
NAME:                                                                POSITION:

SIGNATURE:                                                           DATE:

PHONE NUMBER:                                                        MOBILE NUMBER:


Safe Work Method Statement (SWMS)                                                                          Page 1 of 1
List plant, equipment and                                                List Hazardous Substances                  MSDS       List PPE to be worn    (Tick) List Hazards to consider        (Tick)
     tools to be used                                                       to be used or handled                 available?
                                                                                                                    (Tick)
eg. Electric generator                                                   eg. Unleaded petrol                                   Hard Hat                       Fall from ladder
                                                                                                                               Safety Boots                   Fall from heights
                                                                                                                               High-visy clothing             Fall from scaffold
                                                                                                                               Gloves                         Contact with electricity
                                                                                                                               Hearing Protection             Falling objects
                                                                                                                               Safety Glasses                 Collapse
                                                                                                                               30+ Sunscreen                  Slips, trips and falls
                                                                                                                               Dust Masks                     Manual handling
                                                                                                                               Other (specify):               Exposure to noise
                                                                                                                                                              Struck by moving plant
                                                                                                                                                              Inhalation of dust or fumes
                                                                                                                                                              Cuts
                                                                                                                                                              Other (specify):


                                                               How LIKELY is it to be that bad?                             How to complete the following form
                                             Note: If a hazard is rated 1, 2 or 3, action must be taken immediately.
                                                                                                                               1. List the step-by-step sequence of tasks required to carry out
                                               What          VERY           LIKELY     UNLIKELY           VERY
   Health Risks and Likelihood of Damage




                                             damage         LIKELY           Could        Could          UNLIKELY
                                                                                                                                  the work activity from start to finish.
                                              could it    Could happen      happen     happen, but    Could happen, but        2. Listing of potential hazards associated with each step, and the
                                              cause?        anytime        sometimes    only rarely   probably never will         related OHS risks.
                                            Death or
                                           permanent           1               1           2                  3                3. Using the risk table, rating the identified risks.
                                            disability                                                                         4. List what controls you will implement to reduce the risks to the
                                           Long term                                                                              lowest possible level.
                                            illness or
                                              serious
                                                               1               2           3                  4                5. Rate the level of risk once those controls have been
                                               injury                                                                             implemented (must be 4-6 before you can start work).
                                             Medical
                                           attention or                                                                        6. List the names or positions of the persons responsible for
                                              several          2               3           4                  5                   ensuring the controls are implemented.
                                             days off
                                                work

                                            First Aid
                                            needed
                                                               3               4           5                  6



Safe Work Method Statement (SWMS)                                                                                                                                                       Page 2 of 2
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

1.     Entry to Site                    Entry to unsafe area                                   Report to site office for site induction.

                                        Movement of site                                       Risk assessment of site conditions.
                                        personnel, vehicles, plant
                                        & equipment                                            Training of all employees
2.     Unloading Equipment              Fall from vehicle                                      Training employees in manual handling and team
                                                                                               lifting
                                        Manual handling injuries,
                                        cuts, splinters & abrasions                            Wear gloves (PPE)

                                        Being struck by equipment                              Training employees in manual handling
                                        Crush hands                                            The use of P.P.E equipment such as gloves
                                                                                               Team lifting


                                        Slips, trips & falls                                   Unload equipment on a level clear area
3.     Setting out / up                 Trips & falls                                          Ensure site is clear of any debris, obstructions.
       equipment
                                                                                               Define & barricade work area & fall areas

4.     Drilling piers                   Hit by auger or bobcat                                 Only suitably trained personnel to work with plant
                                        excavator
                                                                                               Plant & equipment to be maintained, operator
                                                                                               must be licensed

                                                                                               The training and use of P.P.E equipment such as
                                                                                               high visible vests, hard hats
                                        Fall in holes                                          Personnel to be trained on relevant works.
                                                                                               Site Induction

Safe Work Method Statement (SWMS)                                                                                                                                                            Page 3 of 3
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

5.     Placing Concrete in piers        Run over by concrete                                   Truck drivers to be made aware of site entry,
                                        pump or trucks                                         driver to be aware of the whereabouts of the
                                                                                               offsider
                                                                                               Reverse siren to be in working order on concrete
                                                                                               pumps & trucks.

                                                                                               Relevant personnel to be in sight of driver at all
                                                                                               times

                                                                                               Pump operators to supply maintenance checklist &
                                                                                               log books
6.     Installing pegs for edge         Back injury from using                                 All relevant personnel to be trained in the use and
       boards                           sledgehammer.                                          shown the correct procedure in using a
                                                                                               sledgehammer.
                                        Missing target when using
                                        sledgehammer.                                          Use P.P.E equipment

                                        Cuts, splinters and                                    Training in manual handling and correct use of
                                        abrasions                                              sledgehammer

                                        Arm & shoulder injuries

                                                                                               Training in manual handling

                                                                                               Keep hands and limbs out of rage

                                                                                               Workers to keep others in sight



Safe Work Method Statement (SWMS)                                                                                                                                                            Page 4 of 4
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

7.     Installation of formwork         Back and shoulder injuries                             Training in manual handling
                                        Injury from nail gun
                                        Hit by materials                                       Keep hands and limbs out of range.

                                                                                               Workers to keep others in sight
8.     Benching / fill slab             Hit by machines / plant                                Training in the use of shovels and wheelbarrows.
                                        Back and shoulder injury
                                                                                               P.P.E equipment eye protection.
                                        Eye injury from dust
                                        Sunburn                                                Sun protection P.P.E equipment such as
                                                                                               sunscreen hats and shirts.
9.     Laying of plastic                Slips and Trips                                        Clear waste materials from work area.

                                                                                               Care taken when walking on plastic.
10.    Carrying steel                   Back and shoulder                                      Training provided in cutting and placing steel.
                                        injuries.

                                        Cuts and abrasions.
11.    Cutting and placing steel        Back and shoulder                                      Training provided in cutting and placing steel.
                                        injuries.

                                        Cuts and abrasions from                                Care taken when stepping over formwork onto
                                        trips & slipping on steel.                             steel or plastic.

                                        Cuts from cut ends of                                  Wear gloves (PPE)
                                        steel.

12.    Set up of electrical leads       Tripping over leads                                    Training in the set up of electrical leads.



Safe Work Method Statement (SWMS)                                                                                                                                                            Page 5 of 5
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

13.    Grinder use                      Pieces of metal                                        P.P.E. equipment use – wear ear and eye
                                        penetrating eyes                                       protection

                                        Electrocution                                          Training in correct use of grinder

                                                                                               Electrical test & tagging. Register of all equipment

14.    Use of Oxy Acetylene             Burns                                                  Wear Gloves

                                                                                               High visibility vests to be removed prior to using
                                                                                               Oxy Acetylene as the vests are highly flammable.
                                        Sparks hitting eyes                                    Wear safety glasses (PPE)

                                        Explosion and Fire                                     All Oxy Acetylene equipment to have flash back
                                                                                               arrestors and have fire extinguishers
                                                                                               accompanying them.

15.    Tying Steel                      Cuts and abrasions                                     Wear gloves

                                        Penetrating wounds                                     Bar caps to be installed on all exposed vertical
                                                                                               bars.

16.    Installing bar chains            Back Injury                                            Bend knees as placing chairs under reo bar

                                                                                               All relevant personnel to be trained in manual
                                                                                               handling

                                                                                               Clear all waste materials



Safe Work Method Statement (SWMS)                                                                                                                                                            Page 6 of 6
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

17.    Set up of concrete pump          Concrete pump (boom                                    Truck drivers / operators to be made aware of site
                                        line) not stable and tipping                           entry, driver to be aware of the whereabouts of the
                                        over                                                   offsider and site personnel.

                                        Machine failure                                        Reverse siren to be in working order on concrete
                                                                                               pump


       Set up of concrete pump                                                                 Pump operators to supply maintenance checklist
       (continued)                                                                             and log books
                                                                                               Concrete pump to be set up in accordance with
                                                                                               the Code of Practice. (concrete pumps are to be
                                                                                               registered with WorkCover)
18.    Placing Concrete                 Hit by concrete                                        No persons to be standing in front of concrete
                                                                                               hose

                                        Back injury from shovelling                            Relevant personnel shown correct posture for
                                                                                               shovelling
                                        Concrete burns
                                                                                               Avoid contact to skin, wash skin and clothing after.

                                        Sun burn, skin cancer, eye                             Sun protection P.P.E equipment such as sun
                                        damage                                                 cream, hats, shirts , sunglasses to be worn




Safe Work Method Statement (SWMS)                                                                                                                                                            Page 7 of 7
                 Job Step                  Hazard Identification                                                  Controls Implemented                                                      Person




                                                                                                                                                                          Revised Risk
                                                                                                                                                                                          Responsible




                                                                                Rating (1-6)




                                                                                                                                                                           Rating (1-6)
                                                                                Initial Risk
                                        Identify any potential hazards                         Decide what controls to use to eliminate or minimise the risks.
STEP

       Beak the job down into steps.
       List the steps in this column.   associated with each step – and                        Detail the controls in this column, and enter the revised risk rating in
                                        any related risks. Detail the hazards                  the next column.
                                        and risks in this column, and enter
                                        the risk rating in the next column.                    Note: If the risk rating is still 1-3, do not begin work.

19.                                     Run over by concrete                                   Truck drivers to be made aware of site entry.
                                        pump or truck
                                                                                               Relevant personnel to be in sight of drivers at all
                                                                                               times.

                                                                                               Personnel to be trained in the use of hazardous
                                                                                               substances e.g. cement.
20.




   THESE ARE STANDARD SWMS, THEY MUST BE MODIFIED TO SUIT YOUR WORKERS, YOUR EQUIPMENT AND
   YOUR SITE.




Safe Work Method Statement (SWMS)                                                                                                                                                            Page 8 of 8
                              CHECKLIST OF ITEMS THAT MAY BE REQUIRED FOR THIS WORK ACTIVITY




  QUALIFICATIONS




  TRAINING




                                            Codes of Practice

                                            OHS Consultation
                                            OHS Induction Training for Construction
  CODES OF PRACTICE OR AS/NZS               Amenities for Construction Work
  STANDARDS TO BE COMPLIED WITH
                                            Australian Standard

                                            AS 1012



Safe Work Method Statement (SWMS)                                                              Page 9 of 9
Declaration by contractors & workers:
1. I have been consulted and assited in the development of this SWMS.
2. I have been given the opportunity to comment on the content of this SWMS.
3. I have read and understand how I am to carry out the activities listed in this SWMS.
4. I have been supplied with the personal protective equipment identified on this SWMS and I have been given training in the safe use of this equipment.
5. I have read and understand the requirements set out in the mateial safety data sheets for the hazardous substances identified in this SWMS.



NAME:                                                SIGNATURE:                                        DATE:




Safe Work Method Statement (SWMS)                                                                                                          Page 10 of 10