coo.uq.edu.au · Web viewSafe Work Method Statement – Sign Off I understand and accept the...
Transcript of coo.uq.edu.au · Web viewSafe Work Method Statement – Sign Off I understand and accept the...
SAFE WORK METHOD STATEMENT
Company Details
Company Name: Contact Name:
ABN: Contact Position:
Address: Contact Phone No:Project Details
Project Name:
High Risk Activities: Leave blank if none are expected during the work.
Client:
Expected start date of work: Expected finish date:
Date SWMS Created: Next Review Date: :
Authorising Name &Signature: Position: :
Mandatory PPE: Leave blank if none are expected during the work.
Equipment Used:
Maintenance checks: Leave blank if none are expected during the work.
Chemicals Used: Leave blank if none are expected during the work.
Resources Involved:
Other:
Other:
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Date______________________________________________________________
This document is provided as a guide only. It is the responsibility of the contractor to ensure that safety documentation is complaint with the relevant statutory laws.
Tasks Hazards and Risk Control Measures*Is the risk after controls acceptable?
Control Responsibility
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Risk Assessments Using Hierarchy of ControlsFollow the guidelines and steps in the following diagram to assess hazards and risks.
REFERENCE: HOW TO MANAGE WORK HEALTH AND SAFETY RISKS, SAFE WORK AUSTRALIA
Legislation
The following legislation has been consulted in order to develop these safe work methods.Environmental Protection Act 1994Work Health and Safety Act 2011Work Health and Safety Regulation 2011
Codes of Practice (COP)
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PRO
BABL
E
MED RISK UNACEPTABLE
HIGH RISK UNACCEPTABLE
IMPR
OBA
BLE
LOW RISK ACCEPTABLE
MED RISK UNACCEPTABLE
MINOR MAJOR
CONSEQUENCE
Control measures have been identified using the Hierarchy of Control. Elimination ->Substitution ->Engineering -> Admin -> PPE
Licensing
The following licenses and qualifications will be utilized on site:
LICENCE/QUALIFICATION TYPE PERSON LICENCE No.
Emergency Response
Unplanned Event Control Measures or Response
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Safe Work Method Statement – Sign Off
I understand and accept the proposed work method and controls described above.I have the competency and training listed in this document.
Name Employee Signature Date Name Employee Signature Date
SWMS Review
Review No. 1 2 3 4 5 6 7 8 9
Name:
Date:
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