Download appendix 3: safe work method statement

BCCA
AN INTEGRATED CATCHMENT
MANAGEMENT GROUP FOR
THE BURNETT REGION
BURNETT CATCHMENT CARE ASSOCIATION
APPENDIX 3: SAFE WORK METHOD STATEMENT
1. Organisation Details
Organisation Name:
Contact Name:
ABN:
Contact Position:
Address:
Contact Phone No:
2. Project Details
Project:
Location:
Date:
Description of Works:
Work Activities to be
undertaken:
Plant & Equipment
involved:
PPE required:
□ Four wheel Drive
□ Trailer
□ Single axle Truck
□ Dual axle truck
□ Bobcat
□ Dingo
□ General hand tools
□ Power Tools
□ Post Borer
□ Chain Saw
□ Other _____________________________________
□ Hard Hat
□ Hearing Protection □ Wide brim hat
□ Safety Glasses
□ HI Vis shirt/vest
□ Safety Boots □ Face Shield □ Gloves
□ Other ____________________________________________
Material Safety Data
Sheet (MSDS):
Emergency Equipment:
□ First Aid Kit
Emergency Contacts:
Police, Fire, Ambulance (000), Poison Information Centre (131126)
□ Snake Bite Kit
□ Excavator
□ Other _____________________________________
□ Post hole digger
□ Respirator
Step 3 Determine the risk score
Step 4 Record risk score on worksheet
(Note - risk scores have no absolute value and should only be used for comparison and to engender discussion)
CONSEQUENCE
LIKELIHOOD
Insignificant
Minor
Moderate
Major
Catastrophic
Score
Almost certain
3
3
4
4
4
4
EXTREME – Requires immediate attention
Likely
2
3
3
4
4
3
HIGH – Require urgent attention
Possible
1
2
3
4
4
2
MEDIUM - Follow management instructions
Unlikely
1
1
2
3
4
1
LOW – OK for now. Monitor and review if changes to equipment, personnel,
work processes or procedures
Rare
1
1
2
3
3
Refer to Appendix 2 for further details on developing risk scores
Action
3. Site Specific Risk Assessment
Task Breakdown
Example:
Planning
Risk Identification
(describe each hazard which could cause injury for
each task)
Personal Injury:
 Hit by moving vehicle / plant
 Animal attacks/bites/stings
 Physical violence
 Exposure to hazardous environment
 Slips/trips/falls
 Problems with back, muscles and joints
Risk Score
before
control
4 – Extreme
1 – Low
4
Transport to Site
Pre-start, P.P.E
requirement, Site
Induction
Preparation
Personal Injury
 Problems with back, muscles and joints
 Hit by moving vehicle
 Slips/trips/falls
 Exposure to hazardous environment
 Electric shock
3
Control Measures to Reduce Risk
Liaise with all people working on the project. Ensure the
following is provided before work commences:
 Site specific induction (include location of amenities,
first aid facilities, emergency plans and evacuation
points, incident reporting, contact persons etc)
 Health and Safety Rules for site
 Supervisor arrangements
 PPE requirements for site
 Types of hazards at site
 Drive to conditions, maintain awareness, observe
road rules and regulations
 Site plans – showing no go zones for pedestrians or
workers
 Traffic Management plans if required
Assess:
 Presence of potentially aggressive persons
 Dangerous plants and animals
 Presence of biological contamination (waste, debris,
animal or human waste, syringes etc.)
 Weather conditions, ground conditions
 Disposal requirements for materials
Ensure:
 Workers to sign SWMS
 Tool Box Talks to be conducted
 Site assessment conducted and reviewed during work
processes.
 Services assessed (power lines, Telstra, water, etc.)
Developed & approved by:
Name:
Position:
Date:
Risk Score
after
control
4 – Extreme
1 – Low
Responsible Person
1
Workers
Supervisor
Project manager
Land owner
This risk is
relevant and has
been considered:
Name:
Signature:
1
I acknowledge that I have been trained in the SWMS listed above, the controls are clearly understood, my qualifications are current to
undertake the activity, I will comply with the SWMS and I have been consulted and had the opportunity to input into the SWMS.
Print Names
Position / Trade
Signature:
Date
Monitoring & Review of SWMS Use and Effectiveness
Observation
Log
01
02
03
04
05
06
Initial:
Date:
Safe Work Method Statement - Appendix 1
Certificates of Competency Required
1.1 Procedures
1.
2.
3.
4.
The SWMS must be specific to task, including the site environment and the particular work crew, equipment and materials
The workers and supervisors involved in carrying out the work activity must be consulted in identifying the safety hazards and determining the safe work methods
Every 12 months the SWMS will be generally reviewed
Any significant change to the work process or sequence or to the type of plant or materials used is to trigger a review of this SWMS, as is any Lost Time Injury/Medically Treated Injury, Near Miss or Environmental breach or
notice served by a regulatory body
5. Changes are not to be made to the safe work methods prescribed in this SWMS without first consulting with the work team. Changes are to be documented, reviewed and approved before instructing the workers involved
into the changes
6. The SWMS will be reviewed by the Project Manager at the commencement of each project to ensure all works to be undertaken are included in the SWMS
7. SWMS will be discussed at Tool Box Talks generally, with any site specific or general changes to SWMS discussed in full
8. Regular inspections and observations will be conducted by the Site Foreman to ensure SWMS is being complied with
9. SWMS must be made available for inspection or review as required by WHS legislation
10. Record of SWMS must be kept as required by WHS legislation (until job is complete or for two years if involved in a notifiable incident
1.2 Considerations






Legislative requirements
Relevant Codes of Practice and Australian Standards (WHS Act 2011
Regulations 2011

Principal Contractor’s Safety Rules / Safety Alerts

Manufacturers’/ Suppliers’ recommendations
1.3 Safety and Environmental Planning
Site Safety Plan
Environmental Management Plan
Engineering / Client approvals
Previous (similar work) injuries, incidents
Formal training, licences required for workers
Training in the following safe work procedures / SWMS / training modules is required
undertaking this task
(All workers to be trained in the relevant procedures)




Plant and equipment suitability
Experience / competency / licensing of workers / operators /
supervisors
MSDS of materials used in works
Industry specific alerts / guides
Duties of workers undertaking this task
Project Managers





QBSA – Site Supervisor Licence
General Industry Induction (Blue/White Card)
Relevant trade qualification


Site specific inductions
Training in this SWMS
Nature of hazards / risks
Emergency procedures
Supervisors
Workers
Land Owners
Details of supervisory arrangements for workers undertaking this task



Competent supervisors for job
Direct on-site supervision
Remote site – communication systems /
schedule



Audits
Spot checks
Reporting systems
Details of regulatory permits / licenses, engineering details,
certificates, approvals




Local council permits
Building approvals
EPA approvals / permits
PPE to comply with relevant Australian Standard
Legislation / Codes / Standards to be complied with
Queensland Work Health & Safety Act 2011
Queensland Work Health & Safety Regulation of 2011
Electrical Safety Regulations 2002, Code of Practice for Noise, Code of
Practice 2010 – Manual Tasks, Qld Plant Code of Practice 2005
Safe Work Method Statement - Appendix 2
Risk Assessment Ranking
Step 1 Determine Likelihood – What is the possibility that the effect will occur?
Criteria
Description
Step 2 Determine Consequence – What will be the expected effect?
Level of Effect
Example of each level
Almost
certain
Expected in most
circumstances
Insignificant / Acceptable
Likely
Will probably occur in most
circumstances
Possible
Might occur at some time
Unlikely
Could occur at some time
Rare
May occur in only
exceptional circumstances
Effect is a common result
Effect is known to have occurred at this site or
it has happened
Effect could occur at this site or I’ve heard of it
happening
Effect is not likely to occur at the site or I have
not heard of it happening
Effect is practically impossible
Minor
No effect – or so minor that effect is acceptable
First Aid treatment only; spillage contained at site
Moderate
Medical treatment; spillage contained but with
outside help
Major
Extensive injuries; loss of production
Catastrophic
Death; toxic release of chemicals
Safe Work Method Statement - Appendix 3
Step 3 Determine the risk score
Step 4 Record risk score on worksheet
(Note - risk scores have no absolute value and should only be used for comparison and to
engender discussion)
CONSEQUENCE
LIKELIHOOD
Insignificant
Minor
Moderate
Major
Catastrophic
Score
Action
Almost certain
3
3
4
4
4
4
EXTREME – Requires immediate attention
Likely
2
3
3
4
4
3
HIGH – Require urgent attention
Possible
1
2
3
4
4
2
MEDIUM - Follow management instructions
Unlikely
1
1
2
3
4
1
LOW – OK for now. Monitor and review if changes to equipment, personnel, work
processes or procedures
Rare
1
1
2
3
3