Civil Drainage Solutions Pty Ltd
Civil Drainage Solutions Pty Ltd
Safe Work Method Statement
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
Created 19 August 2013
Civil Drainage Solutions Pty Ltd
Safe Work Method Statement (SWMS) for Civil Drainage and Construction Works
Pipe Laying (Water and Sewer)
Principal Contractor:
Project:
Job Address:
Job Description:
Approximate Start Date:
Approximate Completion Date:
Review Details
Date Reviewed
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
Who Reviewed
Summary of Changes
Signature of Reviewer
19/08/2013
Page 2 of 11
Civil Drainage Solutions Pty Ltd
Sign Off Details
Principal Contractor Signature:
Print Name:
Position:
Dated:
Contact Details
Company Name:
ABN:
Postal Address:
Civil Drainage Solutions
Contact Person Name:
48 165 437 632
Contact Person Signature:
1391-1404 Waterford Tamborine Pty Ltd
Brett Wilson
Phone No:
LOGAN VILLAGE QLD 4207
Mobile No:
Email:
Associated High Risk Construction
Working where there is a risk of a person falling 2m or more
Prescribed Occupations
Prescribed Activities
Other
Nil
Nil
Nil
OR
OR
OR
Construction work involving a confined space
Working involving excavation at a depth of 1.5m or greater
Working on or near energised electrical installations & services
Working with hazardous or dangerous substances or containment atmosphere
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
19/08/2013
Page 3 of 11
Civil Drainage Solutions Pty Ltd
Working on or near roadways
Work where there is any movement of powered mobile plant
Specify:
Specify:
Specify:
Specify:
Contact
Signature
Load shifting Operations
Vehicle Loading Crane/ Dogging
Toolbox Meetings – Frequency
Weekly or Where Required
Nominated Representatives (Personnel responsible for monitory and managing activity)
Position
Foreperson
Foreperson
Name
Brett Wilson
Shane Austin
Equipment to be used
Insert other equipment
Extension ladder
Cement mixer
Personal protective equipment to be
used. Has PPE been supplied?
Y/N
Common Hazard
Step ladder
Scaffold (mobile)
External scaffold
Fire Extinguisher
Trestles
Electrical leads
Trestles
Electrical leads
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
19/08/2013
Page 4 of 11
Civil Drainage Solutions Pty Ltd

ALL PERSONS INVOLVED IN TASK MUST HAVE THIS SWMS COMMUNICATED TO THEM PRIOR TO WORK COMMENCING
Prior to daily commencement of works inspections and observations will be conducted by _______________________________________to ensure SWMS is
being complied with.

All workers will constantly monitor operations to ensure that authorised work instructions are followed.

Daily Tool Box Talks will be undertaken to identify, control and communicate additional site hazards.

Work must cease immediately if incident or near miss occurs. SWMS must be amended in consultation with relevant persons.

Amendments must be approved by _______________________________________ and communicated to all affected workers before work resumes.
Personal Protective Clothing
Foot
Protection
Hearing
Protection
High
Visibility
Head
Protection
Eye
Protection
Face
Protection
Hand
Protection
Protective
Clothing
Breathing
Protection
AS 1319-1994 Safety signs for the occupational environment reproduced with permission from SAI Global under license 1210-c062. Standards may be purchased at http://www.saiglobal.com
Day Operations – Normal Requirements:
 Safety footwear, hearing protections, high visibility shirt or vest, hard hat and sun protection if required, hand protection (gloves)
Night Operations – As Required or Additional Requirements:
 Safety footwear. Hearing protection, high visibility shirt or vest for night works
Safety Notes
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
Created 19 August 2013
Civil Drainage Solutions Pty Ltd
References
□
AS/NZS 4360:2004 Risk Management Standard
□
Confined Spaces Code of Practice (2011)
□
Construction Work Code of Practice (2012)
□
Electrical Safety Regulations (2003)
□
Formwork Code of Practice (2006)
□
Hazardous Chemicals Code of Practice (2003)
□
Hazardous Manual Tasks Code of Practice (2011)
□
How to manage Workplace Health and Safety Risk Code of Practice (2011)
□
Managing Noise and Preventing Hearing Loss at Work Code of Practice (2011)
□
Managing the Risk of Falls ay Workplaces COP (2011)
□
National Standard for Construction Work [NOHSC:1016 (2005)]
□
National Standard for Plant [NOHSC:1010]
□
Plant Code of Practice (2005)
□
Traffic Management for Construction and Maintenance & Work Code of Practice (2008)
□
Workplace Health and Safety Act (2011)
□
Workplace Health and Safety Regulations (2011)
□
Workplace Health and Safety, consultation, cooperation and coordination Code of Practice (2011)
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
19/08/2013
Page 6 of 11
Civil Drainage Solutions Pty Ltd
WORK METHOD STATEMENT (PIPE LAYING – WATER & SEWER)
Approved
Generic Use
Site specific use
ACTIVITY:
TASK
Control Measures to Reduce Risk
RA
Risk Score
Consequence
Likelihood
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
LOW
Title
Risk Score
Overall Risk Rating After Controls
RB = Risk Rating before controls implemented
Consequence
NOTE:
RB
Likelihood
Possible Safety or Environmental
Hazards
Name
Responsible
Officer
RA = Risk Rating after controls are implemented
MODERATE
HIGH
ACUTE
19/08/2013
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Civil Drainage Solutions Pty Ltd
Please complete the following record, sign and date as evidence that the Safe Work Method Statement has been read, explained where necessary and is understood by
you.
Name of Personnel Involved in Activity
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
Signature
Date [DD/MM/YYYY]
19/08/2013
Page 8 of 11
Civil Drainage Solutions Pty Ltd
Personal Qualifications and Experience required for the
Duties and Responsibilities of those employees
Training Required to Complete the Work:
job:
undertaking the task:
(All employees must be trained in relevant procedures)
Appropriate licence and certificate
Site specific inductions
Relevant training
Training in this SWMS
Details of regulatory permits/licences required
Engineering Details/Certificates/Work Cover Approvals:
Codes of Practice. Legislation
Plant to comply with RTA requirements
PPE to comply with relevant Australian Standards
Plant/Tools/Equipment:
Maintenance Details: (Include maintenance on
(List plant and equipment to be used on job)
equipment/machinery)
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
Created 19 August 2013
Civil Drainage Solutions Pty Ltd
SAFE WORK METHOD STATEMENT – Part 3: RISK ASSESSMENT.
HB 436:2004 Risk Management Guidelines Tables 6.3 – 6.8 reproduced with permission from SAI Global under
license 1210-c062. Standards may be purchased at http://www.saiglobal.com References: Safe Work Australia (2011) - Code of Practice: How to Manage Work Health and Safety Risks, AS/NZS 31000 -2009 Risk
Management Principles and guidelines
Steps 1: Determine Likelihood – Consider how likely a risk is encountered, and what
might happen. What is the possibility that the effect will occur?
Step 2: Determine Consequence – Use the risk level calculator to determine the likely risk
level (outcome) to persons who may be exposed to the hazards. What will be the
expected effect?
Step 3: Determine the risk score – Identify and develop effective control measures.
(Consult the hierarchy of risk control measures when carrying out this step)
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)
RISK ASSESSMENT MATRIX
Rating
Category
LIKELIHOOD OF EVENT OCCURRING
How likely is it that an exposure will
occur?
DETERMINATION OF RISK CONTROL ACTIONS
RISK LEVEL
(OUTCOME)
5
Almost
certain
Expected in most circumstances
4
Likely
Will probably occur in most
circumstances
3
Possible
Might occur at some time
H (High)
Highest management decision required
urgently
2
Unlikely
Could occur at some time
M (Medium)
Follow management instructions
regarding risk
E (Extreme)
HIERACHY OF RISK CONTROLS
ACTION REQUIRED
(Refer to the hierarchy of risk controls)
URGENT – immediate action required
to control risk
1.
Eliminate the risk. If it is not reasonably practicable to
eliminate the risk,
2.
Minimise it by (in descending order):

Substitution Reduce the exposure to the hazard
or risk through substitution (such as using a new
activity, procedure, item of plant, process or
chemical)

Isolation - Isolate persons from the hazard

Engineering Controls (e.g. mechanical or
electrical devices)
Use Administrative controls (e.g. changing the way
the work is done)
Personal protective equipment (PPE) (such as safety
helmets or caps (hard hats), safety spectacles or
goggles, ear muffs or plugs, gloves, etc)
3.
1
Rare
May occur in exceptional circumstances
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
L (Low)
These risks may not require immediate
attention-monitor.
4.
19/08/2013
Page 10 of 11
Civil Drainage Solutions Pty Ltd
Rating
Level of
Consequences
LIKELY CONSEQUENCES OF EVENT OCCURING
What is the likely outcome of an exposure to the risk?
Catastrophic (C)
Fatality or permanent disability; toxic release of chemicals; long
term environmental impact, loss of facilities; very high $ loss
4
High (H)
Extensive injuries; loss of production
3
Moderate (M)
2
Low (L)
1
Insignificant (I)
5
Medical treatment requiring up to several days off work; spillage
contained but with outside help.
Minor injury requiring First aid treatment only; spillage contained at
site; moderate property damage; low-med $ loss.
No injuries; minor property or environmental damage, low-med $
loss.
LOW
Civil Drainage Solutions Pty Ltd
1391-1401 Waterford Tamborine Road
LOGAN VILLAGE Q 4207
ABN 48 165 437 632
MEDIUM
Almost
Certain
E
RISK LEVEL OUTCOME & (SCORE)
Likely
Possible
Unlikely
Rare
E
E
E
H
E
E
E
H
M
E
H
M
M
L
H
H
M
M
L
H
M
L
L
L
HIGH
EXTREME
19/08/2013
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