Safe Work Method Statement
SAFE WORK METHOD STATEMENT (SWMS)
SWMS Title:
SWMS No:
Revision No:
Work must be performed in accordance with this SWMS. The SWMS must be available for inspection where the task is being performed, at all times during the task. If the SWMS is revised, all versions should be kept.
Organisation
Details:
Project
Manager:
Supervisor on
Project:
(Name and Mobile Phone Number)
(Name and Mobile Phone Number)
Date:
Applicable risk
Assessment ID:
(Description of the Job)
Work Activity:
Work Location:
☐
☐
High Risk
Construction
Work Tasks
.
Work at Height where a worker or an object
could fall more than 2 metres
Working in and around Mobile Plant
☐ Work in areas that may be contaminated or
☐ Work on a telecommunication tower
☐
☐ Work in a tunnel
flammable atmosphere
Work in/near trench/shaft deeper than 1.5 m
☐
Work with Temporary Works
☐ Work in or near a confined space
☐ Work likely to involve disturbing asbestos
☐
Working with Live Services
☐ Demolition of load-bearing structure
☐ Use of explosives
☐ Tilt-up or precast concrete elements
☐ Diving Work
☐ Work in artificial extremes of temperature
☐ Work on/ near chemical/fuel/refrigerant lines
☐
☐
☐
Working near Live Traffic (road or
railway including light rail)
Electrical Work
Work involving Mobile Cranes and
Operations
Who will ensure compliance
Lifting
Name: Click or tap here to enter text.
How will the control measures be
reviewed?
SWMS_000 – Template – Rev 0 – 04/04/2023
☐ Work in or near water or other liquid that
involves a risk of drowning
How compliance be
measured
Who will review control
measures
Name: Click or tap here to enter text.
Page 1 of 5
Safe Work Method Statement
Weekly Review and Sign off – Supervisor
(Consult with the workers and ensure the scope of work in the SWMS reflects the work to be completed in the coming week. Where this is not that case, STOP, and update the
Change Management section on with approval from the Project Manager or delegate. In the case of multiple significant changes, review and update the SWMS and get it re
approved. All SWSM require review and approval by a senior Manager every 12 weeks.
Name of Supervisor
Signature
Review Date
Initial Approval
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 12
SWMS Needs to be reviewed and re approved by a senior Manager (General Manager, Operations Manager, HSE Manager)
SWMS_000 – Template – Rev 0 – 04/04/2023
Date:
Page 2 of 5
Safe Work Method Statement
What are the tasks involved?
What are the hazards/risks?
What are the control measures?
List the work tasks in a logical order.
Identify the hazards/risks that may cause harm to workers or the public.
Describe what will be done to control the risk. What will you do to make
the activity as safe as possible?
SWMS_000 – Template – Rev 0 – 04/04/2023
Page 3 of 5
Safe Work Method Statement
Workers Consulted in the development of this SWMS
Name
Position
Company
Change Management
Note: All alterations must be authorised by the Project Manager (or authorised delegate).
SWMS_000 – Template – Rev 0 – 04/04/2023
Signature
Date of Addition or
Alteration
Date
Project Manager Review
(or authorised delegate)
Date of Review
Authorised
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
☐
Yes
☐
No
Page 4 of 5
Safe Work Method Statement
Work Location
1
2
Work Pack Reference
3
4
I understand the requirements of this SWMS
I have been given an opportunity to comment on the method of work
Name of Worker
SWMS_000 – Template – Rev 0 – 04/04/2023
Signature
Date
I understand what the hazards of the work is and what the risks are
I understand what controls must be in place before starting work
Name of Worker
Signature
Date
Page 5 of 5