Safe Work Method Statement
High Risk Activity:
Project:
Working on or near a Road
Company Name:
ABN No:
Company Address:
Company Contact and Phone No:
Supervisor:
Personnel Consulted in Development:
Personnel Responsible for Monitoring this Activity:
Competencies/Qualifications/Training Requirements:
Competent Traffic Controller
Plant/Equipment Required for this Activity
Legislation/Standards
Road Signs
Barricades
Work Health and Safety Act
Work Health and Safety Regulations
COP How to Manage Health and Safety Risks
Materials Used: Nil
Safety Data Sheets Required: Nil
Permits/Licences: Road Closure (Where Required)
PPE/Emergency Equipment Required:
High Visibility Clothing, Safety Footwear
Approved By:
Signature
Review No.
Name & Initials
Date
1
Name
2
SWMS Working on or near a Road 15 July 2013 Version: 1
3
4
Date of Approval
5
6
7
8
Page 1 of 4
9
Safe Work Method Statement
PROCEDURE
(break the job down into steps)
Planning/prestart
Working on or near
roads
POTENTIAL SAFETY AND
ENVIRONMENTAL HAZARDS
(what can go wrong)
Inadequate planning
Workers being struck by
vehicles
Site vehicles/plant
entering & exiting work
zone
Collision between site
plant/vehicles and public
vehicles
Pedestrians struck by
site plant/vehicles
End of shift or
completion of works
Unsafe road conditions
at end of shift
INHERENT
RISK SCORE
L
C
R
3
4
12
L
C
R
3
5
15
L
C
R
3
4
12
L
C
R
3
4
12
L
C
R
3
5
15
L
C
R
3
5
15
SWMS Working on or near a Road 15 July 2013 Version: 1
RESIDUAL
RISK
SCORE
MANAGEMENT METHOD
(controls to be in place in order to manage potential hazards)
Alignment pegged.
Site investigation undertaken.
Traffic management plan compiled by accredited traffic management
organisation.
Police and local authority permits received.
All personnel to wear high visibility clothing.
Traffic management put in place and checked against TMP.
Personnel entering & exiting work zone to alert traffic controllers.
Vehicles moving inside work area to move slowly with audio and visual
alerts on
Spotters used for vehicles reversing inside work zone.
Traffic controllers to hold and release traffic to allow safe entry/ exit.
Site operators/drivers to alert traffic controllers to their intended
movements and obey directions.
Statutory road rules to be obeyed by all site operators/drivers.
Site plant/vehicles to obey directions from traffic controllers.
Operators/drivers to stay alert to public vehicle movement.
Alternate footpath arrangements put in place.
Traffic controllers manage pedestrian traffic.
Operators/drivers stay alert to pedestrian traffic.
Operators/drivers obey directions from traffic controllers
Road returned to trafficable condition where possible.
Open excavations signed, barricaded/fenced.
Construction debris cleaned from road surface.
Road surface hazards signed.
Redundant signage removed during non work hours.
L
C
R
2
2
4
L
C
R
1
5
5
L
C
R
2
2
4
L
C
R
2
2
4
L
C
R
1
5
5
L
C
R
1
5
5
Page 2 of 4
PERSON RESPONSIBLE
(to ensure implementation
of controls)
Project Manager
Site Supervisor
Site Supervisor
Safe Work Method Statement
LIKELIHOOD
CONSEQUENCES
Insignificant
[1]
Minor
[2]
Moderate
[3]
Major
[4]
Catastrophic
[5]
Almost Certain [5]
Moderate (5)
High (10)
High (15)
Catastrophic (20)
Catastrophic (25)
Likely [4]
Moderate (4)
Moderate (8)
High (12)
Catastrophic (16)
Catastrophic (20)
Possible [3]
Low (3)
Moderate (6)
Moderate (9)
High (12)
High (15)
Unlikely [2]
Low (2)
Moderate (4)
Moderate (6)
Moderate (8)
High (10)
Rare [1]
Low (1)
Low (2)
Low (3)
Moderate (4)
Moderate (5)
If the residual
risk
=
Catastrophic (16+)
then
Work unable to proceed seek other methods (Significant)
=
High (10 – 15)
then
Permission from high level management for work to proceed (Significant)
=
Moderate (4 – 9)
then
Permission from worker in charge for work to proceed (Insignificant)
=
Low (1 – 3)
then
Work able to proceed (Insignificant)
1. Eliminate
2. Substitute
3. Isolate
4. Redesign
5. Administrative
6. PPE Last Resort
Eliminate the hazard
Substitute with a less hazardous
material, process or equipment
Isolate the hazard
Redesign equipment or work
process
Introduce administrative controls
Use appropriate Personal
Protective Equipment
C = Consequence
L = Likelihood
5 = Catastrophic = Fatality, permanent disability, long term widespread impacts, huge financial loss.
5 = Almost Certain = It is almost certain that the risk will occur in most circumstances.
4 = Major = Permanent disability or extensive injuries, medium to long term widespread impact, major financial loss.
4 = Likely = The risk is likely to occur in most circumstances.
3 = Moderate = Lost time injury, reversible medium term local impact, high financial loss.
3 = Possible = There is uncertainty that the risk could occur.
2 = Minor = Medical treatment, reversible short – medium term impact to local area, medium financial loss.
2 = Unlikely = The risk could occur at some time but there is confidence that it will not.
1 = Insignificant = First aid, limited impact to minimal area, low financial loss. .
1 = Rare = The impact/risk may occur only in exceptional circumstances.
SWMS Working on or near a Road 15 July 2013 Version: 1
Page 3 of 4
Safe Work Method Statement
We the undersigned, confirm that we have been consulted in the development of this SWMS. If a failure is identified within the SWMS work will stop, the SWMS
amended and changes communicated to the workforce. We also clearly understand that the controls must be applied as documented, otherwise work is to
cease immediately. We also confirm that we are qualified to carry out the works identified above; a copy of our required qualifications has been provided and
where applicable all insurances and work cover policies to undertake this activity are current.
Name
SWMS Working on or near a Road 15 July 2013 Version: 1
Signature
Date
Page 4 of 4