OHS FORM 005 SAFE WORK METHOD STATEMENT (SWMS) – also known as Job Safety Analysis (JSA)
This SWMS has been developed and authorised by:
Name:
Company Name:
Position:
Date:
ABN:
Signature:
Phone:
Mobile:
DESCRIPTION OF WORK ACTIVITY: Painter
Trades involved with undertaking this Work Activity:
This SWMS is submitted to: (principle contractor)
COMPANY:
CONTACT NAME:
PHONE NUMBER:
SITE ADDRESS:
PROJECT DESCRIPTION:
This SWMS was review by: (principle contractor)
NAME:
POSITION:
SIGNATURE:
DATE:
PHONE NUMBER:
MOBILE NUMBER:
Person responsible for OHS on the contractor’s behalf:
NAME:
POSITION:
SIGNATURE:
DATE:
PHONE NUMBER:
MOBILE NUMBER:
Safe Work Method Statement (SWMS)
Page 1 of 7
List plant, equipment and
tools to be used
eg. Electric generator
List Hazardous Substances
to be used or handled
MSDS
available?
(Tick)
eg. Unleaded petrol
Hard Hat
Safety Boots
High-visy clothing
Gloves
Hearing Protection
Safety Glasses
30+ Sunscreen
Dust Masks
Other (specify):
Health Risks and Likelihood of Damage
How LIKELY is it to be that bad?
Note: If a hazard is rated 1, 2 or 3, action must be taken immediately.
What
damage
could it
cause?
Death or
permanent
disability
Long term
illness or
serious
injury
Medical
attention or
several
days off
work
First Aid
needed
VERY
LIKELY
VERY
UNLIKELY
LIKELY
UNLIKELY
Could happen
anytime
Could
happen
sometimes
Could
happen, but
only rarely
Could happen, but
probably never will
1
1
2
3
1
2
3
4
2
3
4
5
3
4
5
6
Safe Work Method Statement (SWMS)
List PPE to be worn
(Tick) List Hazards to consider
(Tick)
Fall from ladder
Fall from heights
Fall from scaffold
Contact with electricity
Falling objects
Collapse
Slips, trips and falls
Manual handling
Exposure to noise
Struck by moving plant
Inhalation of dust or fumes
Cuts
Other (specify):
How to complete the following form
1. List the step-by-step sequence of tasks required to carry out
the work activity from start to finish.
2. Listing of potential hazards associated with each step, and the
related OHS risks.
3. Using the risk table, rating the identified risks.
4. List what controls you will implement to reduce the risks to the
lowest possible level.
5. Rate the level of risk once those controls have been
implemented (must be 4-6 before you can start work).
6. List the names or positions of the persons responsible for
ensuring the controls are implemented.
Page 2 of 7
Identify any potential hazards
associated with each step – and
any related risks. Detail the hazards
and risks in this column, and enter
the risk rating in the next column.
1.
Arrival at site
Hit by other vehicles or on
site plant.
Entry to unsafe areas.
2.
Unloading of vehicle
Back and shoulder injuries
Slips, trips
Site entry & set up
equipment
Controls Implemented
Decide what controls to use to eliminate or minimise the risks.
Detail the controls in this column, and enter the revised risk rating in
the next column.
Note: If the risk rating is still 1-3, do not begin work.
Revised Risk
Rating (1-6)
Beak the job down into steps.
List the steps in this column.
Hazard Identification
Initial Risk
Rating (1-6)
STEP
Job Step
Person
Responsible
Report to site office for induction before entering or
starting work on site, site and general induction of all
employees.
Park in specified area and appropriately.
Risk assessment of job site and work areas
including egress in buildings.
Use team lifting techniques or mechanical means
for manual handling.
Training all employees in manual handling.
Falls in open trenches
Injuries from trips, slips and
falls
Hit by falling objects or hit
by on site plant
& equipment.
Electrocution from
overhead wires when
carrying or setting up
ladders.
Slipping on wet areas.
Back injuries.
Unload vehicles in an area clear of traffic, plant &
Equipment.
Unload vehicle in clear level area.
Determine clear access. Clear egress to be
maintained to job site.
Ensure trenches have been backfilled or barricading
has been erected.
Training in the use of P.P.E equipment such as
hardhats, fluro vest etc.
Check position of wires.
Training in manual handling and the set up of
ladders.
Additional care taken in wet conditions or areas.
Training in manual handling
Safe Work Method Statement (SWMS)
Page 3 of 7
3.
4.
Sanding & Preparation
Paint Application
Internal
Identify any potential hazards
associated with each step – and
any related risks. Detail the hazards
and risks in this column, and enter
the risk rating in the next column.
Controls Implemented
Decide what controls to use to eliminate or minimise the risks.
Detail the controls in this column, and enter the revised risk rating in
the next column.
Note: If the risk rating is still 1-3, do not begin work.
Inhaling dust when sanding
Cuts, splinters
Slips, trips & falls
Use PPE - dust masks when sanding.
Training in the use of P.P.E equipment.
Avoid sanding against the grain. Use P.P.E
equipment such as gloves if required.
Training in the set up & use of portable ladders.
Ensure work area is clear of equipment & waste
building materials. Ensure handrails, void & fall
protection, are in place.
Training in the use & set up of extension leads.
Electrocution from electric
sanders
Back or shoulder injury
when lifting paint
Tins
Electrical test & tagging of all equipment.
Possible injury if lever slips
Read material safety data sheets & manufactures
recommendation prior to opening cans.
Inhale fumes; contaminate
skin, eye damage from
splashing paint.
Revised Risk
Rating (1-6)
Beak the job down into steps.
List the steps in this column.
Hazard Identification
Initial Risk
Rating (1-6)
STEP
Job Step
Person
Responsible
Training in manual handling.
Team lifting when required.
Read MSDS data sheets all ventilation
requirements are to be checked.
Training in use of P.P.E equipment when required.
Falls of ladders
Trips over materials when
rolling
Skin damage or
contamination
Safe Work Method Statement (SWMS)
Training in the use of portable ladders
Ensure work area is clear
Use P.P.E equipment such as protective clothing
eg overalls or long sleeves.
Page 4 of 7
5.
Paint Application
External
Identify any potential hazards
associated with each step – and
any related risks. Detail the hazards
and risks in this column, and enter
the risk rating in the next column.
Controls Implemented
Decide what controls to use to eliminate or minimise the risks.
Detail the controls in this column, and enter the revised risk rating in
the next column.
Note: If the risk rating is still 1-3, do not begin work.
Falls from ladders or
scaffolds
Training in the use of portable ladders & working
from heights.
Hit by falling materials
Falls from lower roofs
Hit by on site plant &
equipment
Ensure when working under others, safety head
protection is worn. Ensure employees don’t either
barricaded or warning signed areas.
Ensure safety guardrails are erected.
Use P.P.E equipment such as fluro vest.
Set up only in safe clear areas.
Sunburn
Revised Risk
Rating (1-6)
Beak the job down into steps.
List the steps in this column.
Hazard Identification
Initial Risk
Rating (1-6)
STEP
Job Step
Person
Responsible
Use P.P.E equipment such as sun cream, hats &
protective clothing
6.
THESE ARE STANDARD SWMS, THEY MUST BE MODIFIED TO SUIT YOUR WORKERS, YOUR EQUIPMENT AND
YOUR SITE.
Safe Work Method Statement (SWMS)
Page 5 of 7
CHECKLIST OF ITEMS THAT MAY BE REQUIRED FOR THIS WORK ACTIVITY
QUALIFICATIONS
TRAINING
Codes of Practice
CODES OF PRACTICE OR AS/NZS
STANDARDS TO BE COMPLIED WITH
OHS Consultation
OHS Induction Training for Construction
Amenities for Construction Work
Australian Standard
AS 1580
Safe Work Method Statement (SWMS)
Page 6 of 7
Declaration by contractors & workers:
1. I have been consulted and assited in the development of this SWMS.
2. I have been given the opportunity to comment on the content of this SWMS.
3. I have read and understand how I am to carry out the activities listed in this SWMS.
4. I have been supplied with the personal protective equipment identified on this SWMS and I have been given training in the safe use of this equipment.
5. I have read and understand the requirements set out in the mateial safety data sheets for the hazardous substances identified in this SWMS.
NAME:
Safe Work Method Statement (SWMS)
SIGNATURE:
DATE:
Page 7 of 7