Safe Work Method Statement

Project Name: WWI BLR Phase-2

Company Name: A3M Contracts India Pvt. Ltd. Activity/Trade: Painting Work
Address: : Unit No-128 & 129,1st Floor, Tower-B3,Spaze I-tech Park,Sector-49, Gurugram-122018
Engineer / Supervisor Name: Sourabh Singh/ Gopal Maurya Contact No: 9993994687/9559528674

Prepared By Reviewed By Approved By

Signature:

Name: Sahid Khan Sourabh Singh

Date: 4/12/2023 5/12/2023

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 1 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Site Access  Untrained Person M  All workers should be under go EHS induction Training. Execution
 Sickness  Task awareness & risk assessment shall be communicated Staff
 Bullying with all manpower’s in training.
 Violent Behavior  Job specific Training shall be conducted before work starts.
 Horse Play  Skilled manpower shall be used.
 Depression  Work shall be performed under proper work permits.
 Alcoholic Influences  Ensure that all workers shall be understood of Site Rules &
 Drugs Regulation.
 Ensure all the workers shall be undergone for the medical
fitness
 Mandatory PPE's and Identity card shall be provided to all
the workforce.
 Breath analyzer test should be done at prior

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 2 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Transportation of Materials  Hit by vehicle due to over speeding, H  Licensed drivers to be engaged for vehicle operations. Execution
reversing  Vehicle / equipment fitness, maintenance log, reverse horn, Staff
 Fall of material rear view mirror (RVM), both outer rear-view mirror (ORVM),
 Fall of vehicle, toppling two-wheel choke, seat belt, indicators, wipers, out rigger,
 Fall of persons while climbing on to tread in tyres, delay start device, boom limit switch, safety
the vehicle latch, safe load indicator (SLI), Load chart shall be checked.
 Blind spot, poor visibility  Banksman and Helper with whistle, flag / light baton to be
 Contact with rotating parts, sharp deployed for guiding the vehicle inside the site for
edges maneuvering the vehicle.
 Caught in between loaded materials.  Toolbox talks to be given by the vendor to drivers, banksman
 Inadequate illumination & helpers daily for the precautions to be taken for vehicle
 Uneven / slippery road surfaces movement inside the site.
 Mechanical failures  Material being shifted by the vehicle to be anchored for
 Dust prevention of fall, protrusion of material to be avoided.
 Deployment of Untrained workforce  Access to be clear of obstructions, slippery surface for vehicle
 Drivers and workforce under the movement, wheel choke / stoppers to be provided.
influence of alcohol & drugs.  Access on to the vehicle to be done by using access ladders.
 Contact with overhead services

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 3 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
E
 PPE’S (Safety helmet, safety shoes, safety jacket, dust mask) xe
to be used while in the site cu
 Medical fitness test to be conducted for drivers tio
 Speed limit to be 10 KMPH inside the project site. n
St
 Relevant legal vehicle / equipment documents to be with
af
valid dates (3rd party certificate, registration certificate, f
pollution, insurance, driving license, etc.) shall be checked
prior to entry at site.
 Separate pedestrian and vehicle movement area with
barricading.
 Breathe analyzer test to examine alcoholic / non alcoholic
condition of the driver / operator & workforce.
 Provision of convex traffic mirror, auto glow signages, caution
tapes.
 Water sprinkling / dust suppression to be done on the access
roads.
 Lighting to be provided with clear visibility for shifting of
material.
 Trained and experienced workforce to be deployed

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 4 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Material Unloading & Shifting  Sharp edges H  Material with Sharp edges shall be covered by cap. E
 Improper method of material lifting  Pathway shall be cleared from unwanted materials. xe
 Overloading of person.  Material shall be stacked in proper way such that it should not cu
Improper Access Egress. exceed more than 5 feet height & 400kgs/square meter area. tio
n
 Proper Barrication and warning Signage shall be provided.
St
 Training shall be provided on Manual material handling
af
 Ensure that the hand / fingers do not get jammed in between f
material and vehicle sides by carrying material with hands
inside the maximum width of the item Carrier.
 Ensure that additional support shall be provided to personnel
before lifting the material.
 Ensure work to be carried under permit system & strict
supervision.
 Appropriate PPE’s (helmet, reflective jacket, steel toe boots,
cut resistance hand gloves) shall be used.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 5 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Gathering of Tools and Tackles  Hand injury may cause due to bare M  Tool box talk shall be given to labours and staff prior to start E
machine spare parts. of work. xe
 Electrical shock due to open bare  All tools and equipment must be inspected, tagged before the cu
wires. works starts. tio
 Faulty machines may lead to  Dedicated Supervisor must be allotted to monitor the job. n
St
accidents.  Visual Inspection of tools on daily basis before working on
af
 Chemical hazards like skin burn, site. f
inhalation of paint smell etc.  Permit system shall be followed.
 Trainings shall be provided to all workers on Electrical Safety
& risks involved in it.
 Faulty machines shall be red tagged and stored in store.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 6 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Sanding & Preparation  Inhaling dust when sanding Cuts H  Use PPE - (helmet, reflective jacket, goggles, cut resistance E
 Splinters hand gloves dust masks when sanding). xe
 Slips, trips & falls  Electrical test & tagging of sanding machine shall be provided cu
 Electrocution from electric sanders  Avoid sanding against the grain tio
n
 Ensure work area is clear of equipment & waste building
St
materials
af
 Provide Dust collector in sanding machine to minimize dust f
particles.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
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 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Paint Application  Paint Spillage H  Permit system shall be followed daily before starting the Execu
 Working near to hot work areas work. tion
 Material Placing near access  Job specific PPE`s (Helmet, reflective jacket, goggles, Nose Staff
 Unsafe working platform mask, cut resistance hand gloves) shall be used.
 Wrong handling methods  No hot work activity is to be performed nearby the
 Improper storage of VOC and painting area.
adhesive  Access should be free from obstruction.
 Platform which is to be used shall be inspected before
using.
 TBT shall be done before start of work.
 Access should be neat & clear.
 Fire extinguishers should be provided near by the work
 Fall protection to be provided.
 Training should be given to all people once in a every
month.
 MSDS shall be displayed at work locations.
 Material Safety Data Sheet shall be explained to all
workers and staff in Tool box talk.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 8 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Work at Height  Usage of damaged scaffolds or H  Trained, experienced & medically fit workforce shall be E
ladders deployed. xe
 Overreaching  Trained, experienced & authorized operator to be deployed cu
 Entanglement with overhead for the equipment. tio
electric cable, Overhead services  Training on the hazards and control measures related to n
St
 Poor design / missing members equipment's & related works to be conducted.
af
 Slip and Trip  Toolbox talks shall be given to the work force daily for the f
 Fall of person precautions to be taken in the activity.
 Fall of materials  All hand tools, power tools shall be inspected and damaged /
 Poor Illumination defective tools to be rectified / removed.
 Structure not firm  PPE'S (Safety helmet, safety shoes, full body harness, cut
 Water spillage / leakage resistance hand gloves, goggles) to be used.
 Nervousness  Access to be clear from obstructions and overhead lines /
services to be avoided, overhead utilities to be protected.
 Fresh air circulation & lighting to be provided.
 Mobile scaffold to be equipped with full boarded working
platform, guard rails, mid rail, toe board, access & egress,
wheel brakes, tested and certified scaffold material to be
used. Inspection tags to be displayed on the scaffolds for
identification of 'safe to use' / 'unsafe to use'.
 Lanyard, Barrication and vertigo test should be done at prior

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 9 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Locking of wheels to be done before using the scaffold. E
 Scaffold not to be dragged/pulled while workers are standing xe
on the platform. cu
tio
 Spill Kit shall be provided.
n
St
af
f

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 10 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Dark Hour E  Training on the hazards and control measures related to Execu
 Sleep Loss equipment's & related works to be conducted by the vendor tion
 Fatigue (weekly, fortnightly, monthly) Staff
 Lowered Performance  Toolbox talks shall be given to the work force daily for the
precautions to be taken in the activity.
 Accidents/ Incident
 No work to be carried out other than permitted (described in
 Stress
work permit).
 Headache  Site supervisor to be available during the night work and the
 Lack of motivation continuous supervision to be in place.
 Poor Illumination  First Aider to be available, Emergency Vehicle must be in
 Slip, trip, fall place or hospital ambulance tie up to be in place.
 Lighting to be provided for clear visibility, Emergency lights to
be available at the stair cases and lift lobbies.
 Sleeping in the work premises must be avoided and such
workmen must not be allowed to work at night.
 Frisking at the gate entrance and at work premises shall be
done.
 Breathe analyzer test to examine alcoholic / nonalcoholic
condition of the driver, operator & workforce.
 Night works to be as per the location sunset and sunrise.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
01 11 of 19
 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Storage yard for paint/ other  Improper storage of paint M E
chemicals  Storage of paint in open place.  Spill kit shall be provided at site & storage area. xe
 Hot work near paint storage yard.  All paint drum shall be stored on separate storage area. cu
 Drip tray shall be provided to store the paint drum. tio
n
 Proper signage shall be provided.
St
 Storage area shall be well ventilated.
af
 No hot work shall perform near paint storage area. f
 MSDS shall be displayed near paint storage area.
 Fire extinguisher shall be placed near paint storage area.

 Housekeeping  Slip Trip M  Keep work area clear off debris and remove tools/equipment E
 Hazards while waste materials when not in use to eliminate trip hazards. xe
handling.  Ensure the waste is always filled up either in stable boxes or cu
plastic bags. tio
n
St
af
f

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
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 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Covid 19  Person can affect from covid-19 by H  Medical Fitness certificate & Covid Negative Report will be E
contact with sick person or touching done before entering at site. xe
with person or any object  Thermal screening will be done before enter the site cu
 Ensure social distancing of at least 2mtr shall always be ti
o
maintained all the time.
n
 Wearing of face cover all the time shall be ensured. Hand St
gloves will be used as long as possible. af
 TBT induction, Induction training others sessions, social f
distancing guidelines should be followed along with
provisions of no-touch attendance
 Sanitizer material like alcohol sanitizer, hand wash, soap
should be available at site & labour colony.
 Hand sanitation shall used in regular intervals

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
Document Name: SWMS Painting Works Version Correct as at: Page No.
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 Safe Work Method Statement

Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures will ensure
(See below) (Describe what action or procedure will be taken to eliminate or this
(Break the job down into steps. Each (Identify the hazards associated with each minimise the risk of injury or damage. Use the Hierarchy of happens
step should accomplish some major step. Examine each to find possibilities that Controls below as a guide
task and be in logical sequence.) could lead to an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Disinfection of Material & Work location shall be ensured on
daily basis.
 Entire work site including site office, toilet, food area, should
be sanitizing on daily basis.
 Exchange of PPEs, water bottles, food utensils & tools &
tackles shall be avoided.
 Good housekeeping & Hygienic work conditions & proper
waste management shall be ensured as per govt. guidelines

 In Case of Emergency  Confusion and Panic H  Workmen should be aware about company emergency E
 Improper Access procedure xe
 Poor Illumination  Proper first aid and Emergency facilities like Ambulance, first cu
aider should be available ti
 Emergency contact number should be displayed o
 Emergency Pathway and Assembly point shall be clean and n
clear S
 Ensure emergency preparedness before start of activity at
 Emergency lights should be available at site ff

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (i.e.: Nil LTI)
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 Safe Work Method Statement

 Personnel Summary

SUPERVISOR’S DETAILS
Supervisors Name & Qualifications: Name: Gopal Maurya
Experience: 5+ Years
Qualifications: Civil Diploma
Supervisor’s Responsibilities: 1. Supervisor will be present throughout the activity.
2. He will ensure work activity to be carried out without compromising with safety norms.
In addition to the above, the supervisor is to provide training in the use of this WMS, issue PPE and provide training in the same,
supervise the work, ensure conformity with this WMS, amend the WMS when additional hazards are found (and if applicable, ensure
all workers receive a tool-box talk to discuss the control measures for the additional hazards).
DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: All workers must have successfully completed industry induction training

WORK ACTIVITY TRAINING: All workers need to have been trained in the activities outlined in this safe work method statement.

SITE INDUCTION: All workers are to be site inducted by the Principal Contractor, prior to commencing work on site.

OTHER: (List other training undertaken by workers): (eg: Confined Space, Manual Handling, Traffic Control etc)

TICKETS, PERMITS or LICENCES REQUIRED to undertake this work (ie. Certificates of Competency, Confined Spaces etc):

N.B. - Copies of the above must be shown to the Principal Contractor during site induction.
LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

All work to comply with the <insert location> H&S Acts and Regulations and amendments, Workplace Injury Management & Workers Compensation Acts

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04 03 Apr 14 15 of 19
 Safe Work Method Statement

Additional Codes and Standards applicable to this trade:

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 Safe Work Method Statement

Equipment & Material Summary

PLANT and EQUIPMENT used and MAINTENANCE FREQUENCY:

Serial Plant/Equipment Contractor Government Plant Hazards Maintenance/service records and log books sighted
Registration No. identified and by Principle Contractor prior to equipment being
controlled within used on site?
(Where applicable)
WMS?
Yes No Sign Date
1
2
3

ELECTRICAL EQUIPMENT USED DURING THE WORKS (Attach Electrical Equipment Register if applicable):
Item Tag/Item Testers Name & Signature License Number Test Date Result Test Date Result
Number
____ /____ /____ ____ /____ /____
____ /____ /____ ____ /____ /____

HAZARDOUS SUBSTANCES or DANGEROUS GOODS USED IN THE WORKS and anticipated volumes (Attach MSDS if applicable):
MSDS
Date on Date Left Purpose Location & Volume Controls MSDS
Product Name Attached
Site Site (ie. Application on site) Used on Site (& PPE to be worn) Date
(Y/N)
/ / / / / /

/ / / / / /

/ / / / / /

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 Safe Work Method Statement

N.B. - All workers must be trained in the safe use of all chemicals and provided with the PPE required when using and storing these chemicals. Disposal is to be as per the waste
disposal methods in the MSDS. Spillage and leaks are to be cleaned up as per the spill/leak procedures identified in the MSDS.

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 Safe Work Method Statement

We agree that we have been consulted in the hazards and control measures and agree to complete the work in accordance with our Work Method Statement (WMS).
We have been provided with training in all tasks outlined in our WMS and in the Codes of Practice applicable to our work.

Employee / Worker Signature Date Employee / Worker Signature Date

1. / / 8. / /
2. / / 9. / /
3. / / 10. / /
4. 11. / /
/ /
5. / / 12. / /
6. / / 13. / /

Reviewed by: Signature: Date:

(Principal Contractor’s Representative)

Any changes, additions or deletions made to this WMS are to be covered with the above personnel and the Principal Contractor’s representative at a Toolbox meeting (Record
date and time of Toolbox meeting below):

Date: Time:
Comments:

A copy of the Toolbox Meeting must be attached to this WMS.

Document Name: Version Correct as at: Page No.

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