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    01. Method Statement - Sample (2) (1) (1)

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    Dani Khan

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    © All Rights Reserved
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    01. Method Statement - Sample (2) (1) (1)

    Uploaded by

    Dani Khan
    10 views3 pages

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    10 views3 pages

    01. Method Statement - Sample (2) (1) (1)

    Uploaded by

    Dani Khan

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Template Work Method Statement Rev01 31/07/2024

    Scope of work in brief:


    Contractor Company:
    Contractor Representative:
    Nestle Representative:
    Site Safety Consultant
    Representative:
    Date:
    Doc # & Rev #:

    WORK METHOD STATEMENT


    WHAT WORK will we do?
    LOCATION of work (as specific as possible):

    DESCRIPTION of work (as specific as possible):

    Start of work (date & time) Expected duration of work:


    Name of Contractor Performing Authority (if known):
    HOW will we do the work?
    DESCRIPTION of work (method and sequence)
    (For Confined space work or working at height provide medical certificates Claustrophobia /Acrophobia/)

    WHO will do the work?


    1 - DESCRIPTION of work team (numbers of people, job tasks, skills)

    2 - Do you plan to use sub-contractors and if yes which company?

    3 - If yes precise for which activity, the duration and the number of employees?
    Template Work Method Statement Rev01 31/07/2024

    WHAT MATERIALS will we use?


    DESCRIPTION of materials (materials, consumables, quantities, hazardous properties)

    WHAT TOOL/EQUIPMENT will we use?


    Ladder (As per Nestle Standard) Hoist
    Mobile Scaffold Tower Material Handling Equipment, e.g., Forklift truck
    Mobile Elevating Working Platform Earth Moving Machineries
    Scaffolding Powered Hand Tools (specify below)
    Crane (Tower crane / Mobile crane) Others (specify below)
    Provide valid copy of certificates for equipment (as per Local Authority & International Standards).
    Additional equipment to be used:

    Power tools used:

    Will we need a PERMIT-TO-WORK?


    High-hazard Confined Mode 4
    Work at Hazardous Critical Lifting Ground
    Hygiene Hot Work Electrical Space Machinery Demolition
    Height Line Breaking Operation Disturbance
    Work Entry Intervention

    What services will need to be ISOLATED...? (Electricity, Compressed Air, Hydraulics, Gravity, Springs, Other stored energy)
    SERVICES TO BE ISOLATED:

    How will we prepare BEFORE STARTING THE JOB?


    PRE-JOB MEASURES to be taken:

    Site Condition requirement:

    What precautions will we take DURING THE JOB?


    PRECAUTIONS required:

    WHAT PPE will we use?

    Protective Safety Reflective Eye Face Ear Protective Respiratory Respiratory Personal fall Others as
    Helmet
    clothing footwear vest protection protection) protection gloves protection protection arrest system applicable

    If using gloves or respiratory protection, indicate type:


    Template Work Method Statement Rev01 31/07/2024
    How will we PROTECT OTHERS?
    Measures to protect OTHERS (e.g., other workers, members of public)

    Measures to prevent POLLUTION (e.g., air, water, land)

    Procedures for DISPOSAL OF WASTES (All project generated waste must be taken out by contractor)

    What if things GO WRONG?


    EMERGENCY PROCEDURES, such as Near miss/ Property damage/Injuries

    Date & signature of the contractor:

    Date & signature of the Permit Issuer:

    Date & signature of the Site Safety


    Consultant:

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