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SAFE WORK METHOD STATEMENT (SWMS) PART 1

Heights (working at)
ACTIVITY: Height (working at) EWP SWMS #: 1

BUSINESS NAME: BOWLEY PLUMBING SERVICES ABN: 97 007 937 439

BUSINESS ADDRESS: 19 SWALLOW AVE, MODBURY HEIGHTS SA

BUSINESS CONTACT: PHILLIP BOWLEY PHONE #: 0418 891 498    

SWMS APPROVED BY: EMPLOYER / PCBU / DIRECTOR / OWNER.
NAME: PHILLIP BOWLEY

SIGNATURE: DATE:

PERSON/S RESPONSIBLE FOR ENSURING COMPLIANCE WITH SWMS: PHILLIP BOWLEY AND ALL EMPLOYEES

PERSON/S RESPONSIBLE FOR REVIEWING THE SWMS: PHILLIP BOWLEY

RELEVANT WORKERS CONSULTED IN THE DEVELOPMENT, ALL PERSONS INVOLVED IN THE TASK MUST HAVE THIS SWMS
APPROVAL AND COMMUNICATION OF THIS SWMS. COMMUNICATED TO THEM BEFORE WORK COMMENCES.

NAME SIGNATURE DATE Daily Tool Box Talks will be undertaken to identify, control and communicate additional site hazards.
Work must cease immediately if incident or near miss occurs. SWMS must be amended in
B SMALL
consultation with relevant persons.
Amendments must be approved by Phillip Bowley and communicated to all affected workers before
M FITCH
work resumes.
T DAWSON SWMS must be made available for inspection or review as required by WHS legislation.
Record of SWMS must be kept as required by WHS legislation (until job is complete or for 2 years if
involved in a notifiable incident).
PRINCIPAL CONTRACTOR DETAILS (The builder or the organisation you are working for.)
PRINCIPAL CONTRACTOR (PC): PROJECT NAME: DATE SWMS PROVIDED TO PC:

PROJECT ADDRESS:

PROJECT MANAGER (PM): PM SIGNATURE: CONTACT PH. #:

SWMS SCOPE: This SWMS provides guidance on the safe operation of Elevated Work Platforms including scissor lifts, boom lifts and cherry pickers.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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THIS WORK ACTIVITY INVOLVES THE FOLLOWING “HIGH Heights (working at) RISK CONSTRUCTION WORK”
☐ Confined Spaces  Mobile Plant ☐ ☐ Asbestos
Demolition
☐ Using explosives ☐ Diving work ☐ Artificial extremes of temperature ☐ Tilt up or pre-cast concrete

 Pressurised gas distribution mains or piping chemical, fuel or refrigerant lines energised electrical installations or services

☐ Structures or buildings involving structural alterations or repairs that require temporary support to prevent collapse

 Involves a risk of a person falling more than 2m, including work on telecommunications towers
☐ Working at depths greater than 1.5 Metres, including tunnels or mines ☐ Work in an area that may have a contaminated or flammable atmosphere

☐ Work carried out adjacent to a road, railway or shipping lane, traffic corridor ☐ In or near water or other liquid that involves risk of drowning

CATASTROPHIC MOST
EFFECTIVE
LIKELIHOOD INSIGNIFICANT MINOR MODERATE MAJOR HIERARCHY OF CONTROLS
SCORE ACTION
ALMOST 3 3 4 4 4
CERTAIN HIGH HIGH ACUTE ACUTE ACUTE
2 3 3 4 4 4A DO NOT
LIKELY
MODERATE HIGH HIGH ACUTE ACUTE ACUTE PROCEED.
Review before
1 2 3 4 4 3H
POSSIBLE commencing
LOW MODERATE HIGH ACUTE ACUTE HIGH
work.
1 1 2 3 4 2M Maintain control
UNLIKELY
LOW LOW MODERATE HIGH ACUTE MODERATE measures.
1 1 2 3 3 1L Record and LEAST
RARE
LOW LOW MODERATE HIGH HIGH LOW monitor. EFFECTIVE
PERSONAL PROTECTIVE EQUIPMENT (PPE): ENSURE ALL PPE MEETS RELEVANT AUSTRALIAN STANDARDS. INSPECT, AND REPLACE PPE AS NEEDED.
FOOT HEARING HIGH HEAD EYE FACE HAND PROTECTIVE BREATHING SUN FALL RINGS, WATCHES,
PROTECTION PROTECTION VISIBILITY PROTECTION PROTECTION PROTECTION PROTECTION CLOTHING PROTECTION PROTECTION ARREST JEWELLERY THAT

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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Heights (working at) MAY BECOME

ENTANGLED IN
MACHINES MUST NOT
BE WORN. LONG AND
LOOSE HAIR MUST BE
TIED BACK.

   ☐ ☐ ☐ ☐  ☐   
AS 1319-1994 SAFETY SIGNS FOR THE OCCUPATIONAL ENVIRONMENT REPRODUCED WITH PERMISSION FROM SAI GLOBAL UNDER LICENCE 1210-C062. STANDARDS MAY BE PURCHASED AT HTTP://WWW.SAIGLOBAL.COM

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
1. Planning & Lack of consultation 3H Liaise with Principal Contractor to establish the following on-site systems and procedures are 2M
preparation with potential in place and take note of:
outcomes for
personal injury,  Health and Safety rules  PPE required
property damage  Induction for all workers – site specific  Site plans – showing no go zones for
&/or environmental and toolbox meetings pedestrians
incident.  Supervisory arrangements  Traffic Management Plan
 Communication arrangements  Exclusion Zones
 All relevant workers are appraised for  Risk Assessments
required competencies & for any pre-  SWMS and JSA’s
existing medical conditions if working in  Injury reporting procedures
remote or isolated locations.  Hazard reporting procedures.

2. Training & Lack of training or 3H Ensure all persons entering a construction site have a General Construction Induction Card 2M
Capabilities the assessment of (white card).
capability may lead
to personal injury, Ensure all relevant workers have undertaken training and/or received instruction in the use of
property damage control measures. Including:
&/or environmental
incident.  Reporting procedures for incidents
 Correct use of EWP including loading / unloading EWP
 Correct use of fall restraint equipment, use, care of and maintenance
 Correct use of all tools & equipment used
 Use of supervision where required (e.g. new starters or new equipment)
 Ensure supervisors, foremen etc. are suitably experienced in the type work to be
conducted.

3. Implement a Personal injury 4A Use of a Spotter: 3H

Falls from fall
Emergency  Spotter to make visual contact with operator at regular intervals (approx. every 5 minutes)
Rescue Plan  Spotter trained in how to lower the EWP in the event of an emergency
(This tool is  Trained first aid providers must be available
included in  A reliable means to contact emergency services.
this SWMS)

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
Suspension trauma Considerations for rescuing workers who have fallen and are suspended:

 Whenever a person is wearing a harness, a rescue plan must be in place as suspension

trauma can occur to persons who fall and remain in the harness for more than 5 minutes
 The rescue must be able to commence immediately
 The victim must be moved from suspension in stages – if moved too quickly from full
suspension into a horizontal position serious injury or death can occur
 If a suspension may last up to 5 minutes – foothold straps or other way of placing weight on
legs must be provided.

In event of a fall and suspension - Workers should be trained to:

 Use a sit – type harness with padded legs to allow legs to remain horizontal
 Move their legs in the harness to push against any footholds
 Move their legs as high as possible and keep their head as horizontal as possible. Note:
The ability for workers to be able to follow these procedures should be a consideration
when selecting harnesses for use
 Ensure all workers on-site are trained and familiar with emergency and evacuation
procedures
 Ensure EWP is fitted with an emergency retrieval device, controlled descent device and an
escape-rescue facility.

4. Delivery and Crush Injuries 3H Ensure the truck/vehicle and/or trailer used to transport the mobile plant is appropriate –
removal of Entrapment weight and size.
EWP
Ramps:  Suitable load capacity for weight of plant, wide enough, foot boards on the
side
 Lock ramps in place, use locking pin/clips if required
 Assess ground conditions at loading/unloading site to determine forward or
reverse loading
 Ensure clear of obstructions (tree branches, structures / overhead electric
lines etc.)
 Ensure persons are clear of loading/unloading site
 Ensure EWP is in fully lowered position.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
To load /  Apply handbrake and block tow/transport vehicle wheels
unload:  Load / unload as per manufacturer’s instructions
 EWP is loaded/unloaded to and from the vehicle whilst on level ground
 EWP is aligned for loading/unloading and positioned with the vehicle by a
suitably qualified, competent and experienced operator
 Use caution during any swivel operation
 Ensure EWP is adequately restrained to prevent movement during transit.

Slips trips and Falls 3H 2M

 Do not climb on EWP while loading/unloading to and from the vehicle
 Do not jump from EWP or vehicle tray
 Wear non slip footwear
 Only access tray of vehicle using manufacturers access points.

Falling objects 3H 2M
 Do not leave any loose items in EWP
 Ensure all fittings and attachments are secure before loading /unloading EWP
 Do not stand behind EWP or vehicle when loading/unloading.

5. Assess Lack of a clear 3H Assess conditions at site on arrival. Ensure: 2M

onsite assessment may
conditions lead to personal  Ensure site-specific induction is undertaken (include location of amenities, first aid facilities,
injury, property emergency plans and evacuation points, incident reporting, communication, contact
damage &/or persons etc.)
environmental  Assess mobile phone reception’ (alternative emergency communications procedures in
incident. place if no reception available)
 Work site is exactly as detailed in Terms of Agreement or contract
 Suitable weather conditions (do not work outside in low visibility, heavy rain, high winds
etc.)
 Suitable access for all equipment required
 Suitable ground / track conditions for operation of equipment
 Suitable lighting, including night-works (include flood lighting and operator head lamps as
applicable)
 Power lines in close proximity
 Take note of other mobile plant movement.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
6. Working near Contact with 4A Do not undertake work in No-Go Zones of electrical power lines unless de-energised/isolated 2M
utilities overhead power from the power supply and evidence of the continuing isolation of the power supply is
lines causing obtained.
electrocution and
property damage Where work is undertaken in close proximity to power lines:

 Use trained Spotters  Use adequately insulated EWP.

In general:

 3m above, either side and below power lines is Note: Authorised persons may be
No Go Zone permitted to work within minimum
 Between 3-6.4m of power lines a Spotter is safe distance zones for jobs such as
required tree clearing work, provided
 Further than 6.4m of power lines is open area requirements of State Energy
 No work to be conducted within 10m radius of Authority and owner of electric line
SWER transformer. are complied with.

7. EWP - Pre Lack of a clear 3H Inspect before use. Ensure: 2M

start check assessment may
lead to potential  Check that plant is in a mechanically sound condition and operator’s instructions are
personal injury, available
property damage  All required safety equipment is fitted and operational
&/or environmental  Equipment, including labelled controls and safety devices, present and working
incident.  Complete log books
 SWL is displayed.

Do not use if any fault/damage/missing parts. Report immediately and follow tag-out/lock-out
procedures.

8. Work area Muscular stress / 3H  Enter and Exit EWP as per manufacturers instruction 2M
set up musculoskeletal  Ensure EWP is as close to work area as possible (avoid leaning out stretching at odd
disorder (MSD) angles).

Work adjacent to 3H  If setting up roadside – comply with local laws and permits 2M
road & public safety  Erect any barriers & signage necessary to keep others safe and aware.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)

Contact with mobile 3H Plan travel  Ground surface is suitable (assessed by competent person) 2M
plant path.  No obstructions (power lines, scaffolding, pipes etc.)
Ensure:  Clear visibility in all directions
 Do not raise platform on slope or drive onto slope when elevated.
 Ensure placement will not cause traffic congestion
 Adequate lighting (especially during night works)
 Ensure work area is barricaded from other mobile plant.

Plant rollover 3H  Verify the work ground / floor is suitable for the particular machine. (Smaller mobile plant 2M
may have higher bearing pressures than larger machines)
 Ensure the ground / floor is safe and approved for use by a competent person. (E.g.
Engineer)
 Ensure the ground / floor is monitored and maintained in good condition for the duration of
the work
 Do not commence work in areas where other site activities (e.g. trenching) may have
affected the integrity of the ground without visual inspection and/or sign off that it is safe.

9. EWP Falls from height 3H Ensure workers operating the platform are trained and instructed in the safe use of 2M
Operation operation fall-arrest equipment and emergency rescue procedures.

Fall arrest system:

 Fall arrest system must comply with relevant Australian Standard

 Formal inspection by competent person per manufacturer (6 monthly or more if exposed to
hazardous environment)
 Inspect all fall arrest equipment before each use.

Operate per manufacturer’s instructions and task specific SWMS:

 Only one designated person  All loads must be stored within the platform
should operate the controls perimeter
(except in an emergency)  All occupants must wear approved fall restraint
 Never exceed the Safe Working device properly attached to designated platform
Load (SWL) of the EWP anchorage points
 Ensure entry gate is closed  No ground-operated controls shall be engaged
before elevating without permission of elevated operator worker
VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
except in an emergency.

Do not exceed working height of the unit. Do not:

 Stand on handrails  Use ladders in platform

 Lean/reach of out platform  Exit platform once elevated.

Crush injuries 3H  Keep all parts of the body inside platform at all times when moving EWP 2M
Entrapment  Never allow any part of the body to be under the EWP platform when it is in an elevated
position
 Always check under EWP before lowering.

Safety of others 3H Do not: 2M

from being hit by Ensure no tools & equipment can
falling object be dropped over the side.  Use EWP to push or pull other objects
 Use lanyard to stop tools falling.

Muscular stress / 3H  Avoid long periods of repetitive movements 2M

musculoskeletal  Avoid working in awkward postures – do not Lean/reach of out platform
disorder (MSD)  Do not work in static positions for more than 30 minutes at a time
 Ensure regular rest-breaks taken
 Consider stretching before and after work.

10. On Crush injuries / 3H  Park EWP in safe area (flat, firm ground, clear of obstructions, traffic) 2M
completion Entrapment  Lower platform to ground
 Shut down machine as per manufactures instructions
 Remove keys and apply park brake
 Inspect equipment for any damage/leaks. If damage is detected – report immediately and
take out of service
 Ensure all equipment /plant is clean of debris and/or contaminants before leaving site.

Note: The hydraulic system remains pressurized when the engine is not running. Using
controls after machine is off may cause sudden/unexpected movements to occur.

11. Remote Personal Injury 3H A ‘Buddy’ system is utilised for high-risk tasks undertaken in remote locations or working in 2M

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
and/or from delay in isolation.
isolated work emergency
assistance to
remote workers A procedure is developed and in place for regular contact with people working remotely or in
isolation, The procedure should identify:

 Travel itineraries, locations, scheduled  An emergency response 

contact persons and times  Appropriate Vehicles 
 Sufficient supplies of water, food, fuel &  Safety equipment including first aid.
supplies needed

12. Add any site-specific hazards, which have not been identified in this SWMS.

13.

14. Refuelling on Fire / explosion 3H  DO NOT smoke during re-fuelling 2M

site  Ensure re-fueling is undertaken in well-ventilated area, clear of ignition sources
o NOTE: Ignition sources include pilot lights, stoves, heaters, cigarettes,
matches/lighters, grinding, welding, power points, lighting, light switches, radio
transmitters, mobile phones, battery powered forklifts etc.
 Material/Safety Data Sheets (M/SDS) for all fuel products on hand
 Follow manufacturer’s manual/recommendations for re-fuelling
 Ensure fire extinguisher available and in date.

Diesel: Fire extinguisher – Water, foam, dry chemical powder, CO2

Unleaded petrol: Fire extinguisher – Dry chemical powder, foam, CO2. Never use water to
extinguish an Unleaded Petrol fire.

Exposure to 3H  Avoid breathing vapours or contact with fuel 2M

hazardous  If clothing is splashed with fuel, change immediately
chemicals /  Do not siphon or swallow fuel as this can be fatal
substances  Do not eat, drink or smoke during/after-handling fuel until hands are carefully washed.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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POTENTIAL RESPONSIBLE
JOB STEP
HAZARD/S
IR CONTROL Heights (working at) MEASURES TO REDUCE RISK RR
PERSON
INHERENT RISK-RATING (IR) RESIDUAL RISK-RATING (RR)
Shower and wash immediately after work. Wash clothes in separate wash from other
clothes.

Muscular stress / 3H Where possible use pump to transfer fuel from container into tank 2M
musculoskeletal
disorder (MSD) If using fuel container, and lifting into place:

 Lift smoothly, do not jerk or throw load upwards

 Avoid any twisting and side-bending during lift
 Bend knees, not back.
 Avoid awkward and sustained positions

Environment 3H  Ensure training in emergency response for chemical spill 2M

incident  Ensure to have spill kit available onsite.

Emergency response – minor fuel spill:

1. Stop the source of the spill or leak or release

a. If that is not possible & it is safe to do so - stop the spill or release from
spreading
2. Turn off any ignition sources if safe to do so
3. Use Spills Kit: (as required)
a. Position socs on a downhill slope or surround spill if on flat ground.
b. Block stormwater inlets with drain sealing mats.
c. Float Booms around the spill if on water.

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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Heights (working at)

FALLS EMERGENCY RESCUE PLAN
Location of closest medical facility: Approximate response time:

Location of closest emergency services: Approximate response time:

Can rescue be undertaken onsite by trained personnel?  Yes (Y)  No (N)

Indicate rescue equipment that will be provided:

 Fibre rope (meets relevant standards)  Auto-stop Descender  Round sling
 Karabiner (number required?)  Triple Lock Karabiner  Pre-rigged control descent device
 Rescue Knife  Rescue stretcher  Recovery pole
 Other? (Specify)  Other? (Specify)  Other? (Specify)
Provide details of communication equipment that will be used:

Provide details of trained rescue Name Course Name Date of training

personnel (trained within last 12 month
period)

Provide details of trained first aiders Name Course Name Date of training
for rescue (trained within last 12 month
period)

Y N Y N Y N
Documented rescue plan developed? Documented rescue plan rehearsed? Documented Rescue plan accessible on site?
☐ ☐ ☐ ☐ ☐ ☐

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
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EMERGENCY RESPONSE - CALL 000 IMMEDIATELY. Heights (working at)

If work is to be conducted on a construction site (or a site controlled Ensure workers have access to:
by another Employer / PCBU) follow the site-specific Emergency Management Plan. Ensure:  First aid kit/supplies
 First Aid trained personnel familiar with Resuscitation and emergency
 Adequate numbers of first aid trained staff are on site when working at heights occurs response for electric shock
 First aiders are trained and competent in managing injuries associated with demolition until  M/SDS
emergency services arrive  Communication devices (check mobile phones will have service in area)
 All rescue equipment is in good condition, available for use and in close proximity to the work  Suitable fire protection equipment.
site.
SAFE WORK METHOD STATEMENT (SWMS) PART 2
FORMAL TRAINING, LICENCES REQUIRED FOR WORKERS RELEVANT LEGISLATION & CODES OF PRACTICE
UNDERTAKING THIS TASK: Retain only the legislation references applicable to your state of operation for this SWMS.
Delete or add as relevant SA, Tasmania Victoria:
Licence to Perform High Risk Work (operating certain Work Health and Safety Act 2012 Occupational Health & Safety Act 2004
plant, equipment) Work Health and Safety Regulations 2012 Occupational Health & Safety Regulations 2007
TAFE or other recognised training organisation Codes of Practice: Safe Work Australia (2011): Compliance Codes: WorkSafe Victoria (2008): Compliance
Construction Induction Card (or equivalent) Construction Work Code:
Competent in operation of make/model of plant First Aid in the Workplace Communicating OHS Across Languages
Emergency procedures – emergency response Managing the Risk of Falls at Workplaces First Aid in the Workplace
PPE Managing the Risk of Plant in the Workplace Prevention of Falls in General Construction
Traffic Management Plans Managing Noise and Preventing Hearing Loss in the Workplace Amenities and Work Environment
Workplace Codes of Practice: WorkSafe Victoria
DETAILS OF SUPERVISORY ARRANGEMENTS FOR WORKERS How to Manage Work Health and Safety Risks (1990): No. 13: Building and Construction Workplaces
UNDERTAKING THIS TASK: Hazardous Manual Tasks (2000): No. 25: Manual Handling
Delete or add as relevant Managing Risks of Hazardous Chemicals (1995): No. 19: Plant
Suitably qualified supervisors for job Managing Electrical Risks in the Workplace (1998): No. 23: Plant (Amendment No. 1)
Direct on-site supervision Managing the Work Environment and Facilities (2004): No. 29: Prevention of Falls in Housing
Remote site – communication systems/ schedule WHS Consultation, Cooperation & Coordination Construction
Audits (2000): No. 24: Hazardous Substances
Spot Checks, etc. Western Australia
Reporting systems Occupational Safety & Health Act 1984
DETAILS OF: REGULATORY PERMITS/LICENSES Occupational Safety & Health Regulations 1996
ENGINEERING DETAILS/CERTIFICATES/WORKCOVER. APPROVALS: Codes of Practice:
Delete or add as relevant
Local council permits PLANT/TOOLS/EQUIPMENT LIST FOR THE JOB. REFERENCE DOCUMENTS
Authorisation to work (Make & Model)
Confined Space Permit
Building Approvals
EPA approvals/permits
Certain plant to be registered with State Authority
PPE to comply with relevant Australian Standards

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018
 Page 14 of 14

SAFE WORK METHOD STATEMENT (SWMS) PART 3 Heights (working at)

This SWMS has been developed in consultation and cooperation with employee/workers and relevant Employer/Persons
Conducting Business or Undertaking (PCBU). I have read the above SWMS and I understand its contents. I confirm that I have the
skills and training, including relevant certification to conduct the task as described. I agree to comply with safety requirements within this SWMS including risk control measures, safe
work instructions and Personal Protective Equipment described.
OVERALL RISK RATING AFTER
 1 LOW  2 MODERATE  3 HIGH  4 ACUTE
CONTROLS
EMPLOYER/PCBU/
EMPLOYEE/WORKER NAME JOB ROLE / POSITION SIGNATURE DATE TIME
SUPERVISOR

REVIEW: Ensure all controls are reviewed as per the following: MONITOR: To ensure controls are implemented and monitored effectively:
 If controls fail to reduce risk adequately  Toolbox /pre-work meetings will be undertaken
 When changes to the workplace or work activity occur that create new / different risks where  Relevant persons will be consulted on hazards and contents of SWMS,
controls may no longer be effective work plans and other applicable information
 New hazards identified  Control measures will be monitored throughout works:
 After an incident involving work activities relevant to this SWMS *Spot checks *Consultation *Scheduled audits
 During consultation with relevant persons indicate review is needed
Corrective actions will be recorded and rectified in a timely manner SWMS
 A Health and Safety Representative (HSR) requests a review in line with the requirements of the will be reviewed and updated accordingly (in consultation with relevant
legislation. persons).
REVIEW NO. 1 2 3 4 5 6 7 8 9 10
NAME:
INITIAL:
DATE:

VERSION 1 AUTHORISED BY: PHILLIP BOWLEY REVIEW #: ISSUE DATE: MARCH 2017 REVISION DATE: MAR 2018