SWMS No: 2

SAFE WORK METHOD STATEMENT SWMS Revision No: 01

Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

[A] GENERAL
Description of the FIRE DETECTION ALARM SYSTEM WORK IN MIRROR PROJECT Work Location: MIRROR
work to be done SITE PROJECT SITE

SGIPL Job In- Name: ABDUL KADIR KHAN Name: VIRENDER KUMAR
charge Contractor Job In-
Mobile No: 9559598880 Mobile No: 7217832872
charge Name
Contractor Name
Start Date & Time: 01-04-2024 End Date & Time: 30-04-2024
Man Power
Skilled 03 Semi-skilled 03 Unskilled
Planned

Hot work Excavation work s LOTO s Roof Work

s
Type of permit to Height work Demolition Pressure Test
S Confined Space
work involved
Opening barricade Opening Pit Radiography Test Safe work s

Welding operation: EXPT Forklift operation:

Gas Cutting: Crane Operation: Grinding: EXP
*Qualification / Scaffolding: EXP Electrician: EXPT
Experience for the
DG Operation: Roof work: Confined Space:
task to be
performed Assembly:

*EXP: - Experience at least 6 months; EXPT: - 2 years or more experience with Qualification / License
Please fill the same with appropriate code either EXP or EXPT - Experience certificate shall be enclosed.
All the people engaged for the work need to be medically fit (medical fitness certificate to be enclosed).
For Crane/Forklift/Heavy Vehicle/Boom lift/Earth mover operator/Signalman, eye test certificate is must.

Welding / Gas Cutting 2 years Electrician C license, 6 months

Scaffolding 2 years Crane Operation HMV license, 2 years
Boom lift Operator 2 years Forklift operation LMV license, 2 years
Earthmover operator HMV license, 6 months Heavy vehicle operator HMV license, 2 years
Mandatory Qualification & DG operation 6 months Powered electrical tool 6 months
Minimum Experience operation (drilling,
cutting, etc.)
Rigger 6 months Confined Space 6 months
Height work/Roof work 6 months Fire Watcher 6 months
Signalman/Banksman 6 months Dismantling/Demolition 2 years
 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

[B] LIFTING PLAN

LIFTING MACHINE
Name of the Machine:
Capacity:
Radius:
Boom Length:
SWL (As Per load chart):

LIFTING ACCESSORIES:

Name of the tackle Sl. No. or Capacity SWL Method of using Lifting Tackle (Vertical, Basket,
Ident No. Choker, etc)

Attach Diagram/Sketch of Detailed Sequence of Steps/Tasks for carrying out the Lifting Job

[C] EHS REQUIREMENTS

Lifting Machine/Equipment Sl. No. or Indicate
Lifting Ident No. Fitness Check/Test & Certification
Machine/Equipment BOOM LIFT OK
[Submit Test Certificate SCAFFOLFING OK
before start of work] PLATFORM LADDER OK
Lifting Tools & Tackles Sl. No. or Indicate Fitness Check/Test/Monthly
Lifting Tools & Tackles Ident No. Inspection & Certification
[Submit Test Certificate
before start of work]

Full Body Safety Harness Sl. No. or Indicate Fitness Check/Test/Monthly

Full Body Safety Harness with Double Lanyard Ident No. Inspection & Certification
with Double Lanyard
[Submit Test Certificate
before start of work]

Fire Fighting Equipment Sl. No. or Indicate Fitness Check/Test/Monthly

Fire Fighting Equipment Ident No. Inspection & Certification
 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

CCTV Surveillance Is the non-routine work covered fully under

If the area is not covered under CCTV
CCTV camera and the recording happening?
surveillance, is portable CCTV camera
or Smart Camera available for
recording the non-routine work?
Yes/No NO Yes/No NO
Portable Electrical Equipment / Hand Tools involved such as Cutting machine, Nail Gun, Gas cutting set, Welding
machine, saw machine, breaker, drilling machine, Vacuum Cleaner, etc.
Equipment / Tools Involved Indicate Fitness Check/Test/Monthly
List of Equipment or Inspection & Certification
Tools involved in the DRILL MACHINE, GRINDER, WELDING OK
work and their fitness MACHINE, PLIER, TESTER, SCREW DRIVER
SET, HAMMER MACHINE, HAMMER,
PUNCHING TOOLS

Enablers Required List of Enablers Indicate Fitness Check/Test/Monthly

[Access Platform, Inspection & Certification
Winches, Ladders, Boom BOOM LIFT, SCAFFOLDING, PLATFORM OK
Lift, Scissor Lift, LADDER
Scaffolding, Excavator, DG
Set, etc.]

Hazardous Substances
[Attach MSDS]
Flammable Toxic Corrosive Oxidizing Explosive Dangerous for
environment

Applicable:
Storage & Handling of Name of Substance Precaution for Storage & Handling
Hazardous Substances NA NA

On-Site Medical Aid

Name & contact number of First Aiders Location of First Aid Box
Available in cold end 4 and OHC OHC

Health and Welfare Requirements Indicate Measures to meet Requirements

Requirements

MATERIAL STORAGE [other than hazardous substances]

Materials Storage (other Construction/Fabrication Supportive Materials Other Materials
than hazardous Materials [Steel, Cement, etc.] [Ladder, Scaffold, etc.]
 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

substances)

[D] Risk Assessment of the Activity (Refer the S&P matrix below)
Risk Risk Risk Risk
Sub-activities Current Hazard
ID Hazards S P (SXP) Level Acceptability
No
/Tasks / Job Steps Controls/Preventative Measures
(Yes/No)
1

*please use additional page if required

Risk Reduction/Mitigation Measures for Medium and High Risk Levels where Risk is not Acceptable
Risk Date of last
Risk Additional Risk Reduction/Mitigation Target
ID Responsibility Status review/Updation
No
Level Measures Date
 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

[E] PPE & Emergency Equipment (tick the appropriate/required items and mention the ones not indicated here)

Mention any
Mandatory PPE other Mandatory
 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

Safety High Visibility Vest Safety Shoes Safety Glasses PPE:

Helmet
with Chin
Strap

Task/
Area Cut Heat Cotton Chemical Leather Cut Leather Heat Leg Arm Half Heat Fleece Bump Ear Face Face
Resistant Resistant Gloves/ Resistant Gloves Resis Apron Resis Guard Guard Mask Resis Top Cap Plug Shi Mask
Specific eld
Gloves Gloves Abrasion Gloves tant tant Respi tant
PPE resistant Sleeve Sleeve rator Hood

Mention any other Task/Area Specific PPE:

Mention Emergency Equipment Required
(other than First Aid Box/Fire Extinguisher):
[F] ENCLOSURES
Sl.No Enclosures Yes NA
1 Diagram/Sketch of Detailed Sequence of Steps/Tasks for carrying out the Lifting Job
2 Test certificates of Lifting Machine, Lifting Tools, Tackles, Safety Harnesses
3 Competency and Medical Fitness Certificates for Specialist/Trade Experts
4 Rescue Plan (Provision and access to bring injured personnel down in height work/confined space)
5 Copy of MSDS (Material Safety Data Sheet) if applicable
[G] APPROVAL
Safe Work Method Statement shall be reviewed every year or in the event of any concern during work or if
there is an incident which makes existing Safe Work Method Statement Ineffective. If work activity changes or
deviates from that originally envisaged, further review is required and an amended method statement shall be
prepared to ensure adequate controls in place and communicated prior to start of work.
Prepared By Reviewed By

Name & Designation: Name & Designation:

Signature & Date: Signature & Date:
Start Date:
Review :01
Date extended

Verification and Recommendations by Functional Head / Line Head:

 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A

Approval of Functional Head / Line Head (Name & Designation):

Signature: Date:
Comments/Recommendations of Plant EHS Team:

Approval of EHS Incharge (Name & Designation):

Signature: Date:
Safe Work Method Statement Briefing Record
[Safe Work Method Statement is part of “Permit to Work” and shall be used to conduct Pep Talk on a daily basis
before start of work]

Briefing Delivered By Name: Designation:

(SGIPL Job Incharge) Signature: Date:
We (the undersigned) have understood the hazards associated with the tasks to be carried out
and will comply with the specified safety requirements / risk control measures.

Name Signature Date

 SWMS No: 2
SAFE WORK METHOD STATEMENT SWMS Revision No: 01
Date of SWMS Preparation / Review:
(SWMS shall be reviewed every year or in the event of any concern during work or if work activity 29-jan-2022
changes/deviates from that originally envisaged or if there is an incident which makes existing SWMS ineffective) Next Date of SWMS Review: N/A