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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: Plumber / Drainer


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 contractors behalf:


NAME:

POSITION:

SIGNATURE:

DATE:

PHONE NUMBER:

MOBILE NUMBER:

Safe Work Method Statement (SWMS)

Page 1 of 12

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

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 12

1.

Preparation and Planning


for job.

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.

Inadequate training,
consultation, planning
& improvisation.

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

Ensure employees are adequately trained to


Complete the job required.
Provide adequate and competent supervision.
Provide correct equipment to ensure job is
completed safely.

2.

Arriving to job site.

Entry to safe unauthorized


areas.

3.

Unloading of equipment.

Fall from vehicle, manual


handling injuries, traffic
hazards, unfamiliar work
site, trips & slips.

Report to site office for site induction.


Risk assessment of site conditions.
Unload vehicles in area clear of traffic, plant &
equipment.
Training employees in manual handling.
P.P.E equipment such as (fluorescent) vest.
Use team lifting techniques or mechanical means
for manual handling.
Conduct a thorough site inspection before
commencing any work to identify potential causes
hazards.

4.

Internal drainage.

Trips, slips & falls.

Ensure work trucks or vans are parked


appropriately.
Ensure clear access to work area.
Ensure trenches have been filled or fall protection
and barricades are in place. Avoid rough terrain.

Safe Work Method Statement (SWMS)

Page 3 of 12

5.

Installation of internal
water service and
drainage.

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.

Manual handling injuries


when carrying tool
equipment and materials

Training employees in manual handling.

Back and shoulder injuries


when using shovels and
wheelbarrows etc.

Training in manual handling and the use of shovels


and wheelbarrows.

Hit by bobcat or excavator

Only licensed personnel to work with plant.


Plant and equipment to be registered and
maintained P.P.E equipment such as (fluorescent)
vest.
Plant operator to be aware of site personnel.

Contact with substances


classified as hazardous.
Short and long term health
affects eg overcome by
vapours, rash, allergy and
disease.
Trips, slips & falls when
carrying in materials.

Provide Material Safety Data Sheet (MSDS).


Provide training in the use of hazardous
substances and P.P.E equipment required.
Provide and wear correct P.P.E equipment
required.

Trips, slips and falls when


entering job

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

Ensure access and entry is clearly defined and


clear of debris.
Avoid rough terrain.
Ensure trenches have been filled or fall protection
and barricades are in place.
Ensure clear and defined egress into job.

Safe Work Method Statement (SWMS)

Page 4 of 12

Installation of internal
water service and
drainage
(continued)

6.

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.

Hit by falling object when


entering job.

Ensure if trades are working above that drop zones


are clearly defined and not entered into.

Falls from ladders or


through voids when
accessing first floor.

Training in the use of P.P.E equipment.


Use P.P.E equipment such as fluorescent vests,
Hard hats, safety footwear.
Training in the set up and use of portable ladders.
Ensure stair void protection is in place and secure.
All ladders should be adequately supported at the
base and tide at the top.
Set ladder at a slope of approximately 4 in 1.
Ladder must be extended past landing by 1.0m.

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

Communicate / consult with Supervisor and other


trades working in the area to ensure minimal
disruption to work.
Always seek assistance if necessary ensuring team
lifts are coordinated.

7.

Trips, falls when setting up


extension leads

Training in the set up and running of extension


leads.

8.

Cuts, abrasions, splinter,


eye, ear damage when
cutting and installing
support trimmers.

Training in the use of P.P.E equipment such as


gloves, safety glasses, ear and foot protection
when required.

Injuries from nail guns.


Injury from power tools.

Keep hands and limbs out of range.


Train and provide correct P.P.E equipment for the
required task.
Training in the use of power tools.

Safe Work Method Statement (SWMS)

Page 5 of 12

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.

9.

Electrocution & electric


shock

10.

Contact with substances


classified as hazardous.
Short & long-term health
affects eg overcome by
vapours, rash allergy and
disease.
Short or long term health
affect from using
LPG cylinders, overcome
by vapours, rash, allergy,
disease and burns.

Safe Work Method Statement (SWMS)

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

Electrical test, tagging and register of all power


tools and equipment.
Ensure earth leakage switch is installed on main
supply or portable generators.
Maintain and service all equipment.
Provide Material Safety Data Sheet (MSDS).
Provide training in the use of hazardous
substances and P.P.E equipment required.
Provide and wear correct P.P.E equipment required

Cylinders should be checked for leaks when


received. Do not allow any fittings of the equipment
to be contaminated with grease or oil under any
circumstances.
Ensure employees are trained to handle and use
cylinders and their contents safely.
Reserve cylinders should not be stored in work
area.
Provide training in the use of P.P.E equipment
used for the required tasks.
A No Smoking rule should be strictly enforced.
Gas cylinders must be stored in a well-ventilated
area away from heat sources, other dangerous
substances and protected from accidental impact.

Page 6 of 12

11.

Installation of internal
water service and
drainage cont.,

12.

Installation of Downpipe

15.

16.

Burns, sparks hitting eyes,


explosion and
fire when using Oxy
Acetylene.

Falls from climbing in and


on frames and trusses or
from ladders.
Injuries from cutting and
gluing materials

13.

14.

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.

Installation of Downpipe
(continued)

Safe Work Method Statement (SWMS)

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.

Person
Responsible

Gloves to be worn, high visibility vests to be


removed prior to using oxy acetylene as the vests
are highly flammable.
Training in the correct use of P.P.E equipment
such as eye protection.
All oxy equipment to have flash-back arrestors
fitted.
Fire extinguisher to be available.
Training in the use of portable ladders and working
from heights.
Provide Material Safety Data Sheet (MSDS).
Provide training in the use of hazardous
substances and P.P.E equipment required.
Provide and wear correct P.P.E equipment
required.

Cuts, abrasion, eye, ear


and damage to feet,
overcome by vapours.

Provide MSDS.
Provide training in the use of hazardous
substances and P.P.E equipment required.
Provide and wear correct P.P.E equipment such as
ear, eye and safety footwear.

Slips & trips when moving


around the site.

Ensure trenches have been filled or fall protection


and barricades are in place.
Ensure work area is clear of waste materials, avoid
rough terrain.
Training in the use and set-up of portable ladders.
Training employees in working at heights.

Falls when installing.

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

Page 7 of 12

17.

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.

Sunburn

Use PPE equipment such as hats, protective


clothing, sun creams.

Manual handling injuries.

Training in manual handling

Electrocution.

Electrical test, tagging and register of all power


tools and equipment.
Ensure earth leakage switch is installed on main
supply or portable generators.

Manual handling injuries


from lifting
materials.

Training in manual handling.


Use team lifting techniques or mechanical means
for manual handling.

Cuts, abrasions, eye, ear


and damage to feet,
overcome by vapours.
Contact with substances
classified as hazardous.

Provide Material Safety Data Sheet (MSDS).


Provide training in the use of hazardous
substances and P.P.E required

19.

Slips, trips & falls when


carrying tools and
materials.

Ensure clear access to work area.


Training in manual handling.
Stack materials neatly and clear of work areas.
Training in the use and set-up of portable ladders.

20.

Electrocution & electric


shock

Electrical test, tagging and register of all power


tools and equipment.
Ensure earth leakage switch is installed on main
supply or portable generators.

18.

Fitting off PC items &


Appliances.

Safe Work Method Statement (SWMS)

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

Page 8 of 12

21.

22.

Fitting off PC items &


Appliances
(continued)

Installation of External
Drainage & Sewer

23.

Safe Work Method Statement (SWMS)

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.

Slip, trips & falls due to


insufficient lighting.

Ensure adequate lighting is provided especially in


basement and other enclosed areas.

Lack of adequate
ventilation in roof or
floor cavity illness,
breathing difficulties,
being overcome by fumes,
dust particles.
Personnel hit by road
traffic, on site plant
and equipment

Ensure adequate ventilation of work area. Do not


allow fuelled equipment to continuously run in the
immediate vicinity of the work area.
Ensure all employees are properly advised and
trained.

Hit by plant and equipment


when excavating trenches
backfilling and installation
of pips.

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

Unload vehicles in area clear of traffic, plant and


equipment.
Ensure workers are supervised when unloading
plant, equipment and materials.
Ensure hazard signage is available for all workers
to display.
Only suitably trained personnel to work with plant.
Plant & equipment to be registered and
maintained.
P.P.E equipment such as (fluorescent) vest.
Plant operator to be aware of site personnel
P.P.E equipment such as (fluorescent) vest. Plant
operator to be aware of site personnel.

Page 9 of 12

24.

Installation of External
Drainage & Sewer
(continued)

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.

Tripping, falling into open


trenches. Collapse /
Entrapment.

Training employees in excavation works. Ensure


trenches have been filled or fall protection and
barricades are in place. Avoid rough terrain.
Induction / awareness, bench and shore trenches if
required.
Ensure position of hole is clearly marked.

25.

Contact with substances


classified as
hazardous.

Provide Material Safety Data Sheet (MSDS).


Provide training in the use of hazardous
substances and P.P.E equipment required.
Provide and wear correct P.P.E equipment
required.

26.

Manual handling injuries


while using
shovels and wheelbarrows.

Manual handling training in using shovels and


wheelbarrows.

27.

Injury from hitting


underground services
such as gas, electricity and
water mains.

Seek instruction from site management; utilize Dial


before you dig where necessary.
Prepare emergency plan in event of accident.

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

THESE ARE STANDARD SWMS, THEY MUST BE MODIFIED TO SUIT YOUR WORKERS, YOUR EQUIPMENT AND
YOUR SITE.

Safe Work Method Statement (SWMS)

Page 10 of 12

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/NZS 3500 (SET)

Safe Work Method Statement (SWMS)

Page 11 of 12

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 12 of 12