Safe Work Method Statement (Non-High-Risk) Example
Example document for Safe Work Method Statement (Non-High-Risk). Use this as a reference when creating your own.
For Informational Purposes
This document template is provided for informational purposes. Customize it for your specific needs.
Document: Safe Work Method Statement (Non-High-Risk)
Example Document
Last updated 7/29/2026
Company Details
Company Name: Peak Electrical Services ABN: 12 345 678 901 Address: 42 Sparks Lane, Melbourne VIC 3000 Phone: 03 5555 1234 Email: admin@peakelectrical.com.au
Project Details
Project / Site Name: Office Fitout Lighting Upgrade Site Address: Level 2, 100 Bourke Street, Melbourne VIC 3000 Client Name: City Real Estate Pty Ltd Date of Issue: 12 October 2023
Job Description
Installation of 20 new LED pendant lights in the open plan office area. Work involves minor ladder work, wiring to existing ceiling circuits, and removal of old fluorescent tubes.
Persons Responsible
Project Manager / Supervisor: John Smith Contact Number: 0400 000 000
Hazards and Controls
| Job Step | Potential Hazards | Risk Rating | Control Measures | Person Responsible |
|---|---|---|---|---|
| 1. Set up work area & ladders | Tripping over tools, falling off ladder | Medium | Keep cords taped down, use ladder standoff, maintain 3 points of contact on ladder, ensure ladder base is level | John Smith |
| 2. Isolate power supply | Electric shock, arc flash | High | Lock out / Tag out procedure at switchboard, test for dead before touching wires, use insulated gloves | Licensed Electrician |
| 3. Remove old fittings | Eye injury from glass, manual handling | Low | Wear safety glasses, lift with knees not back, dispose of tubes in designated bin | Apprentice |
| 4. Install new fittings | Electric shock, falling objects | Medium | Use RCD on leads, do not work directly under other workers, wear hard hat if overhead risk exists | Licensed Electrician |
| 5. Testing and commissioning | Electric shock | Medium | Keep area clear while testing, only authorised personnel to switch power back on | John Smith |
Safety Equipment and PPE
- Safety Helmet
- Safety Glasses
- High Visibility Clothing
- Safety Boots
- Hearing Protection
- Gloves (Insulated)
- Dust Mask
Plant and Equipment
- 2.4m Fibreglass Ladder
- Cordless Drill
- Multimeter
- Lock Out / Tag Out Kit
- RCD Powerboard
Pre-Start Checklist
- Workers briefed on this SWMS
- Emergency contact numbers confirmed
- First aid kit located and accessible
- Site amenities available
- Site induction completed
Sign Off
| Worker Name | Worker Signature | Date |
|---|---|---|
| John Smith | J. Smith | 12/10/2023 |
| Mike Jones | M. Jones | 12/10/2023 |
Supervisor Signature: J. Smith Date: 12/10/2023
Notes
Notes on the Example:
- Specificity: The job description clearly states the location and the specific task (LED lighting upgrade).
- Risk Ratings: The 'Isolate power supply' step is correctly identified as High risk, leading to stricter control measures like Lock Out / Tag Out.
- Hierarchy of Controls: Controls include engineering (RCD) and administrative (testing for dead) measures, not just PPE.
- PPE Relevance: Only relevant PPE is selected. For example, hearing protection is not checked because the work is not loud.
- Responsibility: Specific roles (Licensed Electrician vs Apprentice) are assigned to steps to ensure competency.
About this Example
Part of the Safe Work Method Statement (Non-High-Risk) document collection
Document Type
Safe Work Method Statement (Non-High-Risk)
A written plan that outlines the steps for doing a job safely. It identifies hazards and sets out control measures for work that is not classified as high risk.