COMPANY DETAILS

Company Name: [ENTER COMPANY NAME] ABN: [ENTER ABN] Address: [ENTER ADDRESS] Phone: [ENTER PHONE NUMBER]

JOB DETAILS

Site Address: [ENTER SITE ADDRESS] Client/Principal Contractor: [ENTER CLIENT NAME] Date of Work: [START DATE] to [END DATE] Supervisor Name: [ENTER NAME]

ACTIVITY / TASK DESCRIPTION

Task: [DESCRIBE TASK, e.g., Installation of concrete extruded kerbing along roadway] High Risk Construction Work (HRCW) Checklist:

• Work near traffic
• Use of powered mobile plant
• Risk of fall
• Other: [SPECIFY]

HAZARD IDENTIFICATION AND RISK ASSESSMENT

Step / Task	Hazards / Potential Harm	Risks	Initial Rating (H/M/L)	Control Measures	Final Rating (H/M/L)
1. Site Preparation & Setup	Underground services, uneven ground, moving plant.	Electrocution, crushing, rollover.	[ENTER RATING]	1. Obtain 'Dial Before You Dig' plans.<br>2. Use CAT scanner to locate services.<br>3. Designate pedestrian exclusion zones.<br>4. Use spotters for machinery movement.	[ENTER RATING]
2. Delivery & Handling of Concrete	Heavy lifting, concrete burns, slurry runoff.	Musculoskeletal injury, chemical burns, environmental damage.	[ENTER RATING]	1. Use concrete pumps or conveyors where possible.<br>2. Wear long sleeves and impervious gloves.<br>3. Implement sediment control measures.<br>4. Rotate tasks to minimize fatigue.	[ENTER RATING]
3. Operating Kerbing Machine	Entanglement, noise, vibration, crush points.	Amputation, hearing loss, HAVS.	[ENTER RATING]	1. Ensure all guards are in place.<br>2. Wear class 5 hearing protection.<br>3. Minimize exposure to vibration.<br>4. No riders on machine unless seat provided.<br>5. Emergency stop function tested daily.	[ENTER RATING]
4. Working Near Traffic (Roads)	Collision with public vehicles.	Serious injury or death.	[ENTER RATING]	1. Implement Traffic Management Plan (TMP).<br>2. Use cones, signs and barriers as per AS 1742.<br>3. Traffic controller licensed and present.<br>4. High visibility clothing worn.	[ENTER RATING]
5. Cutting & Finishing (Power Tools)	Dust, noise, kickback.	Silicosis, hearing loss, lacerations.	[ENTER RATING]	1. Use wet cutting methods.<br>2. Attach dust extraction/vacuum.<br>3. Wear P2 respirator minimum.<br>4. Inspect cords and plugs before use.	[ENTER RATING]

HIERARCHY OF CONTROLS SUMMARY

1. Elimination: Can work be done without the hazard? (e.g. pre-cast kerbs to avoid wet concrete)
2. Substitution: Use a less hazardous material or process.
3. Engineering: Guards, physical barriers, dust extraction.
4. Administrative: SWMS, training, signs, job rotation.
5. PPE: See section below.

PERSONAL PROTECTIVE EQUIPMENT (PPE)

Mandatory for all workers:

• High Visibility Safety Shirt (Class D/N)
• Long trousers (heavy drill/cotton)
• Safety boots (Steel cap/composite)
• Safety glasses (clear or tinted)
• Hard hat

Task Specific:

• Hearing protection (Class 5)
• Sunscreen (SPF 30+)
• Nitrile/Chemical resistant gloves (for concrete handling)
• Respiratory protection (P2/N95 for cutting)
• Wet weather gear (if required)

EMERGENCY PROCEDURES

Nearest Hospital: [ENTER NAME AND ADDRESS] Emergency Contact: 000 Site Emergency Contact: [ENTER NAME AND NUMBER]

First Aid:

• Location of First Aid Kit: [ENTER LOCATION, e.g. Site Office ute]
• Location of Eyewash Station: [ENTER LOCATION]

Incident Reporting:

• All incidents must be reported to the Supervisor immediately.
• Serious incidents must be reported to SafeWork NSW.

TRAINING AND COMPETENCY

Worker Name	Role	Induction Date	SWMS Signed	License / Ticket No.
[NAME]	[ROLE]	[DATE]	[SIGNATURE]	[e.g. LF, WP, HRW]
[NAME]	[ROLE]	[DATE]	[SIGNATURE]	[e.g. LF, WP, HRW]

SIGN OFF

I acknowledge that I have read and understood the contents of this SWMS.

Worker Signature: __________________________ Date: //____

Supervisor Signature: ______________________ Date: //____

REVIEW AND AMENDMENT

This SWMS must be reviewed:

• If an incident occurs
• If a hazard is identified
• If controls are not effective
• If there is a change in work practices
• At least every 2 years

Last Review Date: [ENTER DATE]