Safe Work Method Statement (SWMS)

Company Details

Company Name: [COMPANY NAME] ABN: [ABN] Address: [ADDRESS]

Project / Job Details

Project Name: [PROJECT NAME] Job Number: [JOB NUMBER] Site Address: [SITE ADDRESS] Date of Issue: [DATE]

High Risk Construction Work (HRCW)

This SWMS applies to the following High Risk Construction Work (Check all that apply):

• Work that involves a risk of a person falling more than 2 metres
• Excavation work (including trenching) deeper than 1.5 metres
• Work in or near a confined space
• Work in or near a shaft or trench deeper than 1.5 metres
• Work on or near pressurised gas distribution mains or piping
• Work on or near chemical, fuel or refrigerant lines
• Work on or near energised electrical installations or services
• Work in an area that may have a contaminated or flammable atmosphere
• Work near traffic, mobile plant (e.g. roadworks)
• Work near or on water
• Work involving demolition
• Work involving structural alterations
• Work involving the use of explosives
• Work on or adjacent to railway lines
• Work in an area at a workplace in which there is movement of powered mobile plant

Description of Tasks

[List the specific tasks to be performed, e.g., Installation of traffic management devices, Excavation of trench for drainage, Placement of road base, Compaction of asphalt]

Hazard Identification and Risk Assessment

Step / Task	Potential Hazard	Who is at Risk?	Risk Rating (Before Controls)	H	M	L
[e.g., Setting up traffic control]	[e.g., Struck by vehicle]	[e.g., Traffic controllers, public]	[H/M/L]
[e.g., Excavation]	[e.g., Ground collapse]	[e.g., Plant operator, ground workers]	[H/M/L]
[e.g., Operating roller]	[e.g., Rollover, noise]	[e.g., Operator]	[H/M/L]
[e.g., Breaking concrete]	[e.g., Dust, silica, vibration]	[e.g., Labourer]	[H/M/L]
[e.g., Service locating]	[e.g., Strike cable / pipe]	[e.g., Locator]	[H/M/L]

Risk Control Measures

For each task listed above, implement controls using the Hierarchy of Controls.

Task 1: [TASK NAME]

Hazard: [HAZARD]

• Elimination: [Can the hazard be removed?]
• Substitution: [Can something less hazardous be used?]
• Engineering: [e.g., Use of concrete barriers, signage, trench shoring]
• Administrative: [e.g., SWMS briefing, spotters, exclusion zones, permit systems, rotate workers]
• PPE: [List PPE required]

Task 2: [TASK NAME]

Hazard: [HAZARD]

• Elimination: [Can the hazard be removed?]
• Substitution: [Can something less hazardous be used?]
• Engineering: [e.g., Machine guards, ROPS, dust extraction]
• Administrative: [e.g., Traffic management plan, pre-start checks]
• PPE: [List PPE required]

(Repeat for all tasks)

Personal Protective Equipment (PPE)

Mandatory PPE for all workers:

• High visibility clothing (Class D or N)
• Safety Helmet (AS/NZS 1801)
• Safety Boots (AS/NZS 2210.3)
• Safety glasses or goggles

Task Specific PPE:

• Hearing protection (Class 5)
• Gloves
• Respiratory protection (P2 or higher)
• High visibility vest with sleeves
• Sun protection

Emergency Procedures

• Location of First Aid Kit: [LOCATION]
• Location of Fire Extinguisher: [LOCATION]
• Nearest Hospital: [NAME AND ADDRESS]
• Emergency Contact Person: [NAME] - [PHONE NUMBER]
• Emergency Services Dial: 000
• Evacuation Assembly Point: [LOCATION]

Specific Emergency Instructions:

• For injuries: Stop work, administer first aid, call 000.
• For service strikes: Stop work immediately, clear area, call service authority.
• For traffic incidents: Secure scene, divert traffic if safe, call police.

Training and Competency

We confirm that all workers listed in the sign-off section have received the necessary training and instruction to perform the work safely.

• General Construction Induction (White Card)
• Traffic Controller Accreditation
• High Risk Work Licence (e.g., Dogman, Forklift)
• Confined Space Entry Training
• Plant Operator Verification of Competency

Review and Revision

This SWMS will be reviewed:

• Before work commences
• If there is a change in work procedures
• If a new hazard is identified
• If a notifiable incident occurs
• On a regular basis (every [X] months)

Sign-Off Section

Worker Acknowledgement: I have read and understood the contents of this SWMS. I agree to follow all control measures and use the PPE provided.

Name	Signature	Date	Trade / Role
[Name]	[Sign]	[Date]	[Role]
[Name]	[Sign]	[Date]	[Role]
[Name]	[Sign]	[Date]	[Role]

Principal Contractor / PCBU Representative: I confirm this SWMS adequately addresses the risks associated with this work.

Name: __________________ Signature: __________________ Date: ________________