SAFE WORK METHOD STATEMENT

1. General Details

Name of the Project site Details of activity

EHS Risk Assessment Ref. No. Date of Revision:

SWM Ref. No. Date of Revision:

Prepared by

Name of Engineer In charge: Signature:

Review & Approval by

Name of Project EHS In charge: Signature: Name of Project Head: Signature:

Comments of Reviewer & Approver (if any):

Safe System of Work (SSOW) Approval Status Clarification

ACC - Accepted (proceed with work)

AAN - Accepted As Noted (incorporate all comments prior to proceeding with work)

RAR - Revise And Re-submit (rejected)

2. Description of Works: (Provide full description of work method in chronological order, include
time, duration, sequence, location)

3. Resources required (include personnel, supervision, plant / equipment, safety equipment,

materials)
4. Risk Control Measures (Detail the risk controls for each identified Class 1 Risks and any other
significant risks identified in work sequence, include permits, special training refer to risk
management hierarchy)

AnalysisIncident Reporting, Investigation &

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Please Tick

Class 1 risk involved in activity

Description of controls Action by Remarks

Working at Height

Vehicles, Plant & Equipment

Tunneling & Excavation

Use of Explosives

Temporary Works/Formwork

Cranes & Lifting

Working in Confined Space

Working with Electricity

Working in and around Underground & Overhead Services

Working adjacent or in Public Areas

Working over or adjacent to water

Others (add extra rows to address specific risks )

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5. Personnel Protective Equipment requirement (safety helmet, safety footwear, hi-viz vest and any
other PPE identified in the risk assessment).

6. Emergency Arrangements: (Mention potential emergencies, rescue/emergency arrangements,

emergency contacts, emergency equipment and location, special first aid requirements and drills).
7. Temporary Works & Amended Systems: (Include traffic re-routing, isolations, formwork temporary
structures, working times etc.)

8. Dissemination of Information: (To whom the information has / will be communicated to including
checking, review and update provision, change requirements, confirmation of workers briefing )

9. Who, what and when monitoring for compliance will be undertaken (Include all identified Class 1
Risks identified, testing & inspection, calibration requirement, measure conditions like noise, light,
dust etc. and who and when visual 7 written inspections are carried out)

10. Others (include other inputs that are required for the SWM)
Project SHE Plan