SAFE WORK METHOD STATEMENT

Scaffolding erection, modification and dismantling PTW No.

Title & Description of Work:

AP/JML Work Location / Preparation Date 07/09/2022

Work Executed by
Area

Tools/ Ratchet wrench, Hand tools, Forklift, Boom truck, lifting

Materials Scaffolding materials
Equip. gear.

Hold Point Authorization to

No. Briefly describe each critical work step
Continue

1 Transportation of scaffolding materials to nearby working location using forklift, trailer, boom truck, crane.

2 Manual handling scaffolding materials to higher elevation

3 Erection scaffolding

4 Modification scaffolding

5 Dismantle scaffolding

6 Manual handling scaffolding materials to ground level

7 Transportation of scaffolding materials outside working area using forklift, trailer, boom truck, crane.

Position Name Signature Date Position Company

Prepared by Work Execution PIC

Document No.: MD-04-HSE-HS-PD-042 Title: Safe Work Method Statement

Date: 20th April 2022 Rev. No.: 05 Page 1 of 02
 Reviewed by Work Execution Manager

Reviewed by Responsible NSRP TA Team

Member
(Relevant Area Discipline Planner)

Approved by Responsible NSRP TA Team

Member
(Area Manager)

Document No.: MD-04-HSE-HS-PD-042 Title: Safe Work Method Statement

Date: 20th April 2022 Rev. No.: 05 Page 2 of 02