You are on page 1of 2

Work Method Statement (Part 1) Signed Off:

Contractor: Date: No:

Project: Accepted: Yes/No

Job: Area:
Procedure (in steps): Possible Hazards: Safety Controls:
1.
2.
3.
4.
5.
6.
7.
8.

9.

10.

11.

12.

13.

14.
Work Method Statement (Part 2)
Personal Qualifications and Experience: Personnel, Duties and Responsibilities: Training Required to Complete Work:

Engineering Details/Certificates/WorkCover Approvals: Codes of Practice, Legislation:

Plant/Equipment: Codes of Practice, Legislation:

Read and Signed by All Employees on Site:

You might also like