SAFE WORK METHOD STATEMENT DOCUMENT

SWMS Title (to be completed by the Contractor / Service Provider)

Project / Workplace Name: Address:

SWMS Title: SWMS. No.: BM-OSHE-SWMS-035

Pile Hacking Works

Contractor / Service Provider: Next Review Date:

Bauer (M) Sdn Bhd Max. 6 months interval OR earlier if conditions and/or circumstances
change that introduce new hazard/s
SWMS Revision Status (to be completed by Contractor / Service Provider)
Rev Reviewed By Approved By
Date Details of Revisions / Changes
No. (Name & Signature) (Name & Signature)

Bauer Prepared, Review and Approved

PREPARED
I have prepared this SWMS in accordance of BMSB requirement and needs that it meets all BMSB acceptance criteria.

HSE Personnel / Engineer (print name): …………..……………………………….….... Signed: ……………………………… Date: ….…/….…/….…
REVIEW
I have review all aspects of this SWMS and am satisfied to the best of my knowledge that it meets all BMSB acceptance criteria.

HSE HOD/ PM/ HOD (print name): …………………………………………………………. Signed: ……………………………… Date: ….…/….…/….…
APPROVED
I have verified all aspects of this SWMS and am satisfied to the best of my knowledge that it meets all BMSB acceptance criteria and approved this
SWMS.

HOD/ Project Manager (print name): ………………………………………………… Signed: ……………………………… Date: ….…/….…/….…

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A) SWMS REVIEW CHECKLIST (to be completed by BMSB)
NOTE:
 Each Contractor / Service Provider, before commencing work, must provide written Safe Work Method Statement/s (SWMS) for the work to
be carried out. The following checklist is to be completed and reviewed by BMSB, and assessed to have met the BMSB acceptance criteria in
compliance with the requirements outlined in the checklist and any relevant HSE Legislation, Codes and Specifications.
 This SWMS must be reviewed on a regular basis. When new information on HSE risks surface, changes occur or after any inspection,
incident / accident that impact on the agreed method of work, the SWMS must be revised accordingly.
Part A Section 1: Compliance Checklist
Check
SWMS Criteria Remarks
Yes No
1. Sets out step by step how the work activity will be carried out.
2. Identifies the aspects / hazards associated with each step of the work activity.
3. Assesses the impacts / risks associated with each step of the work activity.
4. Defines the controls to manage risks associated with each step of the work activity
based on the hierarchy of controls – Eliminate, Substitute, Isolate, Engineer,
Administrate and PPE.
5. Provides a description of the plant / equipment that will be used in carrying out the work
activity (including equipment maintenance and inspection requirements, certification by
qualified person and / or registration, etc.).
6. Describes the qualifications and training of personnel carrying out the work activity,
including supervisors’ experience, competency, licenses, operators’ certification, etc.
7. Refers to and confirms compliance with relevant HSE Legislation, Standards, Codes,
Regulations and / or Client requirement
8. Includes design requirements, engineered details or certification for both temporary and
permanent structures, platforms or access ways / ladders.
9. Where PPE is nominated, the type of PPE is specifically listed and when it is required.
10. Defines the person who is responsible to ensure that the work activity is monitored and
carried out in accordance with the SWMS.
11. Defines the process and frequency of reviews and methods for ensuring the work
complies with the SWMS controls.
12. Identifies, where any Contractor / Service Provider will be used, the person who is
responsible to monitor and supervise the works, and how impacts/hazards arising from
interaction between trades will be communicated and managed (e.g. induction into more
than 1 SWMS).
13. For complex or high risk work activities (where appropriate), uses photos / diagrams /
sketches / summary to enhance the SWMS.
14. Includes the name and signature of the person who developed the SWMS, a current
date and revision number.
Where an exclusion zone is required, the SWMS must clearly state the detail of the required exclusion zone,
including the person responsible for implementation and supervision.

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B) APPLICATION (to be completed by Contractor / Service Provider)
Part B Section 1: Scope of Works
Tasks / Activities:
1. Pegging of pile cap
2. Excavation
3. Pile Hacking
4. Cutting & straightening of rebar.

Work Location (Attach Site Plan): Duration: From

Remarks:

Part B Section 2: Plant / Machinery / Equipment (Attach Inspection Certificates)

Type of Plant / Machinery / Equipment Is this equipment inspected? Remarks
1. Excavator Yes No

2. Air Compressor Yes No

3. Pneumatic Breaker Machine Yes No

4. Pneumatic Breaker Tool Yes No

5. Oxy Cutting equipment Yes No

6. Yes No

7. Yes No

8. Yes No

Part B Section 3: Key Personnel / Qualified Persons (Attach Training Qualification Certificates)
Name Appointment / Designation Remarks
1.

2.

3.

4.

5.

6.

7.

8.

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Part B Section 4: Work Processes
Job Steps Job Step breakdown (if required)
These steps are to be copied to: Step breakdowns are to be copied to:
 Part C: Risk Assessment  Part C: Risk Assessment

1. Pegging of pile cap

2 Excavation

3 Pile Hacking

4 Cutting & straightening of rebar.

Special Instructions / Remarks:

HOLD POINT
BMSB Manager or Superintendent directly responsible for managing this activity is to verify that the
Job Steps have been captured and are listed in logical sequence
HOLD POINT REVIEW
I have reviewed the above Job Steps. In my opinion they have all been captured and are in logical sequence.

Project Manager / Superintendent (print name): …………..……………………….….... Signed: ……………………………… Date: ….…/….…/….…

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 C) RISK ASSESSMENT (to be completed by Contractor / Service Provider)
Part C Section 1: General Information & Risk Matrix
PREPARED BY: REVIEWED / APPROVED BY: HOD/PM
Name: Signed: ………………………………………………. Name: Signed: ……………………………………………….
Designation: Date: …… Designation Date: ……
Risk Assessment (RA) Team Members Legal requirement Other requirement
Name Designation Signature OSH Act 1994  Client requirement
- Use and Standard of Exposure of Chemical Hazardous to
Health Regulation 2000 (USECHH)  Bauer Malaysia Sdn. Bhd. requirement ( BMSB)
- Noise Exposure 2019
 Factories & Machinery Act (FMA) 1967
- Safety, Health and Welfare Regulation 1970 (SHW)
   ________________________
- Building Operations and Works of Engineering Construction
   ________________________
1986 (BOWEC)
   ________________________

 CIDB Act 520
  ________________________
 MS 1539 Part 4: 2006

 UBBL 2012

Consequence Table
Level 1 – Negligible Level 2 – Minor Level 3- Moderate Level 4- Major Level 5 – Catastrophic
Not likely to cause injury or ill Injury or ill health requiring first aid Injury requiring medical treatment Serious injuries or life threatening Fatality, fatal diseases or multiple
SEVERITY health only. (Includes minor cuts and or ill health leading to disability. occupational diseases. (Includes major injuries
bruises, irritation, ill health with (Includes laceration, burns, sprain, injuries, occupational cancer,
temporary discomforts) minor fractures, dermatitis, acute poisoning)
deafness, work-related upper limb
disorders)

LIKELIHOOD
5 (Almost certain) – Continual or repeating experience 5 10 15 20 25
4 (Frequent) – 1) Common occurrence 4 8 12 16 20
3 (Occasional) – 1) Possible or know to occur 3 6 9 12 15
2 (Remote) – 1) Not likely to occur under normal circumstances 2 4 6 8 10
1 (Rare) – 1) Not expected to occur but still possible 1 2 3 4 5
Risk Rating Action
15-25 (HIGH) A high risk requires immediate action to control the hazard as detailed in the hierarchy of control. Actions taken must be documented on the risk assessment form including date for completion
5-12 (MEDIUM) A medium risk requires a planned approach to controlling the hazard and applies temporary measure if required. Actions taken must be documented on the risk assessment form including date for completion
1-4 (LOW) A risk identified as LOW may be considered as acceptable and further reduction may not be necessary. However, if the risk can be resolved quickly and efficiently, control measures should be implemented and recorded

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Part C Section 2 : Risk Assessment
No Job Steps Potential Possible Impacts / Accountable
(Copy from B – Aspects / Accidents or Ill person(s) /
OH&S Risk OH&S Opportunity
Section 4) Hazards Health & Persons Designation /
at Risk Follow-up Date
Existing Impact or Risk Control / Impact Likeli- Risk Legal & Other Opportunity Impact Likeli- Risk
Preventive Measures hood Rating Requirement hood Rating
OSHA 1994
Sec 15 & 24
i. Use longer length of steel
Pegging of pile Short steel bar Trip and fall/ Surveyor
1.0 bar with visible marking 3 1 3 FMA Nil
cap on the platform Bodily Injury
for easy identification (BOWEC) Supervisor
1986
Reg 119
OSHA 1994
Sec 15 & 24
i. Provide proper work
platform and protection on
FMA
slope / edge.
Working at the Fall (BOWEC)
Surveyor
edge of the person/Bodily 4 1 4 1986 Nil
ii. Compact and levelling the Supervisor
slope injuries Reg 88
work platform (If required)

iii. Adequate PPE to be worn FMA

(SHW)
Reg 32
i. Provide supported
structure (e.g sheet piling)
prior to commencement of
excavation work

ii. Excavated material and

equipment placed at
610mm from the edge of
open excavation area
FMA (BOWEC)
Bodily Injuries/ iii. Cover the expose slope Site Engineer
1986
2.0 Excavation Soil collapse Fatality /Property with plastic sheet to avoid 5 1 5
Reg 113
Nil
damage Site Supervisor
erosion during heavy rain Reg 115

iv. Provide safe access and

egress (e.g. ladder,
stairways, ramps)

v. Pre task briefing

vi. Permit to Work

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 i. Provide adequate
Open barricade surround
FMA (BOWEC)
excavation pit Bodily Injuries excavation
5 1 5 1986 Nil Site Supervisor
/Fatality
Reg 113
ii. Display visible marking
signage

i. Piloting conducted prior to

commencement of work

ii. Cordon the danger area in

a safe method Site Supervisor
Damage Contact with live FMA (BOWEC) Excavator
iii. Display visible 5
underground current/ 5 1 1986 Nil Operator
signage/marking of high
utilties Electrocution Reg 16 Banksman
voltage area for easy
identification

iv. Permit to Work

v. Pre – task briefing

i. Power tool operated by
experienced and trained
worker i. Conduct
FMA (BOWEC) Personal
ii. Good condition of power 1986 Monitoring on
tools to be used Reg 127 noise and
maintain the
iii. Inspection for defects on OSH record
Excessive Project Manager
Hearing tools prior use (Noise
3.0 Pile Hacking noise exposure
loss/Impairment
3 2 6
Exposure) ii. Conduct 2 2 4 Site Supervisor
from hacking iv. Pre task briefing Audiometric Worker
2019
Reg 3 (1) Testing on
v. Permit to work worker
CIDB Act exceeded
vi. Job rotation Sec 33A 82dB(A)

vii. Adequate PPE to be worn

(E.g. Ear Plug)

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 i. Spray water at hacking FMA
area to suppress dust (BOWEC)
1986
ii. Pre task briefing Reg 11
Exposure to Site Supervisor
Respiratory
dust dispersion 3 1 3 Nil
illness iii. Permit to work Worker
from hacking FMA
(SHW)
iv. Adequate PPE to be
Reg 32
worn (E.g. Safety
Goggle, Dust Mask)

i. Power tool operated by

experienced and trained FMA
worker (BOWEC)
1986
ii. Good condition of power Reg 147
Struck by flying
tools to be used
of concrete Eye or bodily Site Supervisor
3 1 3 FMA Nil
debris from Injuries Worker
iii. Inspection for defects (SHW)
hacking
on tools prior use Reg 32

iv. Adequate PPE to be CIDB Act

worn (E.g. Safety Sec 33A
Goggle, Dust Mask)
i. Inspection for defects
on pressure hose prior
use

ii. Install safety clips or

FMA
retainers (e.g. whip
Struck by (BOWEC) Site Supervisor
Bodily Injuries arrestor, R-clip ) 4 1 4 Nil
whipping hose 1986 Worker
Reg 150
iii. Maintain the pressure
level according to
manufacturer safe
operating pressure
specification

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 i. Install portable exhaust /
fan blower to divert heat
, fume or gases FMA
(BOWEC)
ii. Permit to work 1986
Cutting & Inhalation of Reg 11
Respiratory iii. Pre task briefing
4.0 straightening of toxic fumes or
Illness
2 2 4 Nil Welder
rebar. gases OSH
iv. COSSH Briefing – (USECCH)
Oxygen and Acetylene 2000
Reg 14
v. Adequate PPE to be Reg 16
worn
i. Provide safe hot work
area from any flammable
and combustible material

ii. Inspection of
tools/equipment by
competent person

iii. Install non return valve at

both ends hose (cylinder
side and torch side)
FMA
iv. Regular inspection for (SHW)
defect on regulator, cutting Reg 34
torch hose using soap Reg 22
i. Secure the
water ,
cutting torch
Bodily Injuries/ FMA (BOWEC)
Fire & hose inside the Welder
Fatality /Property v. Welding and cutting 5 1 5 1986 3 1 3
Explosion box. Site supervisor
Damage operations performed by Reg 147
trained and certified
welder UBBL 2012

vi. Standby Fire Extinguisher MS 1539

with valid BOMBA Part 4
Certificate

vii. Permit to Work

viii. Pre task briefing

ix. Display visible warning

signage

vi. Adequate PPE to be worn

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 D) SAFE WORK PROCEDURES (to be completed by Contractor / Service Provider) –Pile Hacking Works
Part D Section 1 : Safe Work Procedures
1. Availability of trained operatives and competent Supervisor
2. Sufficient and suitable plant and equipment are used for work
Planning 3. Use wire rope sling with Mill Certificates and Test Certificates
4. Method Statement available
5. Information of ground condition obtained
1. Regular housekeeping / material stacking and ensure fire extinguisher available
2. Permit to work system implemented for excavation and hot works, heavy lifting and night works
Physical
3. Substantial barriers erected around Pile cap
1. Inspection of sling on a weekly basis
2. Provide suitable PPE required and ensure its correct use
Managerial / Supervisory 3. Inspect plant & equipment used regularly
4. Ensure personnel involved in the work are capable, fit and experienced unless under direct
supervision
1. Ensure employees have attended the site specific safety induction and mandatory safety induction
Training 2. Conduct job specific safety briefing on Pile cap construction for employees involved
3. Employees attend daily / weekly toolbox talk
1. Refer to Section 14.0 – Emergency Preparedness Plan in Project OHSAS Management Plan
Emergency Procedures 2. Familiar with Emergency Evacuation Procedure
3. Assist ERT team to carry out the task
1. Safety Helmet
2. Safety shoes
3. Safety Goggles
PPE 4. Glove
5. Ear Plug
6. Body Harness (If Required)
7. Mask (If Required)

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Part D Section 2: Instruction & Communication
This Safe Work Method Statement has been instructed and communicated through induction and consultation, read and understood, and signed by all employees
undertaking the works.
Name Designation Signature Date Name Designation Signature Date
1) 21)
2) 22)
3) 23)
4) 24)
5) 25)
6) 26)
7) 27)
8) 28)
9) 29)
10) 30)
11) 31)
12) 32)
13) 33)
14) 34)
15) 35)
16) 36)
17) 37)
18) 38)
19) 39)
20) 40)
Remarks / Comments (e.g. detail of any feedback or comments received from the crew during this session)

Part D Section 3: Verification

I have provided, accurate and sufficient information and instructions to the work crew pertaining to this Safe Work Method Statement - the aspects / hazards
associated with each work process and activity, the type of potential impact, incident or accident, and the risk controls / practicable measures to be taken in the
course of work and during an emergency - to ensure their safe undertaking of the work.

Conducted by (print name): ……………………………………….. Signed: …………………………………….. Date: …..../…...../……… Time: .............. am / pm

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