Safe Work Method Statement

Project Name: American Express GGN.

Project Address : - American Express India Pvt Ltd Sector-74 A Southern
Periphery Road, Gurgaon- 1210001 Haryana.
Company Name: Cherry hill interiors Activity/Trade: SPRAY PAINTING & COATING WORKS.
Address: Y-33, Sanjay Colony II, Pocket Y, Sanjay Colony, Okhla Phase II, Okhla Engineer/Supervisor Name: Parmod Sharma
Industrial Estate, New Delhi, Delhi 110020
Phone: 011 4920 1900 Contact No:9599791932,

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Preparation of work environment
E - Extreme Risk: The hazard has the potential to kill or permanently disable a person
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days
Document Name:
652184162.doc
Safe Work Method Statement
Person who
Possible Hazards Risk Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
(See
Controls below as a guide happens
could lead to an accident or potential harm below)
arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Tripping due to obstruction in your  Inspect work/walk area for potential slip trip fall obstructions
path. prior to start of work and remove, if not possible mark with
 COVID transmission M visible tape/flags. Supervisor
 Keep work area organized and free of surface obstructions
during task.
 Inform others in area of ongoing works.
 Barricade the work area.
 Always use face mask and cut resistant gloves.
 Use more mechanical aids for shifting ducts.
 Manual material handling shall be carried out by 2 persons
only.
 Ensure COVID 19 Preventive PPEs equipped by the work
force.
 Use cut/abrasive resistant gloves, pad up the uneven surface.
 Maintain social distancing during work and material shifting.
 Works shall be planned with less denser manpower and
maintaining social distancing.
 Social Distancing to be ensured while conducting TBT and
Safety training to the workforce.
 Display posters that alerts workers on COVID, cough and
sneeze etiquette, and hand hygiene, at the entrance to the
workplace and other common areas.
H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps) Possible Hazards Risk
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that (See
task and be in logical sequence.) could lead to an accident or potential harm below)
arising.)
 Shift tools and ducts to the work  Body ergonomics while lifting of
area through trolley material lift. ducts.
 Muscle or back strain for lifting ducts.
 COVID transmission through droplets
during cough/sneeze, common touch
points
Person who
Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
Controls below as a guide happens
1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Lifting of longer ducts by 2 operators.
 Ensure that each person does not carry more than 20kgs.
 Use trolley for shifting of ducts. Supervisor
M  Wear cut resistant hand gloves and face mask all times.
 Bend and lift with legs/ arms, not back.
 Do not place the hand/fingers between the sections and
moving parts.
 Identity positioning of ducts while lifting.
 Proper storing of ducts, barricading in on going work area.
 Service lift shall be used only for material movement. Workers
shall use stairs.
 Sanitize service lift post usage.
 Maintain social distancing while shifting.
 Manual material movement shall be carried out by 2 persons
only.
 Use more mechanical aids for material movement to avoid
close contact.
 Provide soap and water and alcohol-based hand rubs in the
workplace in multiple locations and in common areas to
encourage hand hygiene.
 Do not touch your face, eyes or mouth with hands.
 Make sure that hands are washed thoroughly or disinfected
with hand sanitizer after removing gloves.
 Ensure COVID 19 Preventive PPEs equipped by the work force

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Marking for duct line and
supporting rod fixing.
Person who
Possible Hazards Risk Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
(See
Controls below as a guide happens
could lead to an accident or potential harm below)
arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Fall from height of person during the  Use certified scaffold/airport ladder to ensure appropriate
duct marking. positioning and easy reach position; stand within hand rail of
 COVID transmission working platform keep legs on same platform. Supervisor
M  Scaffold wheels are to be locked in position.
 Do not over reach from the platform for marking.
 Do not move mobile scaffolding while workers are on it. All
workers to climb off scaffolding prior to relocate.
 Do not carry tools and other construction materials while
ascending and descending through the working plat form
access ladder.
 Use tool kit or tool bucket for keeping the tools.
 Never share used tools or machines without sanitizing.
 Maintain social distancing during work.
 Do not touch your face, eyes or mouth with hands.
 Make sure hands are washed thoroughly or disinfected with
hand sanitizer after removing gloves.
 Ensure COVID 19 Preventive PPEs equipped by the work force

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Drilling of anchor points for
erection of ducts.
Possible Hazards Risk
(See
could lead to an accident or potential harm below)
arising.)
 Electric shock due to power machine
malfunction
 Drilling noise during operations.
 Dust formation by drilling
 Cutting /puncture hazard while
mounting drill
 Body position hazard while drilling
 Entry to eye of concrete chips
 COVID transmission
Person who
Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
Controls below as a guide happens
1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Use the approved drilling machine & cutting machine which are Supervisor
tagged and inspected.
 Ensure drill is not powered while mounting and dismounting
H mobile platform or ladder
 Check the tools for malfunction.
 Use industrial Plug top.
 Wear ear plug while working time.
 Wear cut resistance hand gloves.
 Wear dust masks prior to start of work.
 Ensure drill is not powered while mounting and dismounting
 Wear proper hand gloves.
 Body position directly opposite of drill with wide leg apart for
balancing.
 Do not over reach from the platform for drilling.
 Wear face mask always and goggles during the drilling
process.
 Never share used tools or machines without sanitizing.
 Maintain social distancing during work.
 Do not touch your face, eyes or mouth with hands.
 Make sure hands are washed thoroughly or disinfected with
hand sanitizer after removing gloves.
 Ensure COVID 19 Preventive PPEs equipped by the work force

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Stacking/assembly of ducts and
joining of ducts.
 Apply the sealant at corner of the
ducts.
 Duct cutting with help of hammer
and chisel.
Person who
Possible Hazards Risk Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
(See
Controls below as a guide happens
could lead to an accident or potential harm below)
arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Tripping due to stacking of ducts in  Barricade the area and Inform operator in area of ongoing Supervisor
your path. works.
 Hand and leg cuts during joining of M  Keep work area organized and free of surface obstructions
ducts during task. Wearing dust mask and rubber gloves.
 Close work area to prevent entrance of others.
 Use facemask, safety shoes and hand gloves.
 Maintain social distancing during work.
 Ensure COVID 19 Preventive PPEs equipped by the work force
 Cut injury, high noise, material fall.  Need to wear cut resistance hand gloves, while cutting the Supervisor
 COVID transmission through tools duct.
M  All hand tools must be checked before its use.
 Ensure earplug and nose mask while cutting the duct.
 All materials should be kept inside the tool kit.
 Only trained and experienced person engaged in the cutting.
 The area should be barricaded to prevent unauthorized entry.
 Maintain social distancing during work.
 Never share tools and machines without sanitizing.
 Do not touch your face, eyes or mouth with hands.
 Make sure hands are washed thoroughly or disinfected with
hand sanitizer after removing gloves.
 Ensure COVID 19 Preventive PPEs equipped by the work force

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Lifting and hanging of ducts in
the supports
 Installing clip to join Ducting.
E - Extreme Risk: The hazard has the potential to kill or permanently disable a person
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days
Document Name:
652184162.doc
Safe Work Method Statement
Person who
Possible Hazards Risk Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
(See
Controls below as a guide happens
could lead to an accident or potential harm below)
arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Fall risk during work on elevated area  It is advised to use duct lifter machine to avoid manual Supervisor
 Muscle back strain while pulling handling.
 Large ducts can be dropped while  Use scaffold to ensure appropriate positioning and easy reach
mounting(Fall hazard) position.
 COVID exposure M  Stand within hand rails of working platform keep legs on same
platform
 Work area to be marked in order to prevent tripping of other
operators/(Barricading/ signage’s must be provided at the work
location)
 Warning posts to be installed in order to inform others before
lifting of ducts from the floor. Need to ensure at WL.
 Install and lift and position large ducts with 2 or more operators
with maintaining social distancing of more than 2 feet.
 Tools and machineries should not be shared without sanitizing.
 Maintain social distancing during work.
 Provide soap and water and alcohol-based hand rubs in the
workplace in multiple locations and in common areas to
encourage hand hygiene.
 Do not touch your face, eyes or mouth with hands.
 Make sure that hands are washed thoroughly or disinfected
with hand sanitizer after removing gloves.
 Ensure COVID 19 Preventive PPEs equipped by the work force
 Striking hazard with hammers.  Keep hand away from path of travel from hammer while striking Supervisor
 Noise. the clip.
M  Rubber to be used, as it generates less noise.
 Ensure COVID 19 Preventive PPEs equipped by the work force
H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps)
(Break the job down into steps. Each (Identify the hazards associated with each Rating
step should accomplish some major step. Examine each to find possibilities that
task and be in logical sequence.)
 Cleaning of work area
Person who
Possible Hazards Risk Control Measures
will ensure
(Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
(See
Controls below as a guide happens
could lead to an accident or potential harm below)
arising.) 1. Eliminate the Hazard
2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
 Tripping hazards while cleaning work  Keep work area clear off debris and remove tools/equipment Supervisor
area M when not in use to eliminate trip hazards.
 COVID transmission  Maintain social distancing of 2 feet while cleaning.
 Sanitize the common touch points during cleaning.
 Ensure COVID 19 Preventive PPEs equipped by the work
force.
 Provide soap and water and alcohol-based hand rubs in the
workplace in multiple locations and in common areas to
encourage hand hygiene.
 Dispose used hand gloves and facemasks in a container and
treat as biomedical waste.
 Used machines and tools shall be sanitized before reuse.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Personnel Summary
SUPERVISOR’S DETAILS
Supervisors Name & Qualifications: Name:
Experience:
Qualifications:
Supervisor’s Responsibilities:

In addition to the above, the supervisor is to provide training in the use of this WMS, issue PPE and provide training in the same, supervise the
work, ensure conformity with this WMS, amend the WMS when additional hazards are found (and if applicable, ensure all workers receive a tool-
box talk to discuss the control measures for the additional hazards).

DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: All workers must have successfully completed industry induction training

WORK ACTIVITY TRAINING: All workers need to have been trained in the activities outlined in this safe work method statement.

SITE INDUCTION: All workers are to be site inducted by the Principal Contractor, prior to commencing work on site.

OTHER: (List other training undertaken by workers): (eg: Confined Space, Manual Handling, Traffic Control etc)

TICKETS, PERMITS or LICENCES REQUIRED to undertake this work (ie. Certificates of Competency, Confined Spaces etc):

N.B. - Copies of the above must be shown to the Principal Contractor during site induction.

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

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 Safe Work Method Statement

BOCW ACT 1996 & RULES 1998, KARNATAKA BUILDING AND OTHER CONSTRUCTION WORKERS (REGULATION OF EMPLOYMENT AND CONDITIONS OF
SERVICE) RULES 2006.

SP 62 (S and T) : 1997 Handbook on Building Construction Practices (Excluding Electrical Work)

SP 70 : 2001 Handbook on Construction Safety Practices
IS 3696 : Part 1 : 1987 Safety code of scaffolds and ladders: Part 1 Scaffolds
IS 4014 : Part 1 : 1967 Code of practice for steel tubular scaffolding Part 1 Definitions and materials
IS 4014 : Part II : 1967 Code of Practice for Steel Tubular Scaffolding - Part II : Safety Regulations for Scaffolding
IS 13416 : Part 1 : 1992 Recommendations for preventive measures against hazards at workplaces Part 1 Falling material hazards prevention
IS 13416 : Part 2 : 1992 Recommendations for preventive measures against hazards at workplaces Part 2 Fall prevention
IS 13416 : Part 4 : 1994 Recommendations for preventive measures against hazards at workplaces Part 4 Timber structure
IS 7293 : 1974 Safety code for working with construction machinery

Additional Codes and Standards applicable to this trade:

COVID-19 Requirements
All measures taken to prevent the spread of COVID-19 should be done in compliance with requirements under the Occupational Health and Safety Act and associated regulations and public health directives issued by the Chief
Medical Officer of Health department and as per MHA guidelines.

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 Safe Work Method Statement

Equipment & Material Summary

PLANT and EQUIPMENT used and MAINTENANCE FREQUENCY :

Serial Plant/Equipment Contractor Government Plant Hazards Maintenance/service records and log books sighted
Registration No. identified and by Principle Contractor prior to equipment being
controlled within used on site?
(Where applicable)
WMS?
Yes No Sign Date

1
2
3

ELECTRICAL EQUIPMENT USED DURING THE WORKS (Attach Electrical Equipment Register if applicable):
Item Tag/Item Testers Name & Signature License Number Test Date Result Test Date Result
Number
____ /____ /____ ____ /____ /____
____ /____ /____ ____ /____ /____

HAZARDOUS SUBSTANCES or DANGEROUS GOODS USED IN THE WORKS and anticipated volumes (Attach MSDS if applicable):
MSDS
Purpose Location & Volume Used Controls
Date on Site Date Left Site Product Name MSDS Date Attached
(ie. Application on site) on Site (& PPE to be worn)
(Y/N)
/ / / / / /

/ / / / / /

/ / / / / /
N.B. - All workers must be trained in the safe use of all chemicals and provided with the PPE required when using and storing these chemicals. Disposal is to be as per the waste disposal methods
in the MSDS. Spillage and leaks are to be cleaned up as per the spill/leak procedures identified in the MSDS.

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 Safe Work Method Statement

We agree that we have been consulted in the hazards and control measures and agree to complete the work in accordance with our Work
Method Statement (WMS).
We have been provided with training in all tasks outlined in our WMS and in the Codes of Practice applicable to our work.

Employee / Worker Signature Date Employee / Worker Signature Date

1. / / 8. / /
2. / / 9. / /
3. / / 10. / /
4. / / 11. / /
5. / / 12. / /
6. / / 13. / /

Reviewed by: Signature: Date:

(Principal Contractor’s Representative)

Any changes, additions or deletions made to this WMS are to be covered with the above personnel and the Principal Contractor’s representative at a Toolbox
meeting (Record date and time of Toolbox meeting below):

Date: Time:
Comments:

A copy of the Toolbox Meeting must be attached to this WMS.

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