SAFE WORK METHOD STATEMENT DOCUMENT

Document Title (to be completed by the Contractor / Service Provider

Project: Lot 349 SWMS No: AJ 001
This SWMS will be reviewed: 17th July 2017____ (Date)
SWMS Title: Soil Investigation 6 months maximum OR earlier if conditions and/or circumstances
change that introduce new hazard/s.
Contractor / Service Provider: Aneka Jaringan Sdn Bhd
Document Status (to be completed by MBSB)
Rev Contractor MBSB MBSB
Date Comments
No review by review by verification by

MBSB Review, Verification & Endorsement

REVIEW
I have reviewed all aspects of this SWMS and am satisfied to the best of my knowledge that it meets all MBSB acceptance criteria.

Package Manager / Engineer : …………..……………………………….….... Signed: ……………………………… Date: ….…/….…/….…

VERIFICATION
I have verified all aspects of this SWMS and am satisfied to the best of my knowledge that it meets all MBSB acceptance criteria.

ESH Mgr / SHO : ………………………………………………………………. Signed: ……………………………… Date: ….…/….…/….…

ENDORSEMENT
I have verified all aspects of this SWMS and am satisfied to the best of my knowledge that it meets all MBSB acceptance criteria.

Project / Construction Leader : ………………………………………………… Signed: ……………………………… Date: ….…/….…/….…

AJ 001 _Rev 0 Page 1 of 10

A SWMS REVIEW CHECKLIST (to be completed by MBSB)
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 MBSB, and assessed to have met the MBSB acceptance criteria in
compliance with the requirements outlined in the checklist and any relevant ES&H Legislation, Codes and Specifications.
 This SWMS must be reviewed on a regular basis. When new information on ES&H risks surface, changes occur or after any inspection, incident /
accident that impact on the agreed method of work, the SWMS must be revised accordingly.
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 ES&H Legislation, Standards, Codes,
Regulations and / or MBSB ES&H Requirements.
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 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, 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.
15. The SWMS includes specific ES&H controls for key high risk activities .

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.

AJ 001 _Rev 0 Page 2 of 10

B APPLICATION (to be completed by Contractor / Service Provider)
Section 1: Scope of Works
Tasks / Activities:
Mobilization of Soil Investigation drilling rigs to site, Soil Drillings, Rock probing works and use of mobile crane to assist in the shifting and setting of
the SI Equipment.

Work Location (Attach Site Plan): Refer Attachments Duration: From 18/01/2017 (Date) to 18/02/2017 (Date)

Remarks:
- Appendix A - SI Points layout.
- Appendix B - Loading unloading area and Mobile Crane movement route layout

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

Type of Plant / Machinery / Equipment Is this equipment inspected? Remarks
1 SI Machine Yes No

2 Yes No

3 Yes No

4 Yes No

5 Yes No

6 Yes No

7 Yes No

8 Yes No

Section 3: Key Personnel / Qualified Persons (Attach Training Qualification Certificates)

Name Appointment / Designation Remarks
1 SHO

2 Lifting Supervisor

3 Supervisor

4 SI Boring Rig Operator

5 Mobile Crane Operator

6. Traffic Controller

7. Rigger

8. Signal Man

AJ 001 _Rev 0 Page 3 of 10

C RISK ASSESSMENT (to be completed by Contractor / Service Provider)

Section 1: General Information

PREPARED BY: REVIEWED / APPROVED BY:

Name: Jeganathan Nair Signed: Name: Kevin Che Kam Seng Signed:

Designation: Safety and Health Officer Date: ……17…. /…1……. /……17…. Designation: Project Manager Date: …17……. /……1…. /…17…….
Applicable Environment, Safety & Health (ES&H)
Risk Assessment Team Approved Code of Practice (COP) and/or CSR
Legislation
Name Designation Signature

 Chan Ten Song  Construction Manager  ________________________

 Ayavu A/L Nagappan
 ________________________
 ________________________
 ________________________
 ________________________
 Senior Supervisor
 ________________________
 ________________________
 ________________________
 ________________________
 ________________________
 ________________________ FMA- Act139, OSHA- Act514 & DOSH Regulations
 ________________________
 ________________________
 ________________________

AJ 001 _Rev 0 Page 4 of 10

Consequence Table
Very Small - 1 Small - 2 Medium - 3 Large - 4 Very Large - 5
Unlikely injury or ill-health, or Offsite medical treatment. Lost Time Injury or Permanently Disabling Injury Fatality due to Injury or
onsite first aid treatment. Onsite and/or offsite Occupational Illness. or Occupational Illness. Occupational Disease.
Onsite environmental impact environmental damage Onsite and/or offsite Onsite and/or offsite Evacuation of employees
IMPACT with straightforward clean-up taking 0-3 months to clean environmental damage environmental damage due to threat of fatality.
or remedy with available site up or remedy. taking 3-6 months to clean taking 6-12 months to clean Irreversible onsite and/or off-
equipment and controls. No regulatory notification up or remedy. up or remedy. site environmental damage;
No regulatory notification required. Regulatory notification may Regulatory notification or clean-up or remedy from
required. Some community concerns be required. compulsory but no public damage lasting > 12
raised but no impact. Limited impact on investigation likely. months.
community with minor Major impact on local Regulatory notification
concerns raised. community leads to compulsory with public
LIKELIHOOD community protests. investigation likely.
Impact on local community
leads to community outrage.
5 (Very High) - A Very High Likelihood:
1) Almost certain to occur; 2) Almost certain to re-occur due to past trends Minor Moderate Significant Significant Critical
from reported incidents / issues; 3) Quantified very high exposure to the risk
without any controls in place.
4 (High) - A High Likelihood:
1) Strong evidence to likely occur; 2) Highly likely to re-occur due to past Minor Minor Moderate Significant Significant
trends from reported incidents / issues; 3) Quantified high exposure to the risk
without any controls in place.
3 (Medium) - A Medium Likelihood:
1) May occur or known to occur; 2) Infrequent number and regularity of Minor Minor Moderate Moderate Significant
reported incidents / issues; 3) Quantified moderate exposure to the risk without
any controls in place.
2 (Low) - A Low Likelihood:
1) Could occur at some but not expected; 2) One or two reported incidents / Negligible Minor Minor Minor Moderate
issues to date; 3) Quantified low exposure to the risk without any controls in
place.
1 (Very Low) - A Very Low Likelihood:
1) Highly unlikely to occur; 2) No evidence of reported incidents / issues in the Negligible Negligible Minor Minor Minor
past; 3) No quantified and known exposure to the risk without controls in place.

Risk Index Action

Critical Operation not permissible; management attention and consultation with HOD Safety & Health required.
Significant Operation not permissible; risk must be reduced by all possible means (not by interim risk control measures); management attention and consultation with HOD Safety & Health required.
Further risk reduction required where possible; remedial action to be taken immediately; 7 day (max) review needed to ensure risk level assigned is accurate and does not increase over time;
Moderate
management attention required.
Risk tolerable subject to demonstration that risk level is as low as reasonably practicable; remedial action to be taken at appropriate time to further reduce risk level; 30 day (max) review needed to
Minor
ensure risk level assigned is accurate and does not increase over time.
Negligible Risk acceptable; discretionary remedial action to be taken.

AJ 001 _Rev 0 Page 5 of 10

Section 2: Risk Assessment
Unless stated otherwise in this document, ALL WORKERS, will wear (at all times during this activity):-
MANDATORY PPE:- Safety Helmet, Safety Shoes (High Ankle), Safety Glasses, High Visibility Vest & Gloves.

NO Job Steps Hazard Risk Risk Control / Control Measures L I Risk Accountable Person
Rating
- Delivery of SI Equipment, Lorry Crane & Mobile Uncontrolled traffic / Major injury due to contact with Designated & Trained Traffic controllers to be assigned. 2 4 Moderate Supervisor
Crane to worksite vehicle movement moving vehicles or machineries Traffic controller to be equipped with whistle, high visibility clothing & batons/ flags
Proper signage to be placed to warn the public
- Use Of Lorry / truck Mounted Crane to Unsafe lorry crane Major injury due to contact with To use competent operator & rigger 1 4 Minor Lifting Supervisor
unload the SI Equipment &lifting operation load or machinery during lifting Lifting Gears & Crane to be inspected & with valid fitness certificates
operation Truck to be levelled and outriggers fully extended.
Steel plates to be provided for padding.
To lift using designated lifting points only
To only use tested and certified lifting gears & equipment only
Barricade the work area
- Mobilization of boring rigs/SI machines to boring Unsafe lifting operation Major injury due to contact with To use competent operator 1 4 Minor Lifting Supervisor
points / work areas by using mobile crane load or machinery during lifting Crane to be inspected & with valid fitness certificates
operation Crane to use 1m x 1m steel plate for out riggers
Out riggers to be fully extended
Wheels to be slightly above the ground
Crane to be balanced -refer level meter / water leveller on the body
Barricade the work area
Unsafe slinging Major injury due to material fall To use competent rigger 1 4 Minor Lifting Supervisor
To use tested and certified slings & lifting gears
To lift using designated lifting points only
No overhead lifting or standing under suspended load
- Assembly of SI Boring Rig To Attach the Tripod Unstable ground Major injury due to toppling of Ensure ground is stable and levelled 1 3 Minor Supervisor
Frame Tripod frames
Unsafe Tripod structure Major injury due to collapse of Ensure all structure is in good condition 1 3 Minor Supervisor
Tripod structure Secure the Tripod to the main frame once in vertical position
- Setting Up Compressors and water Pumps Unsecured hose & Major injury due to hit or Proper hose & connectors to be used 1 4 Minor Supervisor
connectors contact with high pressure Test the hose and connection with 110% of the normal usage pressure
release
1 4 Minor Supervisor
Unprotected rotating Major injury due to contact with All rotating parts and heating elements of the compressor and water pump to be
parts and heating rotating equipment and heating fitted with machine guarding
elements element of the compressor and
water pump
1 4 Minor Supervisor
- Soil Drilling / Boring & Rock Probing for Unprotected rotating Major injury due to contact with All rotating parts and heating elements of the boring rig to be fitted with machine
sampling. parts and heating rotating equipment and heating guarding
elements element of the boring rig
Inadequate access for Minor to major injury due to fall Proper access ladders to be provided on the Tripod Frame for access during 1 4 Minor Supervisor
mast/ tripod climbing while climbing the Tripod changing of drilling rods.
Frame Safety Harness to be worn to access the pulley or top of the Tripod frame
- Housekeeping Poor housekeeping Minor to major injury due to Regular housekeeping during work progress 1 3 Minor Supervisor
poor housekeeping Proper waste segregation, collection and removal (i.e. construction and Schedule
Wastes)
- Weather Condition Unsafe weather Major injury due to working in To stop work during unfavourable / extreme weather conditions (rain, storm, 1 4 Minor Supervisor
condition extreme weather conditions strong wind, etc)
- Welfare facilities Inadequate welfare Unavailability of welfare To provide First Aider & First Aid Box 1 4 Minor Supervisor & SHO
facilities facilities may limit assistance To ensure availability of drinking waters & shelters for resting.
during emergencies

AJ 001 _Rev 0 Page 6 of 10

D SAFE WORK PROCEDURES (to be completed by Contractor / Service Provider)
Section 1: Safe Work Procedures
Unless stated otherwise in this document, ALL WORKERS, will wear (at all times during this activity):-
MANDATORY PPE:- Safety Helmet, Safety Shoes (High Ankle), Safety Glasses, High Visibility Vest & Gloves. ( Standby and waters for safety glass cleaning purposes)
Safe Work Procedures
Job Steps / Sequence Of Works Permits / Forms Additional Equipment / Hold Point
WHO – WHAT – HOW - WHEN
Required PPE Responsible
(include images / sketches if required for further clarity)
- Safety PreStart All workers and operators need to be briefed into this SWMS and signatures recorded prior
to commence work on daily basis. Supervisor/
Safety PreStart
Safety
Any deviation of activity / method of work from this SWMS need to be discussed and Forms
Personnel
approval obtained from MBSB. Work need to be stopped until the approval is obtained.
- Delivery of SI Equipment, lorry crane and Ensure a designated and trained Traffic Controller assigned at the entrance to manage
mobile crane to worksite trucks / machineries coming into site and the traffic at public road. Crane & Lifting Lifting
Traffic controller to be equipped with whistle, high visibility clothing & traffic control batons / Equipment Inspection Supervisor &
flags Checklist Operator

- Use Of Lorry / truck Mounted Crane to
unload the SI Equipment
- Mobilization of boring rigs/SI machines to
boring points / work areas by using mobile
crane
AJ 001 _Rev 0
Lifting supervisor with the truck mounted crane operator to check the crane and all slings and
liftin equipment / lifting gears. Inspection to be recorded and kept at work area and filed upon
completion of work.
Work area to be barricaded to prevent unauthorised entry using hard barriers.
Outriggers to be fully extended and steel plates used as padding.
Truck to be levelled and stable condition.
Load being lifted should not be more than 80% of the crane’s maximum capacity along the
lifting radius and unloading point (locations to be predetermined and verified by the Lifting Lifting
supervisor to confirm this) Supervisor
Lifting of material then shall be done by competent operator (competencies to be verified
prior to lifting by the Lifting Supervisor) of lorry crane and shall be assisted by lifting
supervisor and 2 riggers.
Loads to be hooked to a designated and engineered lifting points only.
Total load distribution to the slings should not be more than 80% of its capacity. Total loading
to the sling need to be also based on the number of slings and method of slinging.
All Lifting hooks must be fitted with safety latch.
To use 20t or more crane to shift the SI machines to the work areas Crane & Lifting Lifting
Supervisor and operator to inspect the ground condition along the crane movement routes. Equipment Inspection Supervisor &
Where unsuitable grounds suspected further assessment to be conducted by a competent Checklist Operator
Geotech Engineer.
Lifting Supervisor and operator to inspect the crane and all the lifting equipment / gears to
ensure they are all in good condition, properly rated, tested with tags displayed and meets
the capacity needed for the lifting activity.
Page 7 of 10

Assembly of SI Boring Rig To Attach the
Tripod Frame
- Setting Up Compressors and water Pumps
- Soil Drilling / Boring & Rock Probing for
sampling.
AJ 001 _Rev 0
Steel plates to be laid along the crane movement routes where necessary.
Crane to be parked with outriggers fully extended and lifted to level the crane in a balanced
position. 1m x1m steel plates to be placed for load distribution of the mobile crane outriggers.
All the wheels/ tyres of the crane must be slightly above the ground.
To lift the boring rigs and other equipment to the work area. To only use the designated lifting
points.
No overhead lifting is allowed and workers not to stand under any suspended loads.
Setup the boring rig at the drilling point. Ensure ground is levelled. Ensure all the rotating
parts and heating elements are adequately and neatly protected using metal plates or steel
mesh.
Ensure drip trays are positioned under the boring rig to capture and oil leak or spillage.
Place the Tripod frame on a horizontal position in front of the boring rig for lifting and
assembly.
Ensure Tripod frame structures and joints are in good condition.
To ensure pulleys at the top of the frame is in good condition and fitted with guide bar to
prevent dislodging of wire rope during operation. To ensure proper access is inbuilt to the Supervisor
Tripod Frame for climbing purposes during the operation.
Ensure the ground is levelled prior to placing the boring rig and Tripod frame.
Hook the boring rig’s lifting sling to the Tripod Frame and lift slowly to the vertical position.
Balancing of the tripod to be ensured during the process.
Once vertically positioned the tripod to be secured to the main frame of the boring rig to
become one complete unit.
Attach the drilling rods to the boring rig by lifting it using the lifting sling.
Ensure all the rotating parts and heating elements of the compressors and water pumps are
adequately and neatly protected using metal plates or steel mesh.
To ensure all the hoses are in good condition and connected using proper connectors.
Test the compressor with and additional 10% of the pressure used during normal operation.
Supervisor
Check back the hoses and connections to ensure they are still intact
Stop operation if any loose connections or leaks observed and rectify immediately.
To dig a small pond of not more than 400mm deep to manage the runout water during boring
activity. Hard barriers to be provided around the pond for identification and warning.
Continue to bore once all the setup is checked and verified by the supervisor. N95 type of mask to be Supervisor
Drill to the depth required and do sampling at intervals as stated or agreed in the method used dust cannot be
statement. controlled.
Water to be used to minimise any dust pollution.
Ensure proper access is provided for access to the tripod frame for slinging and unslinging
during changing of the drilling rods.
Safety Harness to be worn and hooked at highest point if need to access to the top of the
Tripod frame or pulley.
Not to store or keep materials around the areas where access is required to operate the rig
Page 8 of 10
 or climbing the Tripod.
Keep all the samples as per instruction in the method statement and at a designated storage
area before being transported out for testing.
- Housekeeping Work areas need to be kept neat and tidy at all time before, during and after any activity.
All materials must be stored in proper manner at an agreed location with MBSB.
Unwanted materials must be removed from site on daily basis.
Any contaminated wastes must be collected, handled and disposed incompliance Schedule Supervisor
Waste requirements as established by DOE.
Other general and construction wastes must be collected, handle and disposed as per the
local authority requirements and MBSB’s instruction.
- Weather Condition Works ned to be stopped if weather conditions are not suitable for the task these includes
rain, storms or strong winds. Supervisor
.
Welfare facilities First Aid Box as per DOSH guideline need to be provided
First Aiders must be on site throughout the operation on site
Drinking Water facilities to be provided for workers at work areas. Supervisor &
Proper shelters to be provided prior to work commence for the workers usage during SHO
unfavourable weathers and as temporary rest areas.
Proper signage to be provide for all activities and storage areas.

AJ 001 _Rev 0 Page 9 of 10

Section 2: Instruction & Communication
This Safe Work Method Statement has been developed through consultation with the following crew members and has been instructed through induction, read and understood, and signed by all employees undertaking
the works.
Name Designation Remarks / Comments Signature Date
1 Kevin Che Kam Seng Project Manager
2 Chan Ten Song Construction Manager

Section 3: Verification
I have provided, accurate and sufficient information and instructions 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 its / their safe undertaking.

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

AJ 001 _Rev 0 Page 10 of 10