WMS PART 2
TOOL KIT IMPORTANT
INFORMATION
In the Tool Kit you will find everything you need to
help you develop a WMS. It is the reader’s
responsibility to refer to legislation when reading this
guide or using any of the tools in the tool kit to ensure
the most up to date information is being used. Failing
to do this could lead to a breach of legislation and
legal action being taken. These following pages
provide brief information on getting you started with
your WMS. Refer to samples in the tool kit for further
prompts on completing WMS.
WMS PART 1
Firstly you will need to check the following areas for
information and requirements on high risk
construction activities or prescribed activities before
commencing;
 QLDS Workplace Health and Safety Regulation
2008
 Completed job safety analysis’s
 Site specific risk assessments
 Incident/injury records
Do not go any further if you have not
completed the above. Refer to Queensland’s
Workplace Health and Safety Act and Regulation
for further information on requirements for risk
assessments, construction safety plans and work
method statements.
After you have checked for any high risk construction
activities or prescribed activities commence filling in
all the relevant information in PART 1 of your blank
work method statement.
Be sure to complete all relevant information in the
fields provided about the activity. Missing any
information may result in a serious incident occurring
or a breach of legislation.
When completing this page consult with persons who
have relevant experience and knowledge about the
activity.
TOOL KIT
FORMS E or F
Template for Part 1 of WMS for a High Risk
Construction Activity can be found on page 30
Template for Part 1 of WMS for a Prescribed
Activity can be found on page 31
19TOOL KIT
19
Completing your WMS from a JSA
To be able to complete this part of the process you will
need to have with you either a copy of your completed
JSA for the high risk construction activity and or
prescribed activity and/or your site specific risk
assessment.
Looking at the column in your JSA titled “Steps In
Activity” see where you can group some of the smaller
steps into larger steps and insert in the first column of
your WMS titled “Major Steps In Activity”
The steps should not be so detailed that a large
number of steps result nor so general that basic
steps are omitted.
 Now next to column titled “Major Steps In Activity”
in the WMS is a column titled “Potential Hazards”
insert all the hazards that were identified in the JSA
that relate to the major steps into this column. Be
sure to include all hazards as missing any of them
may lead to an incident occurring.
 Once you have completed this repeat the same
process again for risk assessment score.
You will have several scores because of the number
of steps in the JSA - use the highest score
identified.
 The same applies for control measures, insert all
control measures identified in the JSA into the
column titled “Control Measures” on your WMS.
Ensure they are relevant to the hazards identified.
 In the next column titled “Responsible Officer” insert
titles of persons responsible for maintaining the
control measures; this may include several different
persons.
You are almost there!
 Once you have completed this process consult with
relevant and experienced persons performing the
activity and any other persons who may be affected
by the hazards associated with the activity to
ensure all vital information has been captured. If
you make any amendments in the “Control
Measures” column be sure to check that they
comply with any prescriptive control measures
found in associated legislation.
This completes the process for developing a work
method statement. Have you missed anything?
TOOL KIT
FORM G
Safety Act ofand Regulation for further
A sample WMS Part 2 is available in the
information Tool Kit on page 32
on requirements for risk assessments, construction
safety plans and work method statements.
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FORMS TO USE WHEN DEVELOPING YOUR FIRST WORK METHOD STATEMENT

FORM B - RISK ASSESSMENT FORM PAGE 27

Risk Assessment Form – Use this form to identify any high risk construction activities, prescribed
activities or demolition work that were recorded on this form at the site inspection during the tendering
process or after the contract was won that require a WMS to be completed.

Potential
Hazards
Insert potential hazards
associated with contract
and site in this column
Existing Control Risk Score Risk Control Residual Risk Responsible Date
Measures 1-25 Measures Score Person
1-25
This form can also be Insert risk score using Check legislation and insert Insert new risk score Insert persons Insert date in this
used to review existing Risk Matrix - Form C control measures. If no using responsible for column
control measures. Insert control measures prescribed Risk Matrix - Form C following, implementing,
existing controls in this in legislation use hierarchy of or maintaining control
column if reviewing controls and consult with measures in this column
control measures workers.

FORM C - RISK MATRIX PAGE 28

Risk Matrix Use this form to help you prioritise risks when completing FORMS B and/or D and/or G.

LIKELIHOOD CONSEQUENCES How severely could it hurt someone if it happens?

How likely is it to happen?
INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC
(No injuries) (First aid only, spillage (Medical treatment (Extensive injuries, (Death, toxic release of
contained spillage contained with loss of production) chemicals)
at site) outside help)
ALMOST CERTAIN 15 10 6 3 1
Expected in most circumstances
H H A A A
LIKELY 19 14 9 5 2
Will probably occur in most
circumstances M H H A A

FORM D - JOB SAFETY ANALYSIS PAGE 29

JOB SAFETY ANALYSIS - Use this form to conduct a risk assessment on a high risk construction
activity, prescribed activity, demolition work or other activity where there are no risk assessments, WMS
or procedures. JSA`s are generally site specific and used for the task at hand. They are not used across
other sites as a generic document as they capture the hazards at a specific place and during a specific
time.

NOTE: Two extra columns have been added to the Risk Assessment Form and JSA Form so that they
can be used to review existing control measures for a hazard or a specific activity for example; when
changes are being considered or after an incident has occurred. If you are starting from scratch you will
not need to fill in the Existing Control Measures.

STEPS IN ACTIVITY POTENTIAL EXISTING RISK RISK CONTROL RESIDUAL RESPONSIBLE DATE
HAZARDS CONTROL SCORE MEASURES RISK PERSON
MEASURES 1- 25 SCORE
1- 25
Insert steps in activity in Insert all foreseeable If reviewing an activity Using Risk Check legislation and Using Risk Insert title or name of Insert date
1. this column in the hazards associated insert existing control Matrix assess insert new control Matrix insert persons responsible control
sequence the activity is with each step measures in this the risks of measures. If no control new risk score for following, measures
to be carried out, step column existing control measures written in here implementing, or must be
by step measures if legislation use hierarchy maintaining control met
any and insert of controls and consult measures
risk score here with workers and
professionals
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FORM E - WMS PART 1 (HIGH RISK ACTIVITIES) PAGE 30

WMS Part 1 - Use this form for High Risk Construction Activities.

PART 1 ZYX Civil Contractors Pty Ltd – Work Method Statement

_____________________________________________________________________________________

HIGH RISK CONSTRUCTION ACTIVITY

COMPANY DETAILS Insert Relevant Persons Company Name, Address, HIGH RISK WORK List high risk work licences here
Phone Number here LICENSE/S

ABN Insert Company ABN here DATE WMS DEVELOPED Insert date 00/00/00

SITE ADDRESS Insert work site address here VERSION NUMBER Insert version number

LINKS

FORM F - WMS PART 1 (PRESCRIBED ACTIVITIES) PAGE 31

WMS Part 1 - Use this form for Prescribed Activities or Demolition Work.

PART 1 ZYX Civil Contractors Pty Ltd – Work Method Statement

____________________________________________________________________________________

PRESCRIBED ACTIVITY

COMPANY DETAILS Insert Relevant Persons Company Name, Address, THE ARRANGEMENTS Insert relevant training for
Phone Number here FOR APPROPRIATE prescribed activity and how
TRAINING & SUPERVISION supervision will be carried
out

ABN Insert Relevant Persons Company ABN HIGH RISK WORK CLASS List class of any high risk
here e.g. person carrying out work work here

SITE ADDRESS Insert work site address here

PRESCRIBED Insert name of Prescribed Activity or DATE WMS DEVELOPED Insert Date 00/00/00
ACTIVITY Demolition Work e.g. Removal of 50
DEMOLITION WORS square metres of bonded asbestos, VERSION NUMBER Insert Version Number
Demolish wooden bridge

PRESCRIBED ACTIVITY Insert Relevant Certificate Number LINKS

CERTIFICATE NUMBER

FORM G - WMS PART 2

PAGE 32

WMS Part 2 - FORM G can be used for a High Risk Construction Activity, Prescribed Activity or
Demolition Work

Major Steps In Activity Potential Hazards Risk Score Risk Control Measures Responsible
1-25 Officer
E.G. Control unauthorised access to
site
 Hit by moving plant 2  Ensure security perimeter Principal Contractor/
Relevant Person
 Falls slips, trips fencing and signage erected

 Trench collapse
 Ensure trench has been
benched, battered, shored
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FORM A
CONSTRUCTION SAFETY PLAN ZXY Civil Contractors Pty Ltd

ORGANISATIONAL DETAILS

PRINCIPAL CONTRACTOR’S NAME:

PRINCIPAL CONTRACTORS ABN:

PRINCIPAL CONTRACTORS ADDRESS:

WORKPLACE ADDRESS: (Insert the address where the construction work is to be performed)

TYPE OF CONSTRUCTION: Civil Construction – Excavation

EXPECTED START DATE:

ESTIMATED DURATION OF THE WORK:

WHS COMMITTEE:

WHS OFFICER:

FIRST AID OFFICER:

The risks the Principal Contractor is obliged to manage, the proposed control measures for those risks and how the
controls will be monitored and reviewed can be located in the following documents e.g.

EXAMPLE CONTENTS

 Company Safety Policy

 General Safety Requirements
 Hazardous Substance Register
 Site Rules
 Plant Provided For Common Use
 Risk Assessments
 Job Safety Analysis
 Work Method Statements
 Traffic Management Plans
 Emergency Procedures
 Emergency Phone Numbers
 Public Safety Strategy
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FORM B RISK ASSESSMENT FORM

PRINCIPAL CONTRACTOR/RELEVANT PERSON CONTRACT SITE ADDRESS

Insert name here Insert contract here e.g. Subdivision Ormeau Insert site address here
WORK AREA ACTIVITY DATE

Insert work area e.g. Division 1 Insert name of activity here e.g. Site Preparation Insert date assessment completed here

POTENTIAL EXISTING RISK SCORE RISK CONTROL RESIDUAL RISK RESPONSIBLE DATE
HAZARDS CONTROL 1-25 MEASURES SCORE PERSON
MEASURES 1- 25
Insert potential hazards This form can also be Insert risk score using Check legislation and insert Insert new risk score Insert persons Insert date in
associated with contract and used to review existing Risk Matrix - Form C control measures in this column. using Risk Matrix - responsible for this column
site in this column control measures. Insert If no control measures Form C following,
existing controls in this prescribed in legislation use implementing, or
column if reviewing hierarchy of controls and consult maintaining control
control measures with workers measures in this
column
E.G. Excavation 4 Obtain information on 8 Principal Before work
location of services from Dial Contractor commences
Before You Dig /Relevant Person

Perimeter fencing required 8

for 12 weeks

Complete WMS for this

activity 13

E.G. Entering trench more 4 Complete WMS for this 13 Principal Before work
than 1.5 metres activity Contractor commences
/Relevant Person

E.G. Working near 4 Obtain information on 8

underground services location of services from Dial
Before You Dig

Appoint competent person to 13

locate and mark services

Complete WMS for this activity

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FORM C RISK MATRIX

This Risk Matrix is to be used to identify and assess risks associated with identified hazards when completing Forms
B and/or Form D and or Form G.

LIKELIHOOD CONSEQUENCES How severely could it hurt someone if it happens?

How likely is it to INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC
happen? (No injuries) (First aid only, (Medical treatment (Extensive injuries, (Death, toxic release of
spillage contained spillage contained loss of production) chemicals)
at site) with outside help)
ALMOST CERTAIN 15 10 6 3 1
Expected in most
circumstances H H A A A
LIKELY 19 14 9 5 2
Will probably occur in
most circumstances M H H A A
POSSIBLE 22 18 13 8 4
Might occur at some time
L M H A A
UNLIKELY 24 21 17 12 7
Could occur at some
time L M M H A
RARE 25 23 20 16 11
May occur only in
exceptional L L M H H
circumstances

SCORE ACTION
1-8 ACT NOW – Urgent do something about the risks immediately. Requires
A - Acute immediate attention
9 - 16
H - High
Isolate the hazard and seek the highest management decision urgently

17 - 21
M - Moderate
Isolate the hazard and follow management instructions

22 – 25
L - Low
OK for now. Record and do something about the risks as soon as possible

CONTROL MEASURES

When deciding on control measures they should be implemented in the following order:

ELIMINATION Get rid of the harm or prevent the risk (best outcome)

IF THIS IS NOT POSSIBLE:

Substitution Replace hazardous materials, equipment, chemicals with something less harmful; and/or

Isolation Separate people from harm, for example using barriers

Engineering Separate people from the harm, change the physical working environment, for example, by
redesigning work, plant, equipment, components or premises; and/or

Administration Establish administrative procedures such as work method statements, safety instructions and
provide staff with training in them; and/or

PPE Use protective clothing

 19TOOL KIT

FORM D JOB SAFETY ANALYSIS

29

PRINCIPAL CONTRACTOR/RELEVANT CONTRACT SITE ADDRESS

PERSON Insert contract here e.g. Subdivision Ormeau Insert site address here
Insert name here
WORK AREA ACTIVITY DATE
Insert work area e.g. Division 1 Insert name of activity here e.g. Replace drivers seat excavator Insert date assessment completed here

STEPS IN ACTIVITY POTENTIAL EXISTING RISK RISK CONTROL RESIDUAL RISK RESPONSIBLE DATE
HAZARDS CONTROL SCORE MEASURES SCORE PERSON
MEASURES 1- 25 1- 25
Insert steps in activity Insert all If reviewing an Using Risk Matrix Check legislation and Using Risk Matrix Insert title or name Insert date control
in this column in the foreseeable activity insert assess the risks of insert new control insert new risk of persons measures must be
sequence the activity hazards associated existing control existing/control measures in this score here responsible for met in this column
is to be carried out, with each step in measures in this measures and insert column. If no control Risk Matrix - Form C following,
step by step this column column risk score here. measures written in implementing, or
1 Risk Matrix - Form C legislation use
hierarchy of controls
maintaining control
measures in this
and consult with column
workers and
professionals

E.G. Arrive at site Moving plant 4 Read and obey all signs 13 Plant Operators At all times

2 Stay alert and watch for

moving plant

Pedestrians 4 Stay alert and give way 13 Plant Operators At all times
to pedestrians

Access excavator Falls/slips/trips 7 Park as close to 17 Plant Operators At all times

excavator as possible

3 Stay alert and remove

any trip hazards where
safe to do so
THE FOLLOWING PERSONS HAVE RECEIVED TRAINING ON THIS JSA

_______________________________________________________________________________________________________________________________________
Name and sign
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FORM E
WMS MUST BE SITE SPECIFIC AND MUST BE PREPARED BEFORE ANY HIGH RISK CONSTRUCTION ACTIVITY COMMENCES

PART 1 ZYX Civil Contractors Pty Ltd – Work Method Statement

HIGH RISK CONSTRUCTION ACTIVITY

COMPANY DETAILS Insert Relevant Persons Company Name, Address, HIGH RISK WORK List class of any high risk work here
Phone Number here

ABN Insert Company ABN here DATE WMS DEVELOPED Insert date 00/00/00

SITE ADDRESS Insert work site address here VERSION NUMBER Insert version number

HIGH RISK Insert name of High Risk Construction LINKS Insert links here e.g. other WMS, JSA`s
CONSTRUCTION Activity/Other e.g. Entering trench more
ACTIVITY / OTHER than 1.5. metres

HOW CONTROL MEASURES ARE TO BE MONITORED AND REVIEWED

 Insert how control measures will be monitored and reviewed, by whom and when e.g. control measures will be monitored by
employees and site supervisor and reviewed during pre start checks/tool box talks daily

PLACE TICK IN BOXES TO INDICATE COMPULSORY REQUIREMENTS TO BE ABLE TO COMPLETE THIS ACTIVITY

 Backhoe  Amenities  Scraper  Lights

 Crane  Grader  Skid Steer  Ladders
Plant /  Dozer  Loader  Barriers  Signage
Equipment  Excavator  Road Roller  Fall Arrest System  Jackhammer
 Fall Restraint System

 Backhoe  Dozer  Grader  Scaffold

Licences/  Crane  Dogger  Loader  Scraper
 Demolition  Excavator  Explosive Power Tools  Skid Steer
Permits/  General Safety Induction  Rigger  Traffic Control
Tickets (Blue Card)

 Site Specific Induction  Emergencies  MUTCD Part 3 Level 1  Risk Management

 Task Specific Training  First Aid  MUTCD Part 3 Level 2  Slips, Trips, Falls
Training  Cert 3 In Civil  Manual Tasks  MUTCD Part 3 Level 3  Working Near Utilities
Construction  Moving Plant  MUTCD Part 3 Level 4  Working At Heights
 Confined Spaces

ACTS (QLD) REGULATIONS (QLD) CODE OF PRACTICE OTHER

 WHS  WHS Traffic Management  Guide To Safety In The
Applicable  Dangerous Goods  Dangerous Goods For Construction or Civil Construction
 Electrical Safety  Electrical Safety Maintenance Work Industry
Legislation/  Working Near Live
References Parts

 All Electrical Tools  Amenities  All Equipment Pre Start  All Signage Daily
Maintenance  All Excavations/Pits Daily  Atmospheric Testing Checks  PPE
Checks Monitoring Equipment  Gas Monitoring
Equipment

PPE
     

Insert any other comments/requirements here e.g. fire extinguishers, scaffold, spotter, Authority from the Deaprtment of
Other Main Roads /Police to close roads
 19TOOL KIT
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FORM F
THIS WMS IS A SITE SPECIFIC WMS AND MUST BE PREPARED BEFORE ANY PRESCRIBED ACTIVITY COMMENCES.

PART 1 ZYX Civil Contractors Pty Ltd – Work Method Statement

PRESCRIBED ACTIVITY

COMPANY DETAILS Insert Relevant Persons Company Name, Address, THE ARRANGEMENTS Insert relevant training for
Phone Number here FOR APPROPRIATE prescribed activity and how
TRAINING & SUPERVISION supervision will be carried
out

ABN Insert Relevant Persons Company ABN HIGH RISK WORK CLASS List class of any high risk
here e.g. person carrying out work work here

SITE ADDRESS Insert work site address here

PRESCRIBED Insert name of Prescribed Activity or DATE WMS DEVELOPED Insert Date 00/00/00
ACTIVITY Demolition Work e.g. Removal of 50
DEMOLITION WORK square metres of bonded asbestos, VERSION NUMBER Insert Version Number
Demolish wooden bridge

PRESCRIBED ACTIVITY Insert Relevant Certificate Number LINKS Insert links here e.g. other
CERTIFICATE NUMBER WMS, JSA`s

HOW CONTROL MEASURES ARE TO BE MONITORED AND REVIEWED

 Insert how control measures will be monitored and reviewed, by whom and when e.g. control measures will be monitored by
employees and site supervisor and reviewed during pre start checks/tool box talks daily

PLACE TICK IN BOXES TO INDICATE COMPULSORY REQUIREMENTS TO BE ABLE TO COMPLETE THIS

 Backhoe  Grader  Skid Steer  Lights
 Crane  Loader  Waste Bins  Ladders
Plant /  Dozer  Road Roller  Double thickness plastic  Signage
Equipment  Excavator  Scraper  Air testing equipment  Vacuum
 Air monitoring equipment  Water

 A class license (Friable  Backhoe  Grader  Scraper

Asbestos)
 B Class license (Bonded
Licences Asbestos)
 General Safety Induction
(Blue Card)
 Demolition work DM1
 Demolition work DM2
Training/Tickets/  Site Specific Induction
Permits  Task Specific Training
 Cert 3 In Civil Construction
 Crane  Explosive Power Tools  Skid Steer
 Dozer  Road Roller  Traffic Control
 Excavator  Scaffold
 Confined Space  MUTCD Part 3 Level 1  Risk Management
 Emergencies  MUTCD Part 3 Level 2  Slips, Trips, Falls
 First Aid  MUTCD Part 3 Level 3  Working Near
 Manual Tasks  MUTCD Part 3 Level 4 Utilities
 Moving Plant  Working At Heights

ACTS (QLD) REGULATIONS (QLD) CODE OF PRACTICE OTHER

 WHS  WHS  Management and control  Guide To Safety In
 Dangerous Goods  Dangerous Goods of asbestos in workplaces The Civil
Applicable  Electrical Safety  Electrical Safety [nohsc: 2018 (2005) Construction
Legislation/  Safe removal of asbestos Industry
References 2nd edition [nohsc:2002  AS 2601-2001 :
(2005) Demolition of
structures

 All Electrical Tools  Amenities  Pre Start Checks All Plant  PPE
 Air monitoring equipment  Gas Testing Equipment  All Signage Daily
Maintenance
Checks

      
PPE

 Insert any other requirements e.g. disposable overalls, asbestos removal signs, demolition in progress,
unuathorised entry not permitted
Other

ACTIVITY
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FORM G
PART 2 ZYX Civil Contractors Pty Ltd – Work Method Statement

FAILURE TO PLAN AND FOLLOW THIS WMS MAY LEAD TO PERSONS BEING SERIOUSLY OR FATALLY
INJURED AND POSSIBLE LEGAL ACTION BEING TAKEN. DON’T RISK IT.

HOW THE ACTIVITY WILL BE PERFORMED

Insert how the activity will be performed here

Risk Score Responsible

Major Steps In Activity Potential Hazards Risk Control Measures
1-25 Officer
If developing a WMS from a JSA Extract all the hazards that could Insert risk score Insert all control measures Identify persons
looking at the JSA extract small steps cause harm identified in your JSA from the JSA into identified in your JSA that relate responsible for
from column titled “All Steps In that relate to the major steps in this column to the major steps in the activity complying with control
Activity” and group into larger steps. the activity and insert into this and insert in this column measures
Insert steps into this column in the column
sequence the activity is to be
performed. (Reference Page 19 -
WMS Guidelines for the Civil
Construction Industry)

ADDITIONAL INSTRUCTIONS/COMMENTS

_________________________________________________
Principal Contractors Signature

_________________________________________________ _____________________________
Name of person signing WMS on behalf of the Principal Contractor Date

I have received training in this WMS and I fully understand the hazards and control measures to be implemented as part of this activity.

___________________________________________________________
Name:

___________________________________________________________________ _______________________________________
Signature: Date:

FORM H EMPLOYERS WORK METHOD STATEMENT CHECKLIST
Each tick in the RED zone means you are less likely to be
compliant
ADDRESS THESE AREAS PROMPTLY
 Current Legislation applying to work method statements not
obtained
 High risk construction activities not identified nor the risk
controlled
 Control measures for doing high risk construction work/
prescribed activities safely left up to workers
 Principal Contractor allows persons to start high risk
construction activity without work method statement
 Relevant Person allows persons to start high risk
construction activity without work method statement
 Generic work method statements not reviewed and
amended at each new site
 Work Method Statements not amended as soon as possible
when there is a change in the way the high risk construction
work/prescribed activity is to be performed
 Principal Contractor not given a copy of amended work
method statements by Relevant Persons
 Relevant Person has not ensured each person affected by
the amendment of a work method statement is advised of
the details of the amendment/s
 Work method statements not kept with construction safety
plan
 Work method statements not signed and dated by Principal
Contractor
Each tick in the ORANGE zone means you are increasing
your level of compliance
BUT YOU STILL HAVE WORK TO DO
 Current Legislation for work method statements obtained
 High risk construction work/prescribed activities identified
and some work method statements developed
 Limited involvement of workers in developing work
method statements
 Principal Contractor or Relevant Person monitors some
persons to whom the work method statement applies
 System developed but not maintained for reviewing and
updating work method statements as required by
legislation
 Some work method statements kept with construction
safety plan
 Principal Contractor or Relevant Person signs and dates
some work method statements
 Generic work method statements are reviewed but not
always amended at each new site to reflect site specific
hazards
 Work method statements are easy to follow
 Work method statements for high risk construction work /
prescribed activities developed not always followed in day
to day operations
 Work Method Statements for other high risk activities
identified but not developed
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Each tick in the GREEN zone means your are more likely
to be compliant
MONITOR AND REVIEW TO CONTINUALLY IMPROVE
 Work method statements for high risk construction work /
prescribed activities developed and followed
 Control measures in work method statements contain all
current requirements called up in legislation
 Workers involved in developing work method statements
 Principal Contractor/Relevant Person monitors persons to
whom the work method statement applies to
 System implemented and maintained for reviewing and
amending work method statements
 Generic work method statements amended at each new
site and include site specific hazards
 All people likely to be affected by changes advised of
amendments to work method statement
 Principal Contractor/Relevant Person has signed and
dated work method statements
 Work method statements easy to understand and follow
 Principal Contractor has copies of all work method
statements
 Work method statements kept with construction safety
plan
 Work method statements are readily available for
inspection
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FORM I EMPLOYEES WORK METHOD STATEMENT CHECKLIST

This WMS checklist relates to the following activity:_____________________________________________________

Date:________________________

This WMS checklist relates to the following site address: ________________________________________________

________________________________________________

Place a tick next to each correct answer   

WMS includes the name of the high risk/prescribed construction activity

WMS states the way the activity is to be performed

WMS includes hazards associated with the activity

WMS includes control measures to be followed

WMS includes how the control measures will be monitored and reviewed

WMS includes any relevant prescribed occupations

IF A PRESCRIBED ACTIVITY

WMS includes the arrangements for appropriate training & supervision

WMS takes account of AS 2601 Demolition work

GENERAL

WMS has been signed and dated by Principal Contractor

Part 1 of WMS has been completed

Part 2 of WMS has been completed

This WMS includes site specific hazards related to the above address

I have been trained in this WMS

I understand I am responsible for following this WMS

I have read the above questions and have ticked all boxes where the answers are correct.

_________________________________________________ _________________________________ __________________

Name: Signature: Date:
_________________________________________________ _________________________________ __________________
Name: Signature: Date:

_________________________________________________ _________________________________ __________________

Name: Signature: Date:

SITE SUPERVISOR: NO WORK TO COMMENCE UNTIL ALL ABOVE REQUIREMENTS HAVE BEEN MET