Safe Work Method Statement

Project Name : Address :

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Company Name: Padam Interiors Activity/Trade : PCC work by concrete mixture and concrete pump

Address: Padam Interiors 1101,Lotus Trade Centre Near D.N.Nagar Metro Station, Supervisor Name: Murli Manohar

New Link Road, Andheri (W), Mumbai-400058 INDIA. Contact No: 9571680505

Details: To outline safe methods for mixing, transporting, placing, and Equipment, Tools & tackles Spec:
finishing PCC using an on-site concrete mixer and concrete pump.
Concrete mixer (diesel/electric)

Concrete pump (line or boom)

Mandatory PPE’s
Transit mixers (if applicable)
Safety helmet /High-visibility vest
Vibrator
Safety boots/Safety goggles/Gloves
Formwork tools
Hearing protection (if required)
Shovels, trowels, rakes
Dust mask (if required)
Generator (if needed)

Water supply pipe/hose

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE

Slips Clean and level site

EHS
Trips Ensure formwork is strong and well supported OFFICER
1. Site Preparation &
L L
Falls Clearly mark and barricade work zone FLOOR
SUPERVISOR
Collapse of unstable formwork

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE

Use dust masks when handling cement

2. Concrete Mixing Dust inhalation
Follow proper lifting techniques EHS
OFFICER
Manual handling injuries E L &
Do not put hands near moving parts FLOOR
Mixer entanglement SUPERVISOR
Maintain safe distance from rotating drum

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE
Ensure the cleaning process is included in the work
method statement or Safe Work Method Statement
(SWMS).
High-Pressure Discharge Use water pressure instead of air where possible—
3. Ball Passing in concrete water is safer and reduces the risk of hose whip
pumping Hose Whip Release air pressure gradually if used, with appropriate
EHS
valves and check systems OFFICER
Unexpected Ejection E Use the correct size and type of cleaning ball. L &
FLOOR
Ensure valves and caps are rated for the pressures SUPERVISOR
Line Blockages involved.
Regularly inspect pipelines for wear, cracks, or
Flying Debris blockages
Confirm pipeline is properly secured and supported
Slip and Trip Hazards before ball passing
Clear the area: Ensure no personnel are in front of the
discharge end during ball passing
Wear Job Specific PPEs.
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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE

4. Pump Setup and Tipping of pump Place pump on firm, level ground
Inspection
Hose burst or disconnection E Use stabilizers and outrigger pads L EHS
OFFICER
Contact with overhead powerlines Maintain clearance from electrical lines (min 6.4m) &
FLOOR
SUPERVISOR
Check hose connections and clamps

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE
5.Transporting and Pumping Tripping during transport Use clear paths for wheelbarrow movement
Concrete
Never stand in front of pump hose EHS
Hose whipping E L OFFICER
Wear gloves and goggles &
FLOOR
SUPERVISOR
Contact with wet cement Supervise the operation of pump continuously

6.Vibrating and Surface

Finishing Electric shock from vibrator Use only tested and grounded electrical tools
EHS
OFFICER
&
Back and hand strain E Use mechanical trowels for large areas L FLOOR
SUPERVISOR

Slips on wet surface Wear non-slip footwear

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Control Measures Person who

Procedure (in steps) Possible Hazards Risk (Describe what action or procedure will be taken to Risk will ensure
Rating eliminate or minimize the risk of injury or damage. Use controlled this happens
(Break the job down into (Identify the hazards associated with (See the Hierarchy of Controls below as a guide level
steps. Each step should each step. Examine each to find below) 1. Eliminate the Hazard2. Substitute the material or
accomplish some major tasks possibilities that could lead to an equipment
and be in logical sequence.) accident or potential harm arising.) 3. Isolate the hazard4. Implement Engineering control
5. Implement Administrative control 6.PPE

Premature drying or cracking Start curing immediately after finishing

7.Curing and Protection
Trips over curing covers Secure curing sheets properly to prevent tripping EHS
OFFICER
&
E L FLOOR
SUPERVISOR

High-pressure water Clean in designated wash area

8.Cleaning and Demobilization Use full PPE during cleaning
Environmental contamination
Dispose of slurry and waste properly

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 (i.e.: Nil LTI)
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 Safe Work Method Statement

Personnel Summary

SUPERVISOR’S DETAILS
Supervisors Name & Qualifications: Name: Mr.Murli Manohar
Graduate
10+ exp

Supervisor’s Responsibilities: 1) Implementation of all control measures effectively.

2) Effective supervision.
3) Ensure effective control of health & environmental hazard.
4) Daily inspection and requesting to work permit
5) Communicating to the site in charge in case of any emergencies.
DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: -

WORK ACTIVITY TRAINING: Chemical handling training…

SITE INDUCTION: EHS induction

OTHER:(List other training undertaken by workers):

TICKETS, PERMITS or LICENCES REQUIRED undertaking this work (i.e. Certificates of Competency, Confined Spaces etc.):

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

All work to comply with the JL requirements and H&S Acts and Regulations and amendments, Workplace Injury Management & Workers Compensation Acts

Additional Codes and Standards applicable to this trade:

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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 logbooks sighted
Registration No. identified and by Principal 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
Date on Purpose Location & Volume Controls
Date Left Site Product Name MSDS Date Attached
Site (i.e. Application on site) Used on Site (& PPE to be worn)
(Y/N)

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/ / / / / /

/ / / / / /

/ / / / / /
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.

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. / /

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 Safe Work Method Statement

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 SWMS.

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