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New Method STatement

This document outlines a method statement for a work project, detailing the approval process, work description, organization, and safety measures. It includes sections on site access, environmental considerations, required permits, and emergency arrangements. The acknowledgment section confirms that individuals involved have read and understood the method statement and agree to comply with safety guidelines.

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safety1.jferlanomc
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13 views5 pages

New Method STatement

This document outlines a method statement for a work project, detailing the approval process, work description, organization, and safety measures. It includes sections on site access, environmental considerations, required permits, and emergency arrangements. The acknowledgment section confirms that individuals involved have read and understood the method statement and agree to comply with safety guidelines.

Uploaded by

safety1.jferlanomc
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

PROJECT NAME / REFERENCE

METHOD STATEMENT
COMPANY NAME: Safe System of Work

SUBMITTAL / APPROVAL
Method Statement Version No.: Approved / Rejected
reference number:
Contractor Approver Name: Submission Date: PMI Approver Name:
………………….. ……………………. ……………………
Position: Approval Date:
……………………. Signature: ……………………
Phone/Contact number:
Signature:
………………………

WORK DESCRIPTION
Supervisor Name: Date of Activity: Work Location:
………………… …………………
Distribution / Communication List: Work Duration: No. of workers likely to be
………………… involved: …………………

BRIEF DESCRIPTION OF THE WORK TO BE DONE


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WORK ORGANIZATION
SITE / AREA ACCESS, & STORAGE
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TRAFFIC MOVEMENT / MANAGEMENT & SIGNAGE (Roads, Routes, Pedestrians, etc…)
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ENVIRONMENTAL CONSIDERATIONS & WASTE DISPOSAL
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MAJOR ITEMS OF PLANT OR EQUIPMENT PROTECTIVE EQUIPMENT REQUIRED (for all)
- -
- -
- -
- -
IMPACT ON THIRD PARTIES / OPERATIONS / ADDITIONAL PPE FOR SPECIFIC OPERATIONS
NEIGHBORS -
- -
- -
- -
-
EXTERNAL AUTHORITIES PERMITS REQUIRED WORK PEMRITS REQUIRED (i.e., hot work)
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EMERGENCY ARRANGEMENTS WARNING SIGNS
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REQUIRED INSPECTIONS, PRIOR-DURING- HAZARDOUS / FLAMMABLE MATERIALS
AFTER THE ACTIVITY (Provide MSDS datasheets for all products)
- -
- -
- -
- -
REQUIRED TRAININGS, QUALIFICATIONS & LICENSES (for operators / workers)
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EHS RISKS & CONTROLS – DETAILS

CRITICAL JOB / ACTIVITY HAZARDS / RISKS CONTROL METHODS RESPONSIBLE


STEPS

List the major steps/events in the Identify all potential hazards, What will be done to control Define who is responsible of
work process. environmental aspects and their particular safety or environmental implementing the control
impacts. hazard or risks; methods. Only one person should
be responsible per control
measure.
AKNOWLEDGEMENT

I have read the above method statement and I understand its contents. I confirm that I have the necessary training and skills,
including any relevant certification to undertake the related tasks contained in this Method Statement. I agree to comply with any
safety and environmental guideline, requirement and recommendation as set forth by the approver within this Method Statement
including safety instructions and use of recommended Personal Protective Equipment.

Name Position / Company Signature Date

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