Safe Work Method Statement Company: (Name, Contact Person & Phone) Project/Site: Job Task: Date Created:

Workers Involved in Developing this SWMS Print Name: Signature: Core Drilling - Floors & Walls

Principal Contractor: SWMS No.: Revision Number: Review Date:

Print Name:

Signature:

Relevant Australian Standards / Codes of Practice / Legislation Material Safety Data Sheets Required Plant & Equipment Required Licenses / Competencies Required Hot Work Permit PPE Required: High Risk Work: Fall from Heights > 2m Asbestos Telecommunication Towers Task/Location Specific Risks: Access & Egress Overhead Obstructions Underground Services Pedestrians / Workers Unauthorised Persons Structural Collapse Demolition of Structures
Pressurised Gas Pipes/Mains

Yes

Confined Space Permit

Yes

Crane Lift Plan / Permit

Yes

Other Permit

Yes

Applicable Permit Number(s):

Contaminated/Flammable Atmosphere Ground Conditions Compressed Air Quick Cut Saw Angle Grinder Hot Work / Burns Poor Lighting

Confined Spaces Excavation >1.5m Electrical Extremes of Artificial Temperature Noise Cultural / Heritage Area Snakes / Vermin Dust Significant Trees Flora & Fauna

Work in Tunnel Mobile Plant Traffic Chemical/Fuel/Refrigerant Lines Water Pollution Soil Pollution Rotating Machinery Fatigue Exposure to UV Ignitions Sources

Explosives Drowning Tilt-up/Precast Concrete

Weather Obstacles / Buildings

Other (refer to hazard prompt list)

2012 Master Builders Association of South Australia, Inc

CORE DRILLING FLOORS & WALLS

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Safe Work Method Statement Step 1 Consequences 5 Severe 4 Major 3 Moderate 2 Minor 1 Negligible

Potential to be fatal. Permanent disability. Destruction of property or plant. Serious injury. Long term disability. Major damage to plant, property or environment. Potential for injury resulting in medical attention. Damage to plant, property or environment. Injury requiring First Aid treatment and / or short term discomfort. Cause a near miss, needs to be reported

Step 2 Potential (Likelihood) A Almost Certain This event is expected to occur in most circumstances B Likely The event will probably occur in most circumstances C Possible The event might occur at some time D Unlikely The event could occur at some time E - Rare The event may occur only in exceptional circumstances Step 3 Matrix Potential A Almost Certain B Likely C Possible D Unlikely E - Rare Legend
Risk Rating

Consequences 1 Negligible M (9) L (7) L (5) L (3) VL (1)

2 Minor S (15) M (11) L (6) L (4) L (2)

3 Moderate S (19) S (18) M (13) M (10) M (8)

4 Major H (24) S (21) S (17) M (14) M (12)

5 Severe H (25) H (23) H (22) S (20) S (16)

High Significant Medium Low Very Low

Activity to be re-planned and/or re-designed. If this is not possible, an independent Hazard Assessment of the activity is to be completed by the Project Manager prior to completing the SWMS Activity Must be reviewed by Senior Site Management Representative and have identified risk controls built into the SWMS and work procedure

Site Supervisor must review method of task.

Some action may be required, Supervisor to determine and monitor Minimal risk, monitor where work changes

2012 Master Builders Association of South Australia, Inc

CORE DRILLING FLOORS & WALLS

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Safe Work Method Statement Job Step

Break the job into steps

Potential Hazard
What can cause harm at each step High risk work is to be kept to its own cell

Risk Rating S (17)

Control
Describe the control measures and how they will be used

Residual Risk M (8)

Person Responsible for Controls

EXAMPLE

Electric shock from services Explosion

In conjunction with principle contractor and on site electrician check for any existing services in wall or floor and sign verification form Ensure services are isolated and locked out prior to commencing work by the worker completing the task Barricade drop area for core Erect warning signs Times established to undertake work outside of work hours where possible Use two way communication system between spotter and machine operator or third person to act as runner Consult principal contractor and site engineer check that drilling site/s will not affect strength of structure. Engineer to sign verification that drilling will not affect structural strength of building Wear ear muffs or plugs with safety helmet, glasses / goggles, gloves and boots All electrical equipment to be tested and tagged as per AS 3760 & 3012 Provide RCD protection Hang leads on insulated hooks or lead stands Only trained personnel to complete task Follow manufacturers instructions for safe useEnsure operators adequately trainedSet drill into position and turn on compressor making sure suction is achieved Use wet vac to remove excess water When drilling through wall bolt securely Upon completion finish clean up and securely cover penetration Ensure work area clear of all trip hazards

[insert responsible person]

Preparation

Falling object (core)

[insert responsible person]

Weakening structure

[insert responsible person]

Noise Foreign body in eye Operation Electrocution Drill jamming Slips, trips, falls

[insert responsible person]

H M

M L

[insert responsible person] [insert responsible person]

2012 Master Builders Association of South Australia, Inc

CORE DRILLING FLOORS & WALLS

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Noise Foreign body in eye

Wear ear muffs or plugs with safety helmet, glasses / goggles, gloves and boots Ensure barricades and warning signs erected Use spotter where necessary Use two way communication system between spotter and machine operator or third person to act as runner

[insert responsible person]

Falling object (core)

[insert responsible person]

Have you considered the site specific hazards? e.g. - lay of the land - obstacles (buildings, workers, excavations, plant) - changes to site conditions - other contractors work in progress Have you considered weather conditions? Eg. - wind - rain - heat - cold etc Have you considered job specific details? - different material - different equipment Any other factor that may make affect the risks associated with performing this task?

IN PREPARING A SAFE WORK METHOD STATEMENT YOU MUST: 1. Consider any site specific potential hazards and include any identified risks in Safe Work Method Statement (SWMS) 2. Assess the risk 3. Insert controls using the hierarchy of controls for the hazards identified i.e. Elimination, Substitution (materials, equipment, and chemicals), Isolation, Engineering (guarding), Administration (training) or PPE 4. Review the residual risk to ensure controls are adequate to safely perform the work 5. Document the matters contained in items 1 4, above, in this SWMS 6. Complete the SWMS and Delete these notes to demonstrate that you have considered all relevant matters 7. Ensure that all workers involved in the job task have read, understood and signed off on the SWMS 8. Ensure that work is carried out in a safe manner in accordance with the SWMS NB: If you are unsure of anything seek professional advice. Master Builders WHS department can assist members in developing and implementing safety plans, including SWMS.

2012 Master Builders Association of South Australia, Inc

CORE DRILLING FLOORS & WALLS

Page 4 of 5

Safe Work Method Statement

WORKERS INVOLVED IN JOB TASK We, the undersigned, confirm that we have been consulted regarding the above SMWS and that its content is clearly understood. We also confirm that our required qualification(s) etc. to undertake this activity, is\are current and that we are competent to complete the work safely and without risk to our own health or the health and safety of others. We clearly understand that the control(s) in this SWMS must be applied as documented, otherwise work is to cease immediately, and we will ensure that the work area is made safe, as far as reasonably practicable.

Print Name:

Company:

Signature:

Date:

I, the undersigned Supervisor, confirm that I have checked all qualifications provided and verify that they are applicable and current. I have also ensured that all inductions have taken place and that all tools and equipment are properly maintained and safe to use. I have issued all relevant permits and have ensured to the best of my ability that the work area is safe and that the work will not damage any property or injure any persons.

Supervisor Name

Supervisor Signature

Date________________

2012 Master Builders Association of South Australia, Inc

CORE DRILLING FLOORS & WALLS

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