Task Name

SWMS No Project Date

Consequence
Risk Score Calculator
Disaster Very
Serious
Serious Substantial Minor
L
i
k
e
l
y
h
o
o
d
Almost certain
Likely
Possible
Remotely
Possible
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
3
3 3
Likelyhood / Consequence
Risk Class
The hazard has the potential to:
cause major damage to the structure
have significant impact on the surrounding population and environment
The hazard has the potential to:
cause minor damage to the structure
cause minor damage to the structure
breach the site boundary and pollute local environment
The hazard has the potential to:
cause minor injuryy
be contained within the site boundary
1
2
3
Yes,
risk score
1-High
3-Low
Hazards Identified
(describe the hazards which could cause
injury)
For Each Job Step
Where there is a risk, describe the control measures proposed
Date
Done
Job Step
Address Phone ABN
permanently disable or kill
Page 1 of 4
By
Who?
Check
Form: OHS/0081AUS STATE
BuildersNet Sample
Risk Assessment & Safe Work Method Statement
Insert Contractor Name
ELECTRICAL WORK
Delivery of Electrical
Materials to site
Disconnect all elec services
from the DB
Provide RCD protected
Worksite power
Remove redundant Fittings
Remove redundant Fittings
3
1
1
1
3
Struck by moving Vehicle
Public Access
Electrocution
Cuts to hands
Electrocution
Cuts
Electrocution
Cuts
Slips Trips & Falls
Rough in new circuits 2
Working at height
Cuts Barricade & PPE
Use Al mobile scaffold over 1.8m
Keep work area clean & tidy
Stockpile removed wiring & fittings
Use "voltstick" to double check all fittings
Wear Gloves
Check all circuits
Correct PPE
Check all circuits
Keep access locked
Supervise Vehicles
NSW
BuildersNet Pty Ltd Copyright 2005 www.buildersnet.com.au 1300 652515
Check
Yes,
risk score
1-High
3-Low
Hazards Identified
(describe the hazards which could cause
injury)
For Each Job Step
Where there is a risk, describe the control measures proposed
Job Step
Page 2 of 4
By
Who?
Date
Done
BuildersNet Sample
Install new fittings and
fixtures
Wire in new circuits
Liven up new circuits.
3
3
1
Working at height
Cuts
Working at height
Cuts
Electrocution
Use Al mobile scaffold over 1.8m
Use correct PPE
Ensure RCD is working properly
BuildersNet Pty Ltd Copyright 2006 www.buildersnet.com.au 1300 652515
Codes of Practice / applicable to this work (access from site office)
Certificates, WorkCover Approvals required
Legislation applicable to this work (access from site office)
Standards Relevant to the Work
Environmental Risks Environmental Controls
By
Who?
Check
Date
Done
Page 3 of 4
PLANT AND EQUIPMENT MAINTENANCE AND INSPECTION CHECKS
BuildersNet Sample
New South Wales Occupational Health and Safety Act, 2000. Occupational Health
and Safety Regulation 2001.Workers Compensation Act 1987.Workplace Injury
Management and Workers Compensation Act 1998 .Workers Compensation (Dust
Diseases) Act 1942. OHS Amendment (Dangerous Goods) Act 2003. Supporting
OHS Amendment (Dangerous Goods) Regulation 2005

Electrical Cert AS/NZS 3012:2003 Electrical installations - Construction and demolition sites
BuildersNet Pty Ltd Copyright 2006 www.buildersnet.com.au 1300 652515
NSW Electrical Practices for Construction Work.
RCD_Power_Box Visual Check Daily Check Tag Ensure in Test
Extension_Leads Visual Check Daily Check Tag Ensure in Test
Flood_Light Visual Check Daily Check Tag Ensure in Test
Impact_Drill Visual Check Daily Check Tag Ensure in Test
Ladder_Step Visual inspection daily
Electric_Drill Visual Check Daily Check Tag Ensure in Test
Duties and responsibilities of
supervisory Staff
Names of Supervisory Staff include Qualifications
and experience
This SWMS has been developed through consultation with our employees and has been read & signed by All employees involved with this activity
Inspect and approve work areas,
methods, safety controls, plant
equipment and tools.
Duties and responsibilities of
supervisory Staff
Names of Supervisory Staff include Qualifications
and experience
Trainer Name
Date Name Signature
SKILLS AND/ OR TRAINING REQUIRED
Date Name Signature
Signed by a Senior Management
Representative of the Company for use
Signed:
Position & Name:
Date
I, the undersigned have read this document and approve it as site specific.
Page 4 of 4
BuildersNet Sample
Supervise the work
Roy Atkins
BuildersNet Pty Ltd Copyright 2006 www.buildersnet.com.au 1300 652515