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[Member Company Name]

Risk Assessment / Method Statement


Building Works
Project Client:
Project
Location:
Project
Description:
Site Supervisor:

Contact
No:

Persons Affected by Works (Describe how persons are affected)


Site Operatives

Client Personnel
Other

Members of Public/Site Visitors

Project Hazards
Safety
Working at Height
Confined Spaces
Fragile Roofs
Hot Works
Plant, Equipment &
Gases
Tools
Fire / Explosion
Mobile Plant
Falling Materials
Overhead Services
Collapse of Structure
Underground Services Other
Electrical

Site Operatives:

Health
Noise / Vibration
Asbestos
Hazardous Substances/atmosphere
Manual Handling
Rats/Birds or Other
Lead
Other

Name

Job

Welfare
Facilities:
Plant and
Equipment:

(attach certificates)

Method of
Works /
Sequence:

Safety Association of Federated Employers 2013


www.safety-assoc.co.uk
V2-7/14

Page 1 of 4

Detail:
Storage Facilities
Laydown areas
Site Parking
Personal
Protective
Equipment:

Specification detail:

COSHH

EN 397

EN 345S

EN 388

EN 166 B

EN 352

EN 149FFP3

Product
Details:

Attach relevant msds


sheet

Emergency:

Toxic

Harmful

Corrosive

Flammabl
e

Oxidising

Explosive

Location of nearest
Hospital:
Name(s) of first aid trained
personnel:

First Aid

Fire:

Dangerous to
the
environment

Location of First aid box:

Location of nearest fire station:


Location of fire assembly point:
Water

Foam

Dry
Powder

CO

Site Amendments

Risk Summary Overview

BUILD
001

Brick & Block


Laying

BUILD
002

Applying Scratch
Coat Render

BUILD
003

Concrete Flooring

BUILD
004

Roughcasting

BUILD
005

Coring Holes in
Concrete

GENERA
L
003
GENERA
L
005
GENERA
L
006
GENERA
L
007
GENERA
L 008

Unauthorised
Site Access

PLANT
004

R.T Forklift or
Telehandler

Work in Confined
Spaces

PLANT
005

Crane Operations

Refurbishment
Operations

PLANT
010

Use of Hoists

Materials
Delivery &
Removal
Working in
Clients Premises

PLANT
012

Use of Gin Wheel

PLANT
013

Use of Portable
Power Appliances

Safety Association of Federated Employers 2013


www.safety-assoc.co.uk
V2-7/14

Page 2 of 4

BUILD
012

Falsework

BUILD
014

Work with Concrete


Slabs

BUILD
016

HOTWO
RK
001

GENER
AL
001
GENER
AL
002

Bitumen
Waterproofing/Tank
ing
Manual Handling
Operations

Lone Working

Use of Waste
Skip

PLANT
014

Use of Abrasive
Wheels

Noise &
Vibration
Exposure
Hot Works

PLANT
015

Use of Cartridge
Tools

PLANT
016

Use of Stihl Saw

JOINER
004

Installing
Insulation

SUBST
001

Use of Storage of
LPG

PLANT
001

Use of Plant &


Equipment

SUBST
004

Identification &
Work Near
Asbestos

GENERA
L
009
GENERA
L
013

Risk Summary Overview


Use of Scaffold

Use of a Static
Tower
Use of Mobile
Scaffold
Use of Aluminium
Trestles
Use of Ladders

Danger Areas for


the Fall of Materials
Work Near Holes &
Edges

W@H
001
W@H
002

W@H
003

W@H
004

W@H
005
W@H
007

W@H
008

Safety Association of Federated Employers 2013


www.safety-assoc.co.uk
V2-7/14

Page 3 of 4

Operatives
I have read, understood and will adhere to this method statement. Before undertaking any
changes to the above works I will immediately advise the site supervisor of the changes.
Print
Sign
Date

Safety Association of Federated Employers 2013


www.safety-assoc.co.uk
V2-7/14

Page 4 of 4