Safe Work Method Statement

Project Name: HAI - TK Address:

Company Name: KSV Activity/Trade: Piling work

Address:
Engineer/ Supervisor Name: V. Iyyappan Contact No: 9994808037

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

 Hitting of HT line / live panel 1)Vehicle should be allowed after check by safety officer
Unloading of hydraulic rig from board E 2)Induction to be conducted by safety officer for all new Mr. Iyyappan
trailer.  Ran over of vehicle on parts of workers/visitors.
a) HT line obstruction in body 3)Medical examination to be done by Govt. authorized
west side project gate.  Hitting of men / material physician.
 Failure of vehicle 4)Operator Eye test, pulmonary test certificate to be
 Toppling of vehicle submitted prior to start the work.
 Caught in between 5)Operator competency and valid license to be checked
 Electrocution before engage.
6)Pre - inspection of Equipment to be done by qualified
technician with safety representatives.
7)Equipment Competent person certificate and relevant
documents to be checked before entry.
8)Trailer should be taken through east side gate of phase
1due to HT line obstruction & rig should be positioned on a
rigid earth surface.
9)Rigid steel gratings / structure / soil filling should be used
as a ramp for hydraulic rig unloading.
10)Unloading activity should be done under proper
supervision.
11)Signaling should be done by flag man / banks man.
12)HT line should be raised to 6 m height for safe entry of
vehicles.
13)Height barrier should be provided for vehicle entry.
14)Trained first aider & Emergency vehicle should be
E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk:ensured
The hazard
athas the potential to cause a LTI ≥ 7 days
site.
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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Filling of fuel in to crane & rig.  Spillage of fuel E 1)Diesel to be pumped with hand pump only. Mr. Iyyappan
 Land pollution due to spillage 2)Availability of secondary containers should be ensured.
 fire hazard 3)Spill control arrangements tray to be provided.
 Slip, trip & Fall due to uneven 4)Engine should be in off condition.
earth surface / Spillage 5)Fire extinguisher to be provided in the fuel filling area.
 Struck against rotating objects / 6)Proper PPE’s & supervision to be ensured.
sharp edges. 7)MSDS to be displayed & explained to workers.
 Health hazard due to inhalation. 8)Polluted soil to be disposed through authorized vendor.
9) Trained first aider & Emergency vehicle should be
ensured at site.
10)Hot work should not be allowed near fuel filling area.

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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Marching of Hydraulic rig.  Level of Earth, E 1)Vehicle should be allowed after check by safety officer Mr. Iyyappan
 Failure of hydraulic rig 2)Induction to be conducted by safety officer for all new
 caught in between workers/visitors.
 Slips & trips on same level 3)Medical examination to be done by Govt. authorized
 Unsafe material handling physician.
 Oil spillage 4)Operator Eye test, pulmonary test certificate to be
 Toppling of rig due to uneven submitted prior to start the work.
surface 5)Operator competency and valid license to be checked
 Struck in to the object before engaging for work.
6)Pre - inspection of Equipment to be done by qualified
technician with safety representatives.
7)Equipment Competent person certificate and relevant
documents to be checked before entry.
8)Marching of crane should be done on a rigid & leveled
earth surface.
9)Signaling should be done by flag man / banks man.
10) Secondary container & drip pan to be ensured near the
work spot.
11) PPE's to be checked by safety officer before entry to
the site.
13) Damaged PPE's should be replaced.
14) PPE Manufacturing Test Certificate to be checked prior
to start of work.
15)Trained first aider & Emergency vehicle should be
ensured at site.
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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Positioning of Hydraulic rig with  Level of Earth, E Mr. Iyyappan

suitable tool (Installation &  Failure of hydraulic rig 1)Vehicle / Rig should enter the gate only after checking the
removal of soil and rock auger.)  caught in between vehicle & driver / operator competency.
 Slips & trips on the same level 2)Rig movements to be controlled by a banks man.
 Unsafe material handling 3)Access roads to be rigid (compaction to be ensured) &
 Oil spillage safe without hindrance.
 Toppling of rig due to uneven 4)Haphazard movement of workers to be controlled.
surface 5)Proper usage of PPE’s to be ensured.
 Struck in to the object 6)Safety Induction to be given for all workers & staffs before
 Potential chances of body injury start of work.
whilst evacuating in case of 7)Safe handling of rig tool & hand tools to be ensured.
emergency 8)Trained persons to be deployed in rig tool fixing.
 Hitting of rotating parts / Sharp 9) Signal man to be engaged for control of unauthorized
edges person entry.
 Fall of material whilst 10) Barricading & signage to be provided at all around the
shifting/lifting by manually. area.
 Failure of Personal protective 11) PPE's to be checked by safety officer before entry to
equipment. the site.
12) Damaged PPE's should be replaced.
13) PPE Manufacturing Test Certificate to be checked prior
to use.
14)Job specific training to be given to all workers & staffs
engaged for work.
15) Trained first aider & Emergency vehicle should be
ensured at site.
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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Check for verticality of Mast.  Slips, trips & fall in the floor level H 1)PNM & HSE person should inspect & fill the check list of Mr. Iyyappan
/ from the rig rigs.
 Failure of PPE’s. 2)Third party test certificate to be obtained before the
operation of rig.
3) Proper usage of PPE’s to be ensured.
4) PPE's to be checked by safety officer before entry to the
site.
5) Damaged PPE's should be replaced.
6) PPE Manufacturing Test Certificate to be checked prior
to use.
7) Trained first aider & Emergency vehicle should be
ensured at site

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Boring & Temporary casing  Failure of hydraulic rig H 1)Work permit system to be followed. Mr. Iyyappan
installation (shifting of casing  caught in between 2)Competency of rig operator to be checked.
pipe)  Slips & trips 3)Piling to be done with proper supervision
 Unsafe material handling 4)All lifting tools & tackles to be third party certified.
 Oil spillage 5)Piling area to be completely barricaded with sign boards
 Toppling of rig due to uneven display.
surface 6)Rig operation should be controlled by a flag man.
 Struck in to the object 7)Proper usage of PPE’s to be ensured.
 Fall of person in to the bore 8)Safety harness should be anchored to a rigid structure /
 Potential chances of body injury support during temporary casing installation.
whilst evacuating in case of 9)Casing should be guarded with steel mesh to avoid fall of
emergency person.
 Hitting of person whilst 10)Haphazard movement of workers to be controlled.
swinging 11)Swing alarm to be ensured in crane & rig.
 Hitting of rotating parts/sharp 12) Trained first aider & Emergency vehicle should be
edges ensured at site

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Shifting & Lowering of  Slips, trips & fall, E 1)Crane, all lifting tools & tackles to be third party test Mr. Iyyappan
prefabricated reinforcement  collapse of bore made for pile, certified & physical fitness to be ensured.
cage using hydra / crawler  Fall of person in to the bore, 2)TBT to be given to all workers involved in the activity.
crane.  Toppling of crane, 3)Competency of the workers to be checked before
 Ran over on the parts of body, erection.
 Hitting of men during crane 4)Proper slinging should be ensured with skilled riggers.
marching & swinging, 5)Proper usage of PPE’s & supervision to be ensured.
 Failure of crane, Sling 6)Crane movements to be controlled by signal man with
 Struck against object. flags / light battons.
 Electrocution. 8)Lifting & erection should be done with in the load & radius
 Health hazard due to inhalation capacity of the crane.
of welding fumes. 9) All electrical connections to be routed through ELCB.
 Potential chances of body injury 10) ELCB checked by authorized electrician on periodical
whilst evacuating in case of basis.
emergency 11) All electrical tools to be checked by authorized
electrician.
12) Suitable fire extinguisher to be provided.
13) Fire watcher to be ensured in the hot work area.
14) Welding machines to be properly body earthed.
15) Hot works permit system to be followed prior to start
the work.
16) Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Tremie pipe lowering in the  Slips, trips & fall in the same E 1)Crane, all lifting tools & tackles to be third party test Mr. Iyyappan
bore hole (shifting of tremie level. certified & physical fitness to be ensured.
pipe).  Fall of person in to the bore, 2)TBT to be given to all workers involved in the activity.
 Toppling of crane, 3)Competency of the workers to be checked before
 Ran over on the parts of body, erection.
 Hitting of men during crane 4)Proper slinging should be ensured with skilled riggers.
marching & swinging. 5)Proper usage of PPE’s & supervision to be ensured.
 caught in between 6)Crane movements to be controlled by signal man with
 Unsafe material handling flags / light batons
 Oil spillage 7)Lifting & erection should be done with in the load & radius
 Struck in to the object capacity of the crane.
 Potential chances of body injury 8) Barricading & signage to be provided at all around the
whilst evacuating in case of area.
emergency 9)Secondary container should be provided to avoid oil
 Hitting of person whilst spillage.
swinging 10)Haphazard movement of workers to be controlled.
 Hitting of rotating parts/sharp 11)Swing alarm to be ensured in crane & rig.
edges 12) Trained first aider & Emergency vehicle should be
ensured at site

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Shifting & positioning of  Slips, trips & fall due to spillage E 1) Crane, all lifting tools & tackles to be third party test Mr. Iyyappan
bentonite tank & pumping of of bentonite slurry certified & physical fitness to be ensured.
bentonite slurry.  Fall of person in to the bore 2)TBT to be given to all workers involved in the activity.
 Toppling of crane 3)Competency of the workers to be checked before
 Fall of person from tripod & erection.
Bentonite tank 4)Proper slinging should be ensured with skilled riggers.
 Bentonite slurry spillage 5)Proper usage of PPE’s & supervision to be ensured.
 collapse of tripod 6)Crane movements to be controlled by signal man with
 Electrical shock flags / light batons.
 Fall of material due to sling 7)Tripod to be anchored rigidly to avoid collapse,
failure 8)Lifting tools & tackles to be inspected on daily basis.
 Health hazard 9)Bentonite slurry should be handled safely by proper
 struck against object routing to collection tank.
10)All electrical installations / equipments to be properly
earthed, sheltered and cable to be routed safely.
11) All electrical connections to be routed through ELCB.
12) ELCB checked by authorized electrician on periodical
basis
13)Helmets, safety shoes, reflective jackets, goggles &
nose mask to be strictly ensured.
14)Lifting & erection should be done with in the load &
radius capacity of the crane.
15) Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

 Slips, trips & fall due to spillage E 1)Crane, all lifting tools & tackles, Compressor to be third Mr. Iyyappan
Shifting of compressor & of bentonite slurry party test certified & physical fitness to be ensured.
Flushing of bore hole by  Fall of person in to the bore 2)TBT to be given to all workers involved in the activity.
compressor.  Fall of person from tripod & 3)Competency of the workers to be checked before
Bentonite tank erection.
 collapse of tripod 4)Proper slinging should be ensured with skilled riggers.
 Electrical shock 5)Proper usage of PPE’s & supervision to be ensured.
 Health hazard 6)Crane movements to be controlled by signal man with
 Struck against object flags / light batons.
 Failure of compressor 7)Tripod to be anchored rigidly to avoid collapse,
 Fall of material due to sling 8)Lifting tools & tackles / compressor to be inspected on
failure daily basis.
9)Bentonite slurry should be handled safely by proper
routing to collection tank.
10)All electrical installations / equipments to be properly
earthed, sheltered and cable to be routed safely.
11) All electrical connections to be routed through ELCB.
12) ELCB checked by authorized electrician on periodical
basis
13)Helmets, safety shoes, reflective jackets, goggles &
nose mask to be strictly ensured.
14)Lifting & erection should be done with in the load &
radius capacity of the crane.
15) Trained first aider & Emergency vehicle should be
ensured at site.
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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

 Slips, trips & fall due to spillage 1)Crane, all lifting tools & tackles to be third party test Mr. Iyyappan
Shifting & positioning of of bentonite slurry certified & physical fitness to be ensured.
concrete pump & pumping of  Fall of person in to the bore 2)TBT to be given to all workers involved in the activity.
concrete.  Toppling of crane 3)Competency of the workers to be checked before
 Concrete spillage erection.
 Electrical shock 4)Proper slinging should be ensured with skilled riggers.
 Fall of material due to sling 5)Proper usage of PPE’s & supervision to be ensured.
failure 6)Crane movements to be controlled by signal man with
 struck against object flags / light batons.
 Struck by ball during ball 7)Concrete pump to be shifted (guide rope) & positioned
passing. properly to avoid collapse.
 Environmental impact due to 8)Lifting tools & tackles to be inspected on daily basis.
disposal of concrete slurry 9)Spillage of concrete to be controlled.
 Hitting four head ball whilst 10) Concrete ball catcher to be provided and ensured no
cleaning for pump. one should be stand at near the area.
 Health hazard due to handling 11)Adequate PPE’s to be provided while handling cement/
of cement. concrete.
12)Concrete waste water to be disposed through
sedimentation tank.
14)Lifting & erection should be done with in the load &
radius capacity of the crane.
15) Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Attaching concrete funnel &  Slips, trips & fall E 1)Free movement of single fall sling to be controlled Mr. Iyyappan
pouring concreting.  Fall of person in to the bore, properly with guide rope.
 Toppling of crane, 2)Workers should be positioned at a safe distance from
 Fall of material due to sling / D- crane.
shackle failure, 3)Slings & D shackles should be checked & replaced for
 Caught in between rotating damages on daily basis.
parts, 4)RM 800 to be earthed & cable to be properly routed.
 Health Hazard, 5)Loose clothes should not be allowed near the mixer
 Failure of crane. machine.
 Spillage of concrete. 6)Rotating parts to be properly guarded.
7)TBT to be given to all workers engaged in concrete
production & pouring in to funnel.
8)Barrication & rebar mesh to be provided for pile to avoid
fall of person.
9)If transit miller is used for concreting, vehicle should be
stationed at a safe distance from bore.
10)Restricted flow of concrete to be done with chute
arrangement.
11)Proper usage of PPE’s to be ensured.
12)Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
Document Name: Page No.
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 Safe Work Method Statement

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

Concrete bucket shifting with  Slips, trips & fall, E 1)Crane, all lifting tools & tackles to be third party test Mr. Iyyappan
hydra / crawler crane.  Fall of person in to the bore, certified & physical fitness to be ensured.
 Toppling of crane, 2)TBT to be given to all workers involved in the activity.
 Fall of material due to sling / D- 3)Competency of the workers to be checked before
shackle failure, erection.
 Caught in between rotating 4)Proper slinging should be ensured with skilled riggers.
parts, 5)Proper usage of PPE’s & supervision to be ensured.
 Failure of crane. 6)Crane movements to be controlled by signal man with
 Spillage of concrete. flags / light batons
 Hitting of person whilst swinging 7)Access roads to be rigid (compaction to be ensured) &
 Potential chances of body injury safe without hindrance.
whilst evacuating in case of 8)Lifting & erection should be done with in the load & radius
emergency capacity of the crane.
 Hitting of equipment to others 9) Barricading & signage to be provided at all around the
due to unfit person area.
 Hitting of rotating parts/sharp 10)Secondary container should be provided to avoid oil
edges spillage.
11)Haphazard movement of workers to be controlled.
12)Swing alarm to be ensured in crane.
13) Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
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 Safe Work Method Statement

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

 Slips, trips & fall, E 1)Skilled workers to be engaged in dismantling tremie pipe. Mr. Iyyappan
Removing of tremie pipe.  Fall of person in to the bore, 2)Safe handling of tools & tackles to be ensured.
 Toppling of crane, 3)Lifting tools & tackles to be inspected on daily basis.
 Fall of material due to sling / D- 4)Crane, all lifting tools & tackles to be third party test
shackle failure, certified & physical fitness to be ensured.
 Caught in between rotating 5)TBT to be given to all workers involved in the activity.
parts, 6)Competency of the workers to be checked before
 Failure of crane. erection.
 Hitting of person whilst swinging 7)Proper slinging should be ensured with skilled riggers.
 Potential chances of body injury 8)Proper usage of PPE’s & supervision to be ensured.
whilst evacuating in case of 9)Crane movements to be controlled by signal man with
emergency flags / light batons
 Hitting of equipment to others 10) Barricading & signage to be provided at all around the
due to unfit person area.
 Hitting of rotating parts/sharp 11)Haphazard movement of workers to be controlled.
edges 12)Swing alarm to be ensured in crane.
13) Trained first aider & Emergency vehicle should be
ensured at site.

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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Bentonite slurry collection.  Slips, trips & fall, E 1) Skilled workers to be engaged in bentonite mixing & Mr. Iyyappan
 Spillage of bentonite slurry, collection tank.
a) Excavation for collection pit  Fall of person in or out of 2)Safe handling of bentonite powder 3) Pump & starter to
by Excavator / JCB. bentonite tank / Pit be properly earthed.
b) Dewatering of bentonite pit.  Failure of chain block, 4)Leakage to be strictly controlled by hose & clamping
 Electrical shock, arrangements.
 Health Hazard. 5)Bentonite collection pits to be barricaded properly to
 Environmental hazard, avoid fall of person.
 Hitting of person during JCB 6)Mixing of bentonite in drains, pond or natural water
operation. sources to be strictly controlled.
 Damaged of underground lines 7) Barricading & signage to be provided at all around the
by JCB/manual dicking area.
8) Excavations permit system to be followed prior to start
the work.
9) All electrical connections to be routed through ELCB.
10) ELCB checked by authorized electrician on periodical
basis.
11) All electrical tools to be checked by authorized
electrician.
12) Proper usage of PPE’s & supervision to be ensured
13) Trained first aider & Emergency vehicle should be
ensured at site

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 (ie: Nil LTI)
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 Safe Work Method Statement

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

Equipment, Tools & tackles Spec:

1) Crane - Hydra Crane, SWL: 12 T

2) Hydraulic Rig – SR 155

3) Wire rope sling – Día: 19 mm, L - 2m, SWL – 3.6 T

Día: 25 mm, L – 7m, SWL – 6.2 T

4) D – Shakle – SWL - 3.25 & 4.75 T

Mandatory PPE’s: Safety Helmets, Reflective jacket, Goggles, Hand gloves, Nose mask, Ear plug, Safety shoe / Gum boot.

Role of Supervisor:

1)Implementation of all control measures effectively.

2)Effective supervision for Crane & rig movement.
3)Ensure effective control on health & environmental hazard.
4)Daily inspection of lifting tools & tackles.
5)Communicating to the site in charge in case of any emergencies.

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 (ie: Nil LTI)
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 Safe Work Method Statement

Personnel Summary
SUPERVISOR’S DETAILS
Engineer/ Supervisor’s Name & Qualifications: Name: Mr. Iyyappan
Experience: 20 years
Qualifications: B.E.,
Engineer/ Supervisor’s Responsibilities: In addition to the above, the supervisor is to provide training in the use of this WMS, issue PPE and provide training in the same, supervise the
work, ensure conformity with this WMS, amend the WMS when additional hazards are found (and if applicable, ensure all workers receive a tool-
box talk to discuss the control measures for the additional hazards).

DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: NA

WORK ACTIVITY TRAINING: SWMS is communicated to all, explained work related hazards as well as control measures.

SITE INDUCTION: All workers are inducted by site safety office and conducted TBT on daily basis.

OTHER: (List other training undertaken by workers): Height work, Hot work training has been conducted by safety officer

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

N.B. - Copies of the above must be shown to the Principal Contractor during site induction.

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

All work to comply as per contract agreement and safety Regulations / 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 log books sighted
Registration No. identified and by Principle Contractor prior to equipment being
controlled within used on site?
(Where applicable)
WMS?
Yes No Sign Date

1 Batching plant OEM Yes

2 Hydraulic Rig Dhina Pile Foundation Yes

3 Crane Dhina Pile Foundation Yes

4 Pump OEM Yes

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
NA ____ /____ /____ ____ /____ /____
NA
____ /____ /____ ____ /____ /____
NA

HAZARDOUS SUBSTANCES or DANGEROUS GOODS USED IN THE WORKS and anticipated volumes (Attach MSDS if applicable):
MSDS
Purpose Location & Volume Used Controls
Date on Site Date Left Site Product Name MSDS Date Attached
(ie. Application on site) on Site (& PPE to be worn)
(Y/N)
/ / / / NA / /

/ / / / NA / /

/ / / / NA / /
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.
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 Safe Work Method Statement

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. / /

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 WMS.

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