Aerial Rescue | SAFE WORK METHOD STATEMENT (SWMS)

TASK OR ACTIVITY: Aerial Rescue

Business Name: ABN: SWMS#

Business Address:

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Contact Person: Phone: Email:

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THIS SAFE WORK METHOD STATEMENT IS APPROVED BY THE PCBU OF THE PROJECT
Under the Work Health and Safety Regulation (WHS Regulation), a person conducting a business or undertaking (PCBU) is required to ensure tha t a safe work method statement (SWMS) is prepared before
the proposed work starts.

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Full Name:

Title: Date:
Signature:

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Details of the person(s) responsible for ensuring implementation, monitoring and compliance of the SWMS as well as reviews and modifications of the SWMS.

Full Name: Title: Phone:

HAVE THE FOLLOWING COMMUNICATED

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ALL PERSONNEL PARTICIPATING IN ANY ACTIVITY ON THIS SWMS MUST

Safety meetings or toolbox talks will be scheduled in accordance with legislative

requirements to first identify any site hazards, secondly to communicate those
hazards and then to further take steps to either eliminate or control each hazard.

If an incident or a near miss occurs, all work must stop immediately. Depending
on the severity of the incident, a meeting will be called with all workers to amend
the SWMS if required. The meeting may also be an educational opportunity.
NAME OF ALL RELEVANT PERSONNEL WHO HAVE BEEN CONSULTED AND COMMUNICATED TO IN THE
DEVELOPMENT AND APPROVAL OF THIS SWMS

Any changes made to the SWMS after an incident or a near miss must be
approved by the Person Conducting Business or Undertaking and
communicated to all relevant personnel.

The SWMS must be kept and be available for inspection at least until the work is
completed. Where a SWMS is revised, all versions should be kept. If a notifiable
incident occurs in relation to which the SWMS relates, then the SWMS must be
kept for at least two years from the occurrence of the notifiable incident.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 1

 CLIENT OR PRINCIPAL CONTRACTOR DETAILS

Client: SCOPE OF WORKS

Project Name:

Project Address:

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Project Manager:

Contact Phone:

Date SWMS supplied to Project Manager:

☐ involves a risk of a person falling more than 2 meters

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ANY HIGH-RISK CONSTRUCTION WORK BEING CARRIED OUT

☐
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is carried out on or near pressurised gas mains or piping

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☐ is carried out on a telecommunication tower ☐ is carried out on or near chemical, fuel or refrigerant lines

☐ involves demolition of an element of a structure that is load -bearing ☐ is carried out on or near energised electrical installations or services

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☐ involves demolition of an element related to the physical integrity of a structure ☐ is carried out in an area that may have a contaminated or flammable atmosphere

☐ involves, or is likely to involve, disturbing asbestos ☐ involves tilt-up or precast concrete

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☐ involves structural alteration or repair that requires temporary support to prevent collapse ☐ is carried out on, in or adjacent to a road, railway, shipping lane or other traffic corridor

☐ is carried out in or near a confined space ☐ is carried out in an area of a workplace where there is any movement of powered mobile plant

☐ is carried out in/near a shaft or trench deeper than 1.5m or tunnel involving use of explosives ☐ is carried out in areas with artificial extremes of temperature .

☐ is carried out in or near water or other liquid that involves a risk of drowning . ☐ involves diving work.

ANY HIGH-RISK MACHINERY OR EQUIPMENT NEARBY

Version 2.5 Authorised by Review # Date of Issue: Review Date: 2

 RISK MATRIX

LIKELIHOOD INSIGNIFICANT MINOR MODERATE MAJOR CATASTROPHIC HEIRARCHY OF CONTROLS

SCORE ACTION
ALMOST 3 3 4 4 4
Elimination
CERTAIN HIGH HIGH ACUTE ACUTE ACUTE
Remov e the hazard.
2 3 3 4 4 4A DO NOT

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LIKELY
MODERATE HIGH HIGH ACUTE ACUTE ACUTE PROCEED Substitution
Replace the hazard.
1 2 3 4 4 3H Review before
POSSIBLE
LOW MODERATE HIGH ACUTE ACUTE HIGH work starts.

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Isolation
Ensure control Isolate People f rom the hazard
1 1 2 3 4 2M
UNLIKELY measures in
LOW LOW MODERATE HIGH ACUTE MODERATE
place.
Engineering
1 1 2 3 3 1L Monitor and
RARE

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LOW LOW MODERATE HIGH HIGH LOW keep records. Isolate the hazard.

Administrative
Change the
Notes on Hierarchy of Controls: Elimination methods are the most effective and preferred when controlling a hazard. Substitution
work.
is the second most effective method of controlling a hazard. Engineering by isolation is the third most effective, while Administrative
Controls by changing the work is the fourth most effective method. PPE (Personal Protective Equipment) is the least effective

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method. PPE

PERSONAL PROTECTIVE EQUIPMENT (PPE)

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Select the appropriate PPE above suitable for the equipment used or the job task being performed (if applicable).
FOOT HAND HEAD HEARING EYE RESPIRATORY FACE HIGH-VIS PROTECTIVE FALL SUN HAIR/JEWELLERY
PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION PROTECTION CLOTHING CLOTHING PROTECTION PROTECTION SECURED

☐
Other PPE Required:
☐ ☐
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Permit or Licenses Requirements

☐ ☐ ☐ ☐ ☐ ☐

Mandatory Qualifications and Training

☐ ☐

Version 2.5 Authorised by Review # Date of Issue: Review Date: 3

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK

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- Conduct a site assessment to identify and secure any unstable surfaces prior to commencing work.
- Use ground protection mats or platforms to stabilise the work area if natural ground is uneven or soft.
- Select equipment that is fit for purpose, regularly maintained, and compliant with relevant safety

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standards.
- Ensure all workers are trained and competent in identifying unstable surfaces and choosing appropriate
equipment.

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- Implement a buddy system where one worker checks another’s equipment setup to ensure stability.

1. Preparation Unstable surface, improper equipment 3H - Erect barricades or warning signs around areas identified as having an unstable surface to prevent 2M
accidental entry.
- Perform regular inspections of all equipment before use to detect any damage or wear that could
compromise safety.

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- Establish clear communication protocols and signals among team members to quickly address any
arising instability issues.
- Provide and mandate use of personal protective equipment (PPE) such as helmets, gloves, and non -slip

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footwear.
- Limit weight on potentially unstable surfaces by carefully planning movements and positioning of
equipment and personnel.

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- Conduct thorough inspections of all equipment, including harnesses, ropes, and hardware, to ensure
they are in good condition and meet Australian standards.
- Verify that all personnel involved in aerial rescue operations hold the necessary qualifications and have
undergone recent competency assessments.
- Establish a clear checklist for pre-flight checks that includes equipment inspection, weather assessment,
communication protocols, and emergency procedures.
- Implement a buddy system where team members double-check each other’s gear and readiness before
2. Pre-flight Checks Faulty equipment, human error 3H commencing any aerial activities. 2M
- Maintain a detailed log of equipment inspections, including date, time, findings, and any maintenance
actions taken.
- Ensure a comprehensive understanding of the specific rescue equipment being used, backed by regular
training sessions and refresher courses.
- Brief all personnel on potential human error scenarios and the steps to mitigate them, emphasizing the
importance of focus and adherence to procedures.
- Standardise communication protocols using radio or hand signals, ensuring all team members
understand and can execute them effectively.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 4

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
- Limit distractions by establishing a designated area free from unnecessary personnel and noise during
pre-flight checks.
- Conduct mock rescue drills regularly to familiarise the team with emergency response actions and
improve reflexive responses to unforeseen situations.

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- Review and update the safety management plan periodically to incorporate new industry practices,
technological advancements, and learnings from past incidents.

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- Ensure all workers have completed a working at heights training course before engaging in any aerial
activities.
- Use appropriate personal protective equipment (PPE) such as helmets, harnesses, and non -slip boots.

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- Conduct a pre-task risk assessment to identify any potential hazards in the work area.
- Utilise fall arrest systems where suitable, including guardrails, safety nets, and personal fall arrest
devices.
- Inspect all equipment for defects or damage prior to use, ensuring it meets Australian standards.

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3. Equipment Mounting Fall from height, accidental slips or trips 3H - Keep work areas organised and free of obstacles to minimise the risk of slips or trips. 1L
- Implement a buddy system where one worker can assist and oversee another while mounting
equipment.

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- Establish an exclusion zone around the work area to prevent unauthorised access and reduce the risk of
interference.
- Set up secure anchor points for tethering tools and equipment to prevent falling objects.
- Provide adequate lighting in all work areas to enhance visibility and prevent accidents.

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- Develop and communicate an emergency response plan specific to aerial rescue operations, ensuring
all personnel are aware of and understand the procedures.

X XXXXXXX XXXXXXXXXX XXXXXXXXXXX XX XXXXXX XXX XXXXXXXXX XX XXXXXXXXXXX XXX

XX XXXX XXXXXXXXXX
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4. Take-off Procedures Crashing, flying into obstacles 4A XXXXXXXXX XXXX XXXXXXX XXX XXXXX XXXXXXX 2M
X XXXXXX XXX XXXXXXXX XXXX XXX XXXXXXXXX XXXXXXXXX XXXX XX XXXXXX XXXXXX XX
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XXXXXXXXXXX XX XXXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 5

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXX XXXXX XXXXXXX XXXXXXXXXXX XXXXXXXXX XXXX XXXXX XXX XXXXXXXXXX
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5. In-flight Operation Collision with objects, bad weather 4A XXXXX XXXXXX XXXXXXX 2M
X XXXXXX XXXX XXX XXXXXXXXX XXXXXXXX XXX XXXXXXXXXX XXXXXXX XXX XXXXXXX
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X XXXXX XXX XXXXXXXX XXXX XXXXXXXX XXXXXXXXXX XXXXXXXXX XXXXX XXXXXXXXXXX
XXX XXXXXX XXXXXXXXXXX XXXXXXXXX XXXXXXXX XXXXXXX XXX XXXXXXXXXXXXXXX
XXXXXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 6

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXXXXXX XXX XXXXXXXX XXXXXXXXX XXXXXXXXXX XXXXXXXXXX XXXXXXXXX XXXXX
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6. Navigation & Radio Incoherent communication, navigation 3H XXXXXXXXXXX XXXXXX XXXXXXXXXX XXX XXXXXXXX XXXXXXXX XXX XXXXXX XXXXXXXX XXX 1L
Communication issues
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X XXXXXXX XXX XXXXXXXXX X XXXXXXXXXXXXX XXXXXXXXX XXXXXXXX XXXX XXXX

7. Emergency XXXXXXXX XXXXXXXX XXXXXXXXXX XXX XXXXXX XXXXXX XXXXXXXXXXX
Equipment failure, operator incapacity 4A 3H
Procedures
X XXXXXXX XXXXXXX XXXXXXXX XXXXXXXX XXX XXX XXXXXXXXX XX XXX XXX XX XXXXXXXXX
XXXXXXXXX XXX XXXXXXXXX XX XXX XXXXXX XXXXXX XXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 7

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXXXXX XXX XXXXXXXXX XXX XXXXXXXX XXXX XXXXXXXX XXXXXXXXXXXXX XXXXXXX XX
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X XXXXXXXXXXX XXX XXXX XXX XXXXXX XXX XXXXXX XXXXXXXXXX XXXX XX XXXXXXXXXX
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X XXXXXXXX X XXX XX XXX XXXXXXXXX XXXXXXXXXXX XXX XXXXXXX XXXXXXXXXX XXXX
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X XXXXXXXXX XXXXX XXXXXXXXXXXXX XXXXXXXXX XXXXXXX XXX XXXX XXXXXXX XXXXXXXX

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8. Obstacle Avoidance Crash due to obstacle hit 4A X XXXXXXXXX XX XXXXXXXXXXX XXXXXXX XX XXX XXXXXX XX XXXXXXX XXX XXXXXX XXX 2M
XXXXXXX XXXXXXXX XXXXXX XXXXXXXXXX
X XXXXXX XXXXXX XXX XXXXXXX XX XXXXXXXX XXXXXXXXX XXXXXXXXXX XXXXXXXX XX XXX
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XXXXXXXXX XXX XXXXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 8

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXXXXXX XXX XXXXXXXX XXXXXXXXX XXXXXXXXXX XXX XXXXXXX XXXXXXXXXX XX
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XXXXXX XXXXXXXXXX XXX XXXXXXXX XXX XXXXXXXXXX XX XXXXXXXXXXXX XXXXXXXXXX

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9. Victim Location & X XXXXXX XXXX XXXXXX XXXXXXXXX XXX XXXXXXXX XXXX XXX XXXXXXXX XXXXXXXXX
Wrong identification, unable to locate 3H 2M
Identification XXXXXXXXXX XXX XXX XXXXXXXXXXXXXX XXXXXXXX XXXXX XX XXXXXXXXXXX
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10. Rescue Operation Failure of rescue equipment, inadequate 3H X XXXXXXXXX X XXXXXXXXXXXXXXXX XXXXXXXXXX XXXXXXX XX XXXXXXX XXXXXXXXX XXX 1L
Prep training
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Version 2.5 Authorised by Review # Date of Issue: Review Date: 9

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXX XXXXXXXXX XXXX XXXXX XXXXXXXXXX XXXXXXXXX XXX XXXXXX XXX XXXXXXXXX XXX
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11. Injury Assessment Incorrect assessment, lack of medical XXXXXXXXXX XX XXXXXX XXXXXXX XX XXXXXXXXXXX
3H 2M
and Treatment On-site supplies
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Version 2.5 Authorised by Review # Date of Issue: Review Date: 10

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK

X XXXXXX XXX XXXXXXXX XXX XXXXXXX XXX XXXXXXXXX XX XXXXXX XXXXXX XXXXXXXXXXX
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Additional injury to victim, extraction X XXXXXXXXX XXX XXXXXX XX XXXX XX XXXXXXXX XXXXXX XXXXXXXXXX XXXXXXXXXXX
12. Victim Extraction 4A 2M
difficulty X XXXXXX XXXX XXXXXXXX XXXXXXX XXXXXX XXXX XXXXXXXXX XX XXXXX XXXXXXXXXX
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X XXXXXXX X XXXXXXX XXXXX XXX XXXXXXXXX XX XXXXXXXX XXXXX XX XXXXXXXXXXX XXX
XXXXXX XXXXXXX XXXXXXX XXX XXXXXXXXXXX

X XXXXXX XX XXXXXXXXX XXXXXXXX XXXX XX XX XXXXX XXX XXXXXX XXXXXXXXXX XX XXX

XXXX XXXXXXXX
X XXXXXXXXX X XXXX XXXXXX XX XXXXXXX XXXXXXXXX XXXXXXXX XXXXXXXXXXX
XXXXXXXXX XXX XXXX XXX XXXXXXX
13. Transfer to Medical
Delay in transfer, worsening injuries 3H X XXXXX XXXXXXXXX XX XXXXX XXXXX XXX XXX XXX XX XXXXXXXXX XXX XXXXXXX XXXXXX 1L
Facility
XXXXX XXXXXXXXXXXX XXXXXXX XXXX XXXXXXXX
X XXXXXXXX XXXXX XXXXXXXXXXXXX XXXX XXXXXXXXX XXXXXXXX XXX XXXXXXX XXXXXXXX
XXXXXXXXXXX XX XXX XXXXXXXXX XXX XXXXXXXXX
X XXXXXXXXXXX XXXXXX XXXXXX XXX XXXXX XXXXXX XXX XXXXXXXXX XXXXXXXX XX XXXXX
XXX XXXXXXXX XXXX XXXXXXX XXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 11

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXX X XXXXXXXX XXXXXXX XXXXX XXXXXX XX XXXXXXXX XXXXXXXXXXXXX XXXXXXX XXX
XXXXXX XXXXX XXXXXXXXX XXXXXXXXX XXX XXX XXXXXXX XXXXXXX
X XXXXXXXX XXX XXXXXX XXX XXXXXX XXXXXXXXXXXX XXXXXXX XXX XXX XXXXXXXX
XXXXXXX XXXX XXXXX XXXXXX XXX XXXXXXXX XXXXXXX XXXXX XX XXXXX

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X XXXXXXXXX XXXXXXXX XXXXXXXXX XXXXXXXXXX XXXXXX XX XXXXXX XXXXX XXX
XXXXXXXXXXX XXXXXXXX XXXX XXX XXXXXXXX XXXX XX XXX XXXXXXX XXXXXXXXX
X XXXXXX XXXX XXXXXXXXXXX XXXXXXXX XXXXXXXXXX XXXXXXXXX XXXXX XX XXXX XXXXXX

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XXX XXXXXX XXXXXX XXX XXXXXXXX XXXXXXXX
X XXXXXXXXXX XXXXXXXXXXX XXXXXX XXXXXXXXX XXXXXX XXXXXXXX XX XXXXXXX
XXXXXXXXX XX XXXXXXXXX XXXXXX XXXXXXXXX

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X XXXXX XXX XXXX XXXX XXXXXXXXX XXXXXX XXXXX XXX XXXXXXXXXX XXXXXXXX XXX
XXXXXXXXX XXX XXXX XXXXXXX XXXXXXXXXX
X XXXX X XXXX XX XXXXXX XXXXXXX XXXXXXXXXXX XXXXX XXXX XXXXX XXXXXXX XXXXXXXX
XX XXXXXX XXXXXXXXXXXXXXX XXXXXX XXXXXXXXXXXX
X XXXXXXX XX XXXXXXXXXXXXX XXXXX XXXX XXXXXXX XXXXXXXXX XXXXX XXX

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XXXXXXXXXXXXXXXX XX XXX XXXX XX XX XXXXXX XXXXXX XXXXXXXXX
X XXXXXXXXX XXXXXXXXX XXX XXXXXXXXXXX XXXXXXX XX XXX XXXXXXXX XXX XXXXXXXXX
XXXXXXXX XXXXXX XXXXXXXX XXX XXXXXXXXXX XX XXXX XX XXX XXXXXXX XXXXXXXXX

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X XXXXXXX X XXXXXXXXXX XXXXXXX XXXXXXX XXXXXXXXX XXX XXXX XXXXXXX XX XXXXXXX
XXX XXXXXX XXXXXXXXXX
X XXXXXXXXX XXXX XXXXXXXXXXXXX XXX XXXXXX XXXXXXXX XXXXX XXXX XXXX XXXX XXX

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XXXX XXXXX XX XXXXXXXXX
X XXXXXXXX XXX XXXXXXX XXXXXXX XXXXXX XXX XXXXXXX XXX XXXXXX XXXXXXXXX XXX
XXXXXXXX XXXXXXXXX
X XXXXXXXXX X XXXXXX XXX XXXXXXXX XXXXXXXXXXXX XXXXXXXXX XXXXXX XXX XXXXXXXX
XXXXXXXX XXXX XXX XXXXXXXX XXXXXXXXX
14. Post-rescue
Failure to learn and improve 2M X XXXXXXX XX XXXXXXXX XXXXXX XX XXXXXXXXXX XX XXXXXXX XX XXXXXXXXX XXXXXXXX 1L
operation debrief
XX XXXXXXXXXX
X XXX XXXXX XX XXXXXXXXXXXX XXXXXXXX XXXX XXX XXXXXXXXX XX XXXXXX XX
XXXXXXXXX XXXXXXXXXXX XXX XXXXXXXXXXX XXXXX XXX XXXXXXXXXXXX
X XXXXXX X XXXXXXXXXX XXXXXXXXXXX XXXXX XXXX XXXXXXX XXXX XXXX XX XXXXXXX
XXXXXXXX XX XXXXX XXXXXXXX XXXXXXX XXXX XX XXXXXX
X XXXXXXXX XXX XXXXXXXXX XXXXXXXX XX XXXXXXXXX XXX XXXXXX XXXXX XXX
XXXXXXXXX XX XXXXXX XXXXXXXXXXX
X XXXXXXXXX XXXXXXX XXXXXXX XXXX XXXXXXX XXXXXXXX XXXXXXXX XXX XXXXXXXXXX
XXXXXXXXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 12

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXXXXX XXX XXXXXX XXXXXXXX XXXXXXXXX XXXXXXXXXX XXXXX XX XXXXXXXX XXXXXX
XXXX XXX XXXXXXXX
X XXXXXXXX XXXXXXXXX XXXXXXXX XX XXXXXX XXX XXXXXXXXXXXXXX XX XXXXXXXXXX
XXXXXXXXXXXX XXX XXXXXX XXXXXXXXXXXXXXX

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X XXXXXXX XXX XXXXXXXXX X XXXXXXXXXXXXX XXXXXXXXX XXXXXXXX XXXXXXXXX XX
XXXXXX XXX XXXX XXXXXXX XXXXXXXXXX XXXXXX XXXXXXXX XXXXXXXX

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X XXXXX XXXXXXXXX XX XXX XXXXXXXXXXXXX XXXXXXX XXX XXXXX XXXXXXXXXXXX
XXXXXXXXXX XXXX XXXXXXXX XXXXXXXX XX XXXXXXXXXX
X XXXXXXXXX XXXXXXXX XXXXXXXXX XXXXXXXXXXX XXX XXXXXXXXXX XXX XXXXXXXXX
XXXXXXXXX XXXXXXXX XXXXXXXXX XX XXXXXXXXXXX XXXXXXXXXXX

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X XXXXXX XXXX XXX XXXXXXXXX XX XXXXXXXXX XXX XXXXXX XX XXXXXXX XXXXXX XXXXX
XXXXXXXX XXX XXXXXXXXXXX XXX XXXXXXXX XX XXXXXXXXXX
X XXXXXXXXX XXXXX XXXXXXXXX XXX XXXXXXXXXXXXX XXXXXXXXX XXX XXXXXXXXX
XXXXXXXXX XX XXXXXXXX XXXXXXXX XXXXXXXX

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15. Equipment
Improper disposal, lack of maintenance 3H X XXXXXXX XXXXXXXXXX XXXXXXXX XXXXXXXXXX XX XXXXXXXXX XXXXXXX XXXX XXXXXX 1L
Disposal/Maintenance
XXXX XXXXXXXXXXXXX XXX XXXXXXXXXX XXXXXXXXXX
X XXXXXXXX XXXXXXX XXXXXXXXXXX XXXXXX XXX XXXXXXXXX XXX XXX XXXXXXXXX XX

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XXXXXXX XXXXXXXXXXXXX XXX XXXXXX XXXXXXXXXXX XXXXXXXXXXXX
X XXXXXXXX XX XXXXXXXXXX XXXXXXXXXXX XXXXXXX XXX XXXX XXXXX XX XXXXXXXXXX
XXXXXXXXX XXX XXXXXXXXXXXX XXXXXXXX XXX XXXXXXXXX XXXXXXXXXXX
X XXXXXXX XXXXXXXX XXXXXXXX XXXXXXX XX XXX XXXXXXXXXX XX XXXXXXX XXXXXXXXXXX

S
XXX XXX XX XXXXXXXX XXXXX XXXXX XX XXXX XXX XXXXX
X XXXXXXXXX X XXXXXX XXX XXXXXXXXX XXX XXXXXXXXXX XXXXXXXXXXX XXXXXX
XXXXXXXX XX XXXXXXX XXXXXXX XXXXXXXXX XXXXXX XX XXXXXXXXXXX XXXXXXXX
X XXXXXX XXX XXXXXX XXXXXXXX XXX XXXXXXXXXXX XXXXXXXXXX XXXXXXXXXXXX XX
XXXXXXX XXX XXXXXXXXXXXX XXXXXXXXXXXXX XX XXXXXXXXXXXXXX XXXXXXXX

X XXXXXX XXX XXXXXXXXX XXXXXXXX XX XXXXXXXXXXXXX XXX XXXXXXX XX XXXXXX

XXXXXXXXX XXXXXXXXXX XXX XXXXXXXXXX XXXXX XXXXXXXXXXXXX
X XXXXXXXXX X XXXXXXXXX XXX XXXXXXXXXXXXX XXXXXXXXXXXX XX XXXXXX
XXXXXXXXXXX XXX XXXXXXXXXXXX XX XXXXXXXXXX
16. Documentation &
Incorrect/inadequate documentation 2M X XXXXXXXXX X XXXXXXXXXXX XXXXXX XX XXXXXXX XXX XXXXXX XXXX XXXXXXXXXXXXX XX 1L
Reporting
XXXXXXXXX XXXXXXXXXX XXX XX XXXXX
X XXXXXXX XXXXXXXXXXXX XXXXX XXX XXXXXXXXX XX XXXXXXXXXX XXX XXXXXXXXXXXXX
XXXXXXX XXX XXXXXX XXX XXXXXXXXXX XX XXXXXXX
X XXXXXXX XXXXXXX XXXXXX XX XXXXXXXXXXXXX XXXXXXXXX XX XXXXXXXX XXXXX
XXXXXXX XXXXXXXXXXX XXX XXXXXX XXXXXXXXXX XXXX XXXXXXXXXXXX

Version 2.5 Authorised by Review # Date of Issue: Review Date: 13

 JOB STEP POTENTIAL HAZARDS IR CONTROL MEASURES RR

INITIAL RESIDUAL
SPECIFIC WORK STEPS HAZARDS THAT MAY ARISE SPECIFIC MEASURES TO BE PUT IN PLACE TO ELIMINATE OR CONTROL THE RISKS
RISK RISK
X XXXXXXXXX XXXXXXX XXXXXXXXXXXXX XXXXXXX XX XXXXXXX XXXXXXXXX XXXXXXX
XXXXXXXX XXX XXXXXXXXXX XXXX XXXXXX XXX XXXXXXXXXX XXXXXXXXXX
X XXXXXXXXX X XXXXXXXX XXX XXXXXXXXX XXX XXXXXXXX XXXXXXXXXXXXX XXXXXXXXX
XXXXXXXXX XX XXXXXXX XXX XXXXXXX XX XXXXXXXXXXX XX XXXXXXX XXXXXXXXX

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X XXXXXXXXX XXXXXXXXXXXXXXX XXXXXXXXXX XXXXX X XXXXXX XXXXXX XXXXXXX
XXXXXXXXXXXXX XXX XXXXXXXXXXXX XXX XXXXXXXXXXX XXXXXX XXXXXXXXXXX
X XXXXXXX XXXXX XXXXXXXXXXXX XXX XXXXXXXX XXX XXXXXXX XXXXXXXXXXXXX

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XXXXXXXXX XXXXXXXXXX XX XXX XXXXXXXX XXXXX XXXXXXXX
X XXXXX XXXXXXX XXXXXXXXX XXXXXXXX XXXXXXXX XX XXXXXXXXXXXXX XXXXXXXXXX XX
XXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXX XXXXX XXXXXXXXXX

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X XXXXXXXXX X XXXXXXX XX XXXXXXXXXXXX XXX XXXXXXXXXXXXXX XXXXX XXXXX XXXX
XXXXXXXXXXX XXXXXXXXX XXXXXXXXXXXXX XX XXXXXXXXXXXX XXXXXXX XXXX XX
XXXXXXXXX

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Version 2.5 Authorised by Review # Date of Issue: Review Date: 14
 EMERGENCY RESPONSE – CALL 000 FOR EMERGENCIES

Ensure to have an Emergency Management Plan in place as well as adequate numbers of trained first aid staff with easy access to fully stocked first aid kits, rescue equipment, material safe ty data sheets,
adequate access to emergency communication equipment and fire -fighting equipment suitable for all classes of fire and ignition sources.

LEGISLATIVE REFERENCES

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RELEVANT LEGISLATION AND CODES OF PRACTICE. DELETE THE LEGISLATIVE REFERENCES IN ANY STATE THAT ARE NOT APPLICABLE

Queensland & Australian Capital Territory Victoria

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Work Health and Safety Act 2011 Occupational Health and Safety Act 2004
Work Health and Safety Regulations 2011 Occupational Health and Safety Regulations 2017
Legislation QLD: [Link] Legislation VIC: [Link]
Codes of Practice QLD: [Link] regulations
Legislation ACT: [Link] Codes of Practice VIC: [Link]

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Codes of Practice ACT: [Link]

New South Wales Western Australia

Work Health and Safety Act 2011 Work Health and Safety Act 2020
Work Health and Safety Regulations 2017 Work Health and Safety Regulations 2022

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Legislation NSW: [Link] Legislation Western Australia: [Link]
Codes of Practice NSW: [Link] Codes of Practice WA: [Link]

Northern Territory Safe Work Australia Links

Work Health and Safety (National Uniform Legislation) Act 2011 Law and Regulation (All States): [Link]

A
Work Health and Safety (National Uniform Legislation) Regulations 2011 Model Codes of Practice: [Link]
Legislation NT: [Link] codes-of-practice
Codes of Practice NT: [Link]
Model Codes of Practice

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South Australia
Work Health and Safety Act 2012 (SA) - Managing noise and preventing hearing loss at work
Work Health and Safety Regulations 2012 (SA) - Confined spaces
Legislation for SA: [Link] - Labelling of workplace hazardous chemicals
Codes of Practice for SA: [Link] - Managing risks of hazardous chemicals in the workplace
- Welding processes
Tasmania - First aid in the workplace
Work Health and Safety Act 2012 - Managing the risk of falls at workplaces
Work Health and Safety (Transitional and Consequential Provisions) Act 2012 - Hazardous manual tasks
Work Health and Safety Regulations 2012 - Managing the risk of falls in housing construction
Work Health and Safety (Transitional) Regulations 2012 - Managing electrical risks in the workplace
Legislation for TAS: [Link] - Demolition work
Codes of Practice for TAS: [Link] - Excavation work
- Work health and safety consultation, cooperation and coordination
Details of permits, licenses or access required by regulatory bodies (add or delete as required): - Managing the work environment and facilities
- How to manage work health and safety risks
- Permits from local council - Managing risks of plant in the workplace
- Authorisation to commence work - Construction work
- Any required documents.

Version 2.5 Authorised by Review # Date of Issue: Review Date: 15

 SIGNATORIES OF THE SAFE WORK METHOD STATEMENT

The signed and dated personnel listed below have cooperated in the consultation and development of this Safe Work Method Statement which has been approved by the Person/s Conducting a Business or
Undertaking (PCBU). In signing this Safe Work Method Statement each individual acknowledges and confirms that they have read this SWMS in full, having raised any questions for items on this Safe Work
Method Statement that require clarification, and confirms that they are competent, skilled and knowledgeable for the task ass igned to them. Every person acknowledges that they have received the relevant
training and qualifications where required, before carrying out any work contained in this Safe Work Method Statement. By signing this Safe Work Method Statement each individual agrees to work safely, to
follow any safe work instructions which are provided, and agrees to use all Personal Protective Equipment where appropriate.

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Worker Name Signature Date

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SAFE WORK METHOD STATEMENT MONITORING AND REVIEW

The SWMS must be reviewed regularly to make sure it remains effective and must be reviewed (and
revised if necessary) if relevant control measures are revised. The review process should be carried out in
consultation with workers (including contractors and subcontractors) who may be affected by the operation
of the SWMS and their health and safety representatives who represented that work group at the
The SWMS must be monitored regularly for the effectiveness of ensuring hazard controls are
effective in reducing the risk of incidents, keeping the workplace safe for all personnel. The
person responsible for monitoring the effectiveness of the Safe Work Method Statement should
employ a multi-faceted approach which includes but is not limited to:

S
workplace.
1. Spot Checks.
When the SWMS has been revised the PCBU must ensure that all persons involved with the work are 2. Consultation with workers, contractors and sub-contractors.
advised that a revision has been made and how they can access the revised SWMS , including all persons 3. Internal audits on a continual basis.
who will need to change a work procedure or system as a result of the review are advised of the changes in
a way that will enable them to implement their duties consistently with the revised SWMS . All workers that An approach of continuous improvement, promptly recording inconsistencies or deficiencies,
will be involved in the work must be provided with the relevant information and instruction that will assist followed up by immediate corrective action and consultation with all relevant personnel ensures
them to understand and implement the revised SWMS. that the PCBU is consistently developing ever-improving systems of safe work principles.

REVIEW NUMBER 1 2 3 4 5 6 7
NAME

INITIALS
DATE

Version 2.5 Authorised by Review # Date of Issue: Review Date: 16

 SAFE WORK METHOD STATEMENT REVIEW CHECKLIST

This Safe Work Method Statement Review Checklist is to be followed and used upon initial development of the SWMS to help ensure that all steps have been adequately taken before work commences.
Think of this document as an internal audit review checklist before commencing work, and may form part of a Toolbox Talk (safety meeting) and may be used as an opportunity for education and training.

ITEMS WHICH MUST BE INCLUDED IN THE SWMS COMPLETED COMMENTS

The company details have been entered, including the project name and address.

All relevant personnel consulted during the development of the SWMS.

Name, signature, position and date signed of the person approving the SWMS.
☒
☒
☐

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Specific personnel and qualifications, experience is noted in the SWMS. ☒
Provides a step-by-step process of tasks required to carry out the activity or task. ☒
Adequate risk assessment of any identified hazards has been completed. ☒

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Foreseeable hazards are identified and documented for each step. ☒
Any hazards listed in any site risk assessments have been added to the SWMS. ☒
SWMS initial risk (IR) column as well as residual risk (RR) columns completed. ☒

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Check control measures added to the SWMS are the most effective selections. ☒
Responsible person is assigned and listed on the SWMS for the implementation of control measures. ☒

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Permit or licenses requirements specified, such as Hot Work, Electrical Work, Work at Heights etc. ☒
SWMS identifies plant and equipment to be used. ☒
Details of inspection checks required for any equipment listed are noted on the SWMS. ☒
Describes any mandatory qualifications, experience, training or skills required to perform the work. ☒
Applicable personal protective equipment is selected on the SWMS. ☒
Reflects and documents any legislative references and/or Australian Standards. ☒
Identifies any hazardous substances used with specific control measures in line with any SDS. ☒

REVIEWED BY DATE REVIEWED

SIGNATURE DATE COMPLETED

Version 2.5 Authorised by Review # Date of Issue: Review Date: 17