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Hindmarsh Management System Doc No.

600-100-F007-{NAT} Doc Rev: 10 Page 1 of 2


The Hindmarsh Management System version of this document is the controlled master document. Project Document Control Systems (ie Aconex)
control Project Raised\Specific documents. Unless specifically noted thereon, printed or hard\soft copies of this document are uncontrolled.


SWMS Review Form

THIS DOCUMENT MUST BE COMPLETED BY THE SUBCONTRACTOR AND ATTACHED TO THE RELEVANT SWMS AND ISSUED
TO, AND REVIEWED BY, HINDMARSH PRIOR TO ANY WORKS COMMENCING ON SITE.

Project:
Subcontractor: Work Supervisor:
Trade Package: Activity:
SWMS Title:
Ref # Rev # Rev Date / /
Mandatory
Item Subcon
tractor
HCA
Confirm the SWMS:
A sets out a logical step-by-step process of all work activities to be undertaken? Y \ N Y \ N
B describes how each activity will be carried out? Y \ N Y \ N
C considers the environment within which the activities are to be undertaken? Y \ N Y \ N
D identifies safety, health and environmental hazards that may arise through the work? Y \ N Y \ N
E clearly document and control risk for each hazard identified? Y \ N Y \ N
F describes all plant and equipment that will be used? Y \ N Y \ N
G has identified and conforms with relevant Standards, Codes of Practice & Legislation ? Y \ N Y \ N
H identifies any pre-start and in-process certifications / authorizations / permits / meetings? Y \ N Y \ N
I was developed in consultation with workers and or provides for and identifies consultation with the workers that will
undertake the task?
Y \ N Y \ N
As Applicable
1 Does the SWMS provide for emergency procedures including rescue requirements for high risk activities Y \ N \ NA Y \ N \ NA
2 Does the SWMS effectively communicate any high risk activities which may affect interfacing trades? Y \ N \ NA Y \ N \ NA
3 Does the SWMS provide specific licensing and qualifications required by workers for specific tasks?
Refer to Competencies for Subcontractors - Safety Work Instruction
Y \ N \ NA Y \ N \ NA
4 Does the SWMS specify supervision, training and/or trialing required to enable the work to be done safely? Y \ N \ NA Y \ N \ NA
5 Does the SWMS and risk assessment provide controls for public, people & plant in the vicinity of the task? Y \ N \ NA Y \ N \ NA
6 Applicable additional requirements as outlined in the Hindmarsh document PD5.1.3A High Risk Construction Work
are addressed.
Y \ N \ NA Y \ N \ NA
7 Where a harness is nominated the Harness Application form has been completed and supplied to HCA (attach): Y \ N \ NA Y \ N \ NA
Project Specific (add extra lines as applicable)
Item Complies
Y / N
TO BE SIGNED BY A MANAGEMENT REPRESENTATIVE OF THE COMPANY SUBMITTING THE SWMS FOR REVIEW
By signing below I declare the accompanying SWMS for High Risk Construction Work (as per Model WHS Regulations 2011) was prepared
taking into account all relevant matters, including: project circumstances that may affect the way in which the high risk construction work is carried out;
and the HCA Project Safety Management Plan and HCA Project Safety Risk and Opportunity Profile
Name: (Signature): / /

HINDMARSH COMMENTS \ SWMS STATUS
SWMS has been reviewed no comments (all items are marked Y or NA)
SWMS has been reviewed - Items marked N or where comments \ issues have been raised and documented below.
This form must be completed again with the revised SWMS attached.
ISSUES \ DISCUSSIONS \ FOLLOW-UP



Reviewed by: Hindmarsh (Name): (Signature): / /
Received by Supervisor: Hindmarsh (Name): (Signature): / /

Hindmarsh Management System Doc No. 600-100-F007-{NAT} Doc Rev: 10 Page 2 of 2
The Hindmarsh Management System version of this document is the controlled master document. Project Document Control Systems (ie Aconex)
control Project Raised\Specific documents. Unless specifically noted thereon, printed or hard\soft copies of this document are uncontrolled.






HIGH RISK CONSTRUCTION ACTIVITIES
(Work Health and Safety Regulations 2011, Office Federal Safety Commission)
CRITICAL NOTE refer to Hindmarsh document PD5.1.3A High Risk Construction Work for detailed information and
applicable additional requirements which must be addressed within relevant SWMS.
Artificial Extreme Temperatures
Asbestos
Chemical, Fuel or Refrigerant Lines
Confined Space
Contaminated or Flammable Atmosphere
Demolition
Diving
Drowning Risk Construction work in, over, adjacent water \ liquid where risk of drowning
Electrical
Explosives
Plant Powered \ Mobile \ Other
Pressurised Gas, distribution mains or piping
Structural Alterations \ Temp Support Structures
Tilt-up \ Precast Concrete
Traffic out, in or adjacent road, railway, shipping lane or other traffic other than pedestrians
Working at Heights \ Risk of Falling \ Falling Objects
Work in or near shaft, trench, tunnel