OHS FORM 005 SAFE WORK METHOD STATEMENT (SWMS) also known as Job Safety Analysis (JSA) also

known as Job Safety Analysis (JSA) Company Name: ABN: This SWMS has been developed and authorised by: Name: Position: Date: Signature: Phone: Mobile: DESCRIPTION OF WORK ACTIVITY: Electrician Trades involved with undertaking this Work Activity: This SWMS is submitted to: (principle contractor) COMPANY: CONTACT NAME: PHONE NUMBER: SITE ADDRESS: PROJECT DESCRIPTION: This SWMS was review by: (principle contractor) NAME: POSITION: SIGNATURE: DATE: PHONE NUMBER: MOBILE NUMBER: Person responsible for OHS on the contractor s behalf: NAME: POSITION: SIGNATURE: DATE: PHONE NUMBER: MOBILE NUMBER: Safe Work Method Statement (SWMS) Page 1 of 9

List plant, equipment and tools to be used tools to be used List Hazardous Substances to be used or handled MSDS available? (Tick) List PPE to be worn (Tick) List Hazards to consider (Tick) eg. Electric generator eg. Unleaded petrol Hard Hat Fall from ladder Safety Boots Fall from heights High-visy clothing Fall from scaffold Gloves Contact with electricity Hearing Protection Falling objects Safety Glasses Collapse 30+ Sunscreen Slips, trips and falls Dust Masks Manual handling Other (specify): Exposure to noise Struck by moving plant Inhalation of dust or fumes Cuts Other (specify): How LIKELY is it to be that bad? Note: If a hazard is rated 1, 2 or 3, action must be taken immediately. What damage could it cause? VERY LIKELY Could happen anytime LIKELY Could happen sometimes UNLIKELY Could happen, but only rarely VERY UNLIKELY Could happen, but probably never will Death or permanent disability 1 11 1 11 2 22 3 33 Long term illness or serious 1 11 2 22 3 33 4 44

d Likelihood of Damage How to complete the following form 1. List the step-by-step sequence of tasks required to carry out the work activity from start to finish. 2. Listing of potential hazards associated with each step, and the related OHS risks. 3. Using the risk table, rating the identified risks. 4. List what controls you will implement to reduce the risks to the lowest possible level. 5. Rate the level of risk once those controls have been injury Medical attention or several days off work 2 22 3 33 4 44 5 55 Health Risks anFirst Aid needed 3 33 4 44 5 55 6 66 implemented (must be 4-6 before you can start work). 6. List the names or positions of the persons responsible for ensuring the controls are implemented. Safe Work Method Statement (SWMS) Page 2 of 9

STEP Job Step Beak the job down into steps. List the steps in this column. Hazard Identification Identify any potential hazards associated with each step and any related risks. Detail the hazards and risks in this column, and enter the risk rating in the next column. Initial RiskRating (1-6) Controls Implemented Decide what controls to use to eliminate or minimise the risks. Detail the controls in this column, and enter the revised risk rating in the next column. Note: If the risk rating is still 1-3, do not begin work. Revised RiskRating (1-6) Person Responsible 1. Arrival at site Hit by another vehicle or on site plant Report to site office for site induction before starting work or entry to site Entry to unsafe areas Site Induction for ALL employees Park in specified areas Risk assessment of job site and work area 2. Unloading of vehicle Back strain Slips and trips Training in manual handling Team lifting Unload vehicle in clear level area 3. Site entry and setting up of equipment Falls in open trenches Determine clear access Injuries from climbing through scaffold to enter site Clear egress to be maintained to job sites Trips and slips over waste materials Avoid difficult terrain Team lifting to carry equipment Ensure site is clear of waste materials Safe Work Method Statement (SWMS) Page 3 of 9

STEP Job Step Beak the job down into steps. List the steps in this column. Hazard Identification Identify any potential hazards associated with each step and any related risks. Detail the hazards and risks in this column, and enter the risk rating in the next column. Initial RiskRating (1-6) Controls Implemented Decide what controls to use to eliminate or minimise the risks. Detail the controls in this column, and enter the revised risk rating in the next column. Note: If the risk rating is still 1-3, do not begin work. Revised RiskRating (1-6) Person Responsible Site entry and setting up of equipment (Continued) Hit by passing traffic Keep a good lookout, training PPE equipment and wear a safety vest Electrocution form overhead wire Check position of wires. Use timber ladders in these areas manual handling injuries Training in manual handling wear a hard Hit by falling materials Training in use of PPE equipment hat at all times while on site Slipping on wet areas Additional care taken when working in wet areas Drop damage to feet Wear steel cap boots Tripping over extension leads Training in set up of lead stands Fall from ladders accessing job site Training in the set up of portable ladders 4. Installation of Conduits to slabs Trip on steel Care taken when walking on steel Cuts and abrasions when feeding conduits Training in the use of PPE, wear gloves Sunburn Wear hats, use sunscreen and skin protection clothing Safe Work Method Statement (SWMS) Page 4 of 9

STEP Job Step Beak the job down into steps. List the steps in this column. Hazard Identification Identify any potential hazards associated with each step and any related risks. Detail the hazards and risks in this column, and enter the risk rating in the next column. Initial RiskRating (1-6) Controls Implemented Decide what controls to use to eliminate or minimise the risks. Detail the controls in this column, and enter the revised risk rating in the next column. Note: If the risk rating is still 1-3, do not begin work. Revised RiskRating (1-6) Person Responsible Vapour inhalation from conduct Use in a well ventilated area. Avoid eye/mouth contact. Avoid sources of ignition. Training in the use of MSDS hazardous substances 5. Setting out pre wire Back strain Splinters from timber walls Strain to arm, wrist, shoulder or hand when installing wall plates Eye & hearing damage Back strain from generator placement Electrocution from drilling and cutting timber Falling from ladders Bend knees, loosen up exercise training in manual handling Care taken when marking out, Training in the use of PPE such as gloves Use hammer steadily as per manufacturers recommended procedure Training in the use of PPE equipment such as safety glasses & ear protection Training in basic lifting & carrying / manual handling run generator when required Training in the use of power tools & running of leads. Ensure equipment is free from damage. Electrical test, tag and register of all power tools Training in the set up of portable ladders Safe Work Method Statement (SWMS) Page 5 of 9

STEP Job Step Beak the job down into steps. List the steps in this column. Hazard Identification Identify any potential hazards associated with each step and any related risks. Detail the hazards and risks in this column, and enter the risk rating in the next column. Initial RiskRating (1-6) Controls Implemented Decide what controls to use to eliminate or minimise the risks. Detail the controls in this column, and enter the revised risk rating in the next column. Note: If the risk rating is still 1-3, do not begin work. Revised RiskRating (1-6) Person Responsible 6. Run in cables Back and shoulder strain when carrying cable Slips Trips & falls Cuts, crush damage to hands & eye damage Bend at knees, do not lift more than 20kgs & use a cable roller system. Training in manual handling. Ensure work area is clear and tidy of waste materials Training in the use of PPE equipment where required 7. Install Earth Stake Slips, trips and falls Muscle strain from hammering in stake Eye damage when using spray can Ensure work area is clear of debris. Use hammer as per manufacturers recommendation Wear eye protection. Training in the use of MSDS hazardous substances 8. Install Meter Box Back strain from lifting box and pulling cables Eye, hand damage when drilling Drop box on feet Electrocution Damage to hearing Sunburn Irritation from use of silicon Training in manual handling & team lifting, use cable roller system glasses, gloves Wear PPE equipment Wear safety boots Electrical tag, test and register Wear ear protection Wear hats, use sunscreen and skin protection clothing Training in the use of MSDS hazardous

substances avoid direct contact with skin 9. Tape Brackets. Clean site Cuts Dust from sweeping up Use PPE when required gloves & dust mask Safe Work Method Statement (SWMS) Page 6 of 9

STEP Job Step Beak the job down into steps. List the steps in this column. Hazard Identification Identify any potential hazards associated with each step and any related risks. Detail the hazards and risks in this column, and enter the risk rating in the next column. Initial RiskRating (1-6) Controls Implemented Decide what controls to use to eliminate or minimise the risks. Detail the controls in this column, and enter the revised risk rating in the next column. Note: If the risk rating is still 1-3, do not begin work. Revised RiskRating (1-6) Person Responsible 10. Fit Out Cuts, eye damage when cutting out gyprock Use eye protection if cutting out above eye level or when required. Extreme care in using pliers. Use in accordance with manufacturer s recommendation. Ensure work area is clear of materials & waste. Ensure clear access. Training in the use of portable ladders 11. Fit Out (continued) Cuts, strains when twisting cable, securing cable Use screwdrivers & battery drill in accordance with manufacturer s recommendation. Training in manual handling and the use of PPE equipment 12. Install meter panel Electrocution Gas inhalation / burns Trips and falls Ensure cables are dead. Use of PPE equipment training in MSDS use and training in manual handling 13. THESE ARE STANDARD SWMS, THEY MUST BE MODIFIED TO SUIT YOUR WORKERS, YOUR EQUIPM ENT AND YOUR SITE. Safe Work Method Statement (SWMS) Page 7 of 9

CHECKLIST OF ITEMS THAT MAY BE REQUIRED FOR THIS WORK ACTIVITY QUALIFICATIONS TRAINING CODES OF PRACTICE OR AS/NZS STANDARDS TO BE COMPLIED WITH Codes of Practice OHS Consultation OHS Induction Training for Construction Amenities for Construction Work Electrical Practices for Construction Work Safe Work Method Statement (SWMS) Page 8 of 9

Declaration by contractors & workers: 1. I have been consulted and assited in the development of this SWMS. 2. I have been given the opportunity to comment on the content of this SWMS. 3. I have read and understand how I am to carry out the activities listed in s SWMS. 4. I have been supplied with the personal protective equipment identified on s SWMS and I have been given training in the safe use of this equipment. 5. I have read and understand the requirements set out in the mateial safety a sheets for the hazardous substances identified in this SWMS. Declaration by contractors & workers: 1. I have been consulted and assited in the development of this SWMS. 2. I have been given the opportunity to comment on the content of this SWMS. 3. I have read and understand how I am to carry out the activities listed in s SWMS. 4. I have been supplied with the personal protective equipment identified on s SWMS and I have been given training in the safe use of this equipment. 5. I have read and understand the requirements set out in the mateial safety a sheets for the hazardous substances identified in this SWMS. NAME: SIGNATURE: DATE: Safe Work Method Statement (SWMS) Page 9 of 9

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