The Sample Company Pty Ltd

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Diane Lamb
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Job Safety and Environmental Analysis (JSEA) / Safe Work Method Statement (SWMS) Part 1: Project and Task Identification Process Initiators of SWMSs are responsible for consulting the Project

1 Job Safety and Environmental Analysis (JSEA) / Safe Work Method Statement (SWMS) Part 1: Project and Task Identification Process Initiators of SWMSs are responsible for consulting the Project Supervisor, Quality WHS Manager or other persons directly in charge of the work and other personnel involved in the execution of the task (as appropriate) for input into the SWMS. Other persons may be consulted for technical advice or review of the SWMS to see that proposed measures are effective and workable. The task is to be broken up into steps. For each step, the safety hazards are identified. For each of the hazards identified, corrective action, precautions, equipment are identified to reduce the hazard. All involved in the task must review and sign this SWMS form. Client: TotalTrack Pty Ltd Site: Sydney warf, 1st st Sydney NSW 5035 Contact Name Job Title Phone Mobile FAX Scott LeBlanc Director scott@totaltrack.com.au SWMS Initiated By Sample Guy Date: SWMS No. 3 Rev: 0 Rev. Date: 8/10/2017 Supervisor Review Sample Guy Date: Work Locations/Areas: All Management Review Sample Guy Date: Description of Work to be Undertaken: Cleaning of floors Sunday, 8 October 2017 Page 1 of 8

2 First, identify and assess the risks, then decide the best way to control them by applying the Hierarchy of Control as follows: LEVEL CONTROL DEFINITION Level 1 Elimination Controlling the Hazard at source Level 2 Substitution Replacing one substance or Activity with a less hazardous one Isolation Separating the hazard from the person Engineering Installing Guards on machinery Level 3 Administration Personal Protective Equipment Implementing policies and procedures for safe work practices Use of safety glasses, hardhats, protective clothing, etc. Hierarchy of Controls Eliminate the hazard Substitute the hazard Isolate the hazard Use engineering controls Use administrative controls E f f e c t i v e n e s s Use PPE Sunday, 8 October 2017 Page 2 of 8

3 Part 2: Worker Qualifications and Induction Record Personal Qualifications and Experience Required To Carry Out the Works: Certificate III in Cleaning Operations preferred or a shown competency in cleaning procedures and use of cleaning products Duties and Responsibilities of Personnel Completing the Task: Adherence to company's and the site's WH&S policies and procedures Maintain adequate house-keeping on site Reporting of any injuries / incidents to your Project Supervisor Operate safely and perform daily pre-shift inspections Formal or Specialised Training or Licenses Required to Complete Work or Operate Specific Plant or Equipment: Competency in the Safe Operating Procedure of the selected power tools SWMS Sign Off Your signature below indicates that you have been consulted in development of the SWMS and accept and will implement the requirements of the SWMS and control measures No. Name Classification Employed By Signature Date Sample Guy Cleaner Sunday, 8 October 2017 Page 3 of 8

4 Part 3: Hazard Analysis, Control and Legislation Worksheet Step No. Job Safety and Environmental Analysis (JSEA) Process Steps Potential Hazard(s) Hazard Control Measures New List the steps needed to do the job in the sequence to be done. Against each step list potential hazards that could cause injury when the job is done. Safe Work Method Statement (SWMS) For each hazard, identify control measures to eliminate or minimise the risk of injury. 1 Site Orientation/ Induction 1.1 Report to client s reception Entering restricted areas 19 Follow posted signs and go directly to reception 1.2 Undertake a site induction Unfamiliarity with emergency procedures 14 Listen and ensure you obtain information and site emergency and evacuation procedures Unawareness of site specific hazards 14 Listen and ensure you obtain information about any and all site hazards Unawareness of restricted areas 18 Listen and ensure you obtain information about any restricted areas Unawareness of other operations or hazardous activities being undertaken on site 9 Listen and ensure you obtain information about any other activities being undertaken on site 2 Vacuum the floors 2.1 Plug in vacuum Electrocution 25 Ensure appliance is functional, tested, tagged and current Check electrical lead for cracks, fraying or exposed wires Use RCD protection 2.2 Operate the vacuum Muscle strain 13 Do not over reach 3 Installer Personal Injury 20 Ensure that you have received training in safe use of the equipment 2.3 Turn off the vacuum Electrocution 25 Do not remove plug by jerking or tugging electrical leads 5 All 1 Driver 3 Inspection and use of Low-Speed Electric Floor Buffer 3.1 Collect machine from vehicle Muscle strain 13 Ensure correct manual handling procedures 3 Installer Ensure adequate personnel is utilised to distribute the load 3 All 3.2 Perform pre-operational inspection on the machine Faulty equipment machine failure 14 Do not operate unit that has faulty parts or 2 Operator equipment. If a problem is found, contact supervisor to initiate repairs of any damage or abnormalities Ensure Operating labels undamaged and legible Check all safety devices 3 Operator Action By Sunday, 8 October 2017 Page 4 of 8

5 Step No. Job Safety and Environmental Analysis (JSEA) Process Steps Potential Hazard(s) Hazard Control Measures New List the steps needed to do the job in the sequence to be done. Against each step list potential hazards that could cause injury when the job is done. Safe Work Method Statement (SWMS) For each hazard, identify control measures to eliminate or minimise the risk of injury. Only use buffing pads designed for use with the make and model of the machine 2 Operator 3.3 Start the machine Electrocution 25 Ensure all electrical tools and cables are functional, tested, tagged and current Use RCD protection Personal Injury 20 Ensure that you have received training in safe use of the equipment 1 Driver 3.4 Using the floor buffer Environmental -Noise/ disturbing the peace 13 Ensure regular maintenance is carried out Replace noisy machines 1 Manager Vibration 13 Vibration handle to be used 2 Operator Do not exceed the maximum hours of daily exposure as per the manufacturers recommendations Slippping on floor 13 Be mindful of wet floors 3 All Wear non-slip footwear 3 Operator Regularly remove slurry 2 Operator Environmental -Spills to water -stormwater 4 Collect waste water and slurry using a wet vacuum Containment socks to be in place at drain points Storm water entries to be sealed Personal Injury 20 Ensure that you have received training in safe use of the equipment Crushing 23 The machine must only be used and moved on level surfaces. There is a risk of crushing if the machine starts to roll. Do not bump into shelves or scaffoldings, especially where there is a risk of falling objects 3 Operator 1 Driver 2 Operator 4 Operator 3.5 Clean the machine Personal Injury 20 Ensure unit is unplugged before cleaning Action By Sunday, 8 October 2017 Page 5 of 8

6 Part 4: Hazard Analysis, Control and Legislation Worksheet - Site modifications, additions or alterations Step No. Job Safety and Environmental Analysis (JSEA) Process Steps Potential Hazard(s) Hazard Control Measures New List the steps needed to do the job in the sequence to be done. Against each step list potential hazards that could cause injury when the job is done. Safe Work Method Statement (SWMS) For each hazard, identify control measures to eliminate or minimise the risk of injury. Action By Sunday, 8 October 2017 Page 6 of 8

7 Reference and Detail Applicable Sections of: Legislation Codes Of Practice Project WHS Site WHS Manufacturer Or Supplier Recommendations Work Health and Safety Regulations 2011 under the Work Health and Safety Act 2011 Hazardous Manual Tasks Code of Practice Managing Electrical s in the Workplace Code of Practice Plant and Equipment to be used for task: Vacuum Low-Speed Electric Floor Buffer Plant, Equipment and Area Safety Inspections: Electrical appliances to be tested and tagged and current Electrical tools to be tested and tagged and current Power Tools Pre Operational Checks Sunday, 8 October 2017 Page 7 of 8

PPE Requirements for Task: Eye and Hearing Protectiopn

GREEN BLUE - June to August - March to May - September to

LTI - Lost Time Injury PPE - Personal Protection Equipment

8 PPE Requirements for Task: Eye and Hearing Protectiopn ELECTRICAL TAGGING COLOURS: RED - December to February GREEN BLUE - June to August - March to May - September to November Gloves Safety Boots Acronyms and Abbreviations: LTI - Lost Time Injury PPE - Personal Protection Equipment PTD - Permanent and Total Disability Sunday, 8 October 2017 Page 8 of 8

Job Safety and Environmental Analysis (JSEA)/Safe Work Method Statement (SWMS)

Job Safety and Environmental Analysis (JSEA)/Safe Work Method Statement (SWMS) Part 1: Project and Task Identification Process: Initiators of JSEAs are responsible for consulting the Project Supervisor,