1. SHEWMS DETAILS. Project No. Valid From

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1 Name of Project Name / Description of Work Activity being undertaken Location at which Activity is being undertaken Name of SHEWMS Owner (Contractor) SHEWMS Owner Business Address Name of person who prepared SHEWMS Name of Activity Supervisor General Crane Operations Legislation / Codes of Practice / Standards / Safety Essentials / Standard Work instructions consulted or applicable to the activity Legislation Occupational Safety and Health Act 1984 Occupational Safety and Health Regulations 1996 Codes of Practice Code of Practice, Prevention of falls at workplaces Standards AS/NZS , 2, 3, 4, 5 & 6 1. General Requirements, 2. Couplers and accessories, 3. Prefabricated and tube and coupler scaffolding, 4. Suspended scaffolding, 5. Prefabricated splitheads and trestles, 6. Metal tube and coupler scaffolding. AS/NZS 4576 Guidelines for scaffolding AS 1577 Scaffold Planks AS/NZS Industrial fall-arrest systems and devices Harnesses and ancillary equipment Safety Essentials CSE2 1. SHEWMS DETAILS Project No 2. SUPPORTING INFORMATION Permits To Work and other specific permits and control documents required for the activity Confined Space Entry Energy Isolation Utility / Asset Owner Authorisation Road Occupancy Licence Excavation & Penetration Explosives Heavy Lift High Voltage Access Hot Work Applicable Construction Method Statement No SHEWMS No / Rev. No. Contractor SHEWMS No. / Rev. No. Contractor ABN No Valid From Valid To (maximum duration allowed is 3 months) Supervisor s Contact No What is the monitoring frequency for this activity (Task Observation)? Daily Weekly Monthly Penetration / Void Pressure Testing Radiation Control Sanction to Test Work at Height / Use of Harness Workbox Working In the Vicinity of Overhead Powerlines Other (including Environmental) list items here: Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 1 of 14

2 2. SUPPORTING INFORMATION (contd.) Plant and Equipment required for the activity e.g. excavator, scaffold (include inspection and maintenance requirements) Crane is already onsite, inspected and site approved - 100T Liebherr All Terrain Crane - 95T Liebherr All Terrain Crane - 25T Terex Franna MAC25 Crane - 70T Tadano Rough Terrain Crane - 200T Liebherr All Terrain Crane, Rigging equipment to have current inspection and test tags attached - Chains - Slings - Shackles - Chain blocks Competencies, Licences and/or Qualifications required to operate plant or required to undertake the Activity Construction white / blue card Driver Licences HR WL (CN, C1, CO, DG, RB, R1, RA etc) VOC s 2 way radios EWP (Cherry Picker) is already onsite, inspected and site approved Materials required to undertake activity e.g. geofabric, hazardous chemicals (where a hazardous chemical is required, attach the applicable Safety Data Sheet (SDS) to this SHEWMS) N/A SDS attached What are the specific Emergency Response Preparedness requirements for this activity e.g. arrangements for trench rescue or rescue of a worker suspended from height? Follow Project Emergency Procedure Turn off any running plant if it is safe to do so If conditions are unsafe, follow task step 8, emergency response Raise emergency on Channel 28 Administer first aid if it is safe to do so and you are qualified Report to your Supervisor Call 000 or 112 if required Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 2 of 14

3 3. PERSONS CONSULTED IN DEVELOPMENT OF SHEWMS Name Company Position Signature 4. SHEWMS REVIEW Position Name / Position Signature Date Authorised Engineer Area Supervisor Project Safety & Health Team Project Environment Team 5. SHEWMS APPROVAL / ACCEPTANCE Position Name / Position Signature Date Contractor Approval Project Director / Manager (or authorised delegate) Approval / Acceptance Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 3 of 14

4 Task No: 1 Prepare work area and task 6. WORK METHODOLOGY Detail steps of work methodology 2 Set up crane 3 Maintenance with EWP (top oil, water, check and a line winch drums) 4 Rigging the load 5 Lifting the load 6 Loading and unloading on or near roadways 7 Pack up area and demob Crane load charts - Load calculation 7. DIAGRAMS / SKETCHES Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 4 of 14

5 Task Nos. control applies to 1 Hazard what can harm you or the environment? Area not safe for lifting operations uneven / unstable ground Poor housekeeping 8. HAZARD CONTROLS * C = CONSEQUENCE (Impact), P = PROBABILITY (Likelihood), R = RISK Applicable Safety Essential N/A Current Control Measures (existing industry standards in operation within and / or operating controls) Engineering Flat level hardstand to be prepared suitable for crane Assess site for safe operations Prestart to inform personnel of crane lifts, housekeeping to kept at a high standard, take 5, read and sign SHEWMS All Personnel conducting task to have undertaken mandatory inductions, attend and sign prestart All mandatory and appropriate as per project requirements. Safety boots, hard hat, safety gloves, long sleeve hi vis shirt, safety glasses and long pants. Note gloves shall be worn for all manual handling activities and carried on personnel at all times. Crane defects N/A Ensure plant is suitable for the task. Prestart machine inspection, daily inspection checklist. Ensure that all faults are reported immediately. Should faulty equipment be found, place tag on equipment and notify site manager/supervisor Working outdoors sunburn, eye damage from UV rays, high temperatures, dehydration, heat stress N/A All mandatory and appropriate as per project requirements Drink plenty of water, work in shade where possible, and take rest breaks, job rotation where necessary, report symptoms of dehydration to supervisor keep an eye on your work mates for signs of dehydration. Current Rating* (Initial Rating) C P R Is there an Above the Line control? Y / N Person Responsible for Implementing Control N Supervisor N Supervisor Operator N Supervisor And all workers Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 5 of 14

6 2 Faulty operating equipment i.e. computer Possible underground conditions not suitable for crane operations High wind speed Vehicle movements interaction/obstructions of other activities on site. Lack of spotter, Sunscreen, long pants, long sleeves, safety glasses at all times full brim on hard hat if required. 5 Engineering Regular calibration tests of crane with test weights offsite Prestart machine inspection daily inspection checklist; ensure that any faults are reported immediately. Should faulty equipment be found place tag on equipment and notify site supervisor. Regular cranage and plant risk assessment. All mandatory and appropriate as per project requirements. 7/5 Isolate Place barriers around any services that could be damaged by crane operations. Shoring plates to be placed on ground beneath crane for shallow services. Pre lift assessments of area to be carried out by supervisor. Rigger and operator lifting methodology to take into account to position crane and take into account no underground services underneath crane. Suitable parking to be used under outriggers. For all lifts over 75% and under 85% SWL a Geotech engineer engineer must undertake an inspection of ground conditions and approve the area as fir for lifting. If ground conditions are not suitable do not proceed. Operator and rigger to ensure crane remains level. Assess and monitor wind speeds and weather conditions prior and throughout lift (max wind speeds 12m/s or as per manufacturers specs. All mandatory and appropriate as per project requirements. 5 Isolate Sufficient exclusive zones to be established to ensure other personnel or equipment cannot enter the lift Y Supervisor Operator Riggers Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 6 of 14

7 3 4 unwanted personnel or vehicles and machinery in work area zone/immediate work area. (outriggers of crane to be inside the exclusion zone) All vehicles to be fitted with fire extinguisher. Current project vehicle movement plan in place. All vehicles and personnel to establish radio communications. All driving on site and road rules to be followed at all times. Spotters to be in place to control interface where required. Spotters to escort if mobile cranes are to move from one place to another. Only authorised personnel to be inside exclusion zone. Sufficient signage in place to inform all of exclusion zone. All mandatory and appropriate As per project requirements EWP Maintenance N/A Isolate Sufficient exclusion zones to be established to ensure other personnel or equipment cannot enter the drop zone/immediate work area. Engineering Flat level hardstand to be prepared for EWP use, tool lanyards and spill kits. Assess sire for safe EWP operations, access and egress, site approved and inspected, mandatory induction, VOCs for operator and spotter, spotter to control area, establish radio communications. All work crew to attend and sign prestart. All mandatory and appropriate as per project requirements. Safety boots, hard hat, safety glasses, long sleeve shirt, long pants, gloves, harness with 100% hook up. Incorrect rigging equipment, potential for dropped loads, loads not correctly slung, injury to personnel 4 Engineering All lifting points to be certified for use. Check all lifting slings before loads are slung and lifted. Correct rigging equipment to be used at all times. All rigging equipment to be tested and tagged prior to use. Rigging gear to be appropriately stored to prevent N Supervisor Operator Spotter Y Supervisor Operator Rigger Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 7 of 14

8 5 6 Unsafe operation of crane operator unable to see load properly. Uncontrolled/unexpected movement of load. Damage to equipment injury to personnel. Poor housekeeping manual handling injuries deterioration. Rigger to visually inspect all rigging equipment prior to use. Any damaged equipment is to be tagged out of service and replaced. Only licenced and VOC d riggers are to sling load. Correct manual handling techniques to be used. Participate in pre start stretches. Leighton broad what is not a routine lift form All mandatory and appropriate as per project requirements riggers to wear correct riggers gloves. 5 Eliminate No lifts greater than 80% if the cranes SWL are permitted. N/A Isolate Sufficient exclusion zones to be established to ensure other personnel or equipment cannot enter the lift zone/immediate work area. Outriggers of crane to be inside exclusion zone. Any lift greater than 75% of the SWL of the crane to be done only with a lift study in place signed by supervisor. Establish sufficient communication, verbal and visual (2 way radios in place) rigger has control of the area at all times during the lift, spotter to ensure other personnel do not enter the exclusion zone. Tag lines to be used at all times to control the loads. Rigger to ensure load to stay level during the lift. All mandatory and appropriate as per project requirements. Riggers to wear correct riggers gloves. Site to be maintained in a clean state. All loose items (paper, plastics, wood gluts) are to be placed in bins provided. All tools and rigging equipment used to be placed back in storage at the end of shift. Ensure all equipment is removed and packed up when task is complete. Area is to be made safe once task is complete Y Supervisor Operator Rigger Spotter Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 8 of 14

9 As per site requirements safety boots, hard hat, safety glasses gloves, long sleeve shirt and long pants. Note gloves shall be carried at all times and worn for all manual handling activities Step 1 Determine Consequence (Impact) Impact Band Negligible (1) Minor (2) Moderate (3) Major (4) Substantial (5) Health and Safety First Aid Treatment (Class 3) Medical Treatment (Class 2) Lost Time Injury (Class 2) Permanent Injury (Class 1) Fatal Incident (Class 1) Health and Safety Injury that requires no treatment or simple first aid Damage that temporarily inconvenienc es a person Damage that temporarily alters a person s future Damage that permanentl y alters a person s future (e.g. quadriplegi a, paraplegia, Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 9 of 14 Fatality

10 Step 2 Determine Probability (Likelihood) of event occurring Probability Band Almost Certain (5) Likely (4) Possible (3) Unlikely (2) Rare (1) Environment and Heritage Description Description Description Common / Frequent Occurrence Is known to occur or It has happened regularly Could occur or I ve heard of it happening Not likely to occur very often Conceivable but only in exceptional circumstances Can be expected to occur 75% - 99% Can quite commonly occur 50% - 75% May occasionally occur 25% - 50% May infrequently occur 10% - 25% May occur in exceptional circumstances 0% 10% More than 1 event per month More than 1 event per year 1 event per 1 to 10 years 1 event per 10 to 100 years Less than 1 event per 100 years Short term ecological damage 9. SHEWMS APPROVAL / ACCEPTANCE Limited but medium term ecological damage Major but recoverable ecological damage amputation ) Heavy ecological damage, costly restoration Step 3 For Risk Level combine Consequence with Probability Low (5) Moderate (10) Very High (18) Low (4) Moderate (9) Very High (17) Low (3) Moderate (8) High (13) Extreme (23) Very High (20) Very High (19) Permanent widespread ecological damage Extreme (25) Extreme (24) Very High (22) Low (2) Low (7) High (12) High (15) Very High (21) Low (1) Low (6) Moderate (11) High (14) High (16) In signing below I confirm that: I have read this SHEWMS and / or it has been explained to me. I clearly understand and have accepted its contents. I clearly understand that the controls in this SHEWMS must be applied as documented; otherwise work is to cease immediately. I have the required and current competencies and qualifications to undertake this activity. I have received training sufficient to enable me to undertake this activity. Name Employer (Subcontractor) Signature Date Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 10 of 14

11 9. SHEWMS WEEKLY REVIEW BY RESPONSIBLE SUPERVISOR In signing below I confirm that: I have reviewed this SHEWMS with workers on the job. All hazards and controls on this SHEWMS are still current and effective. All workers performing this activity have a clear understanding of the work methodology, associated hazards and agreed controls. Supervisor Name Employer (Subcontractor) Signature Date of Review Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 11 of 14

12 10. UNPLANNED CHANGE / DEVIATION FROM SHEWMS * C = CONSEQUENCE (Impact), P = PROBABILITY (Likelihood), R = RISK Adopt a risk based approach for any Unplanned Change/Deviation from SHEWMS: Refer to Risk Mitigation Table in Section 10a for further guidance. 1. Document all changes in this table. 2. Obtain approval from unplanned change / deviation from SHEWMS. 3. Implement the agreed controls. 4. Conduct a new Daily Task Pre-start briefing to advise all workers of the change/deviation and sign-on all work crew members. Current Rating* Applicable Current Control Measures Hazard what can harm you or the (Initial Safety (existing industry standards in operation within environment? Rating) Essential and / or operating controls) Task Nos. control applies to C P R Is there an Above the Line control? Y / N Person Responsible for Implementing Control Approval / Date Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 12 of 14

13 Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 13 of 14

14 10a. UNPLANNED CHANGE / DEVIATION FROM SHEWMS Unplanned change/deviation from SHEWMS may result from, but not be limited to: task observations; reassessment of an activity; introduction of additional hazards; change in method of work; incidents; consultation with the work crew; circumstances that arise where the SHEWMS cannot be applied as documented. CHANGE IN WORK METHODOLOGY OR REMOVAL OF ABOVE THE LINE CONTROLS Where an agreed ABOVE THE LINE control is removed or a NEW TASK (change in work methodology) is identified while undertaking a work activity/task, the Leading Hand/Work Crew must CEASE work immediately and refer the SHEWMS to the Authorised Supervisor/Engineer for reassessment, review and approval before re-starting. Risk Rating Low (1-7) Moderate (8-11) NEW OR UNIDENTIFIED HAZARDS Where hazards are identified in the work area that have not previously been identified, they will be treated as unplanned change and a deviation from the approved SHEWMS. A risk based approach must be used for any unplanned change/deviation from the approved SHEWMS and all changes must be documented in the Unplanned Change / Deviation from SHEWMS form. Minimal alterations to SHEWMS may be marked up on the original SHEWMS. Refer to Table below for Levels of Authority Level of Risk Mitigation Actions Authority Authorised Supervisor/ Engineer If additional hazard(s) are presented and the Target risk rating is LOW (1-7). The work activity/tasks may proceed provided all controls to manage the identified hazard(s) are implemented prior to re-starting work. If additional hazard(s) are presented and the Target risk rating is MODERATE (8-11). The work activity/tasks may proceed provided all controls to manage the identified hazards are implemented and documented in the Unplanned Change / Deviation from SHEWMS Section and the Work Crew is briefed by the Leading Hand prior to re-starting work. Authorised Supervisor/ Engineer High (12-16) Very High (17-22) If additional hazard(s) are presented and the Target risk rating is HIGH (12-16) the Leading Hand/Work Crew must refer the SHEWMS to Authorised Supervisor/Engineer for reassessment, review and acceptance/approval. The work activity/task may proceed provided all controls to manage the identified hazard(s) are implemented and documented in the Unplanned Change / Deviation from SHEWMS Section and the Work Crew is briefed on the revised SHEWMS by the Authorised Supervisor/Engineer prior to re-starting the work. If additional hazard(s) are presented and the Target risk rating is VERY HIGH (17-22), the Work Crew must cease work immediately and refer the SHEWMS to the Project Manager via their Supervisor for reassessment, review and approval. Work shall only re-start when all controls to manage the identified hazard(s) are implemented and documented. Approval / acceptance has been obtained in writing by the Project Manager. Work Crew must be briefed on the revised SHEWMS by the Authorised Supervisor/Engineer prior to re-starting work. Authorised Supervisor/ Engineer Project Manager Extreme (23-25) No work activities/tasks with a Target risk rating of Extreme (23-25) must be carried out under any circumstances on an Project. Where a work activity/task has been rated as an extreme risk it must be referred to General Manager and/or Operational Manager off project. Prior to any work starting, the risk must be reduced So Far As Is Reasonably Practicable (SFAIRP). Approval / acceptance in writing to proceed must be obtained from General Manager and/or Operational Manager prior to starting work. General Manager/ Operational Manager off project *NOTE: Project Manager (or, for Extreme risks, General Manager) must ensure all options have been researched to implement additional controls to reduce the level of 'Target' risk to a level SFAIRP prior to granting approval / acceptance. An Above the Line control must be in place for all risks rated High and above. Title: Safety Health & Environment Work Method Statement (SHEWMS) template Date Published: 26/03/2015 Page 14 of 14

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