Workplace Address: Page 1 of PART 1: TASK DETAILS Client: JOB/TASK: Using Water blaster PART 2: RESOURCES Relevant Legislation/Codes Practice: Training Required: Equipment Used: Materials Used: Substances Used: PPE Required: WH&S Act 2011 & Regulations 2011, Environmental Protection Act and Regulations Site induction (as required), SWMS induction, Water blaster or similar/ Gun / hoses, compressor, vacuum cleaner, buffing machine, heat gun, air tools Water Petrol, cleaning agents High Vis tops, safety glasses, ear protection and masks as needed PART 3: SWMS PROCEDURES 1. The SWMS must be specific to the task to be undertaken including persons involved, equipment and materials. 2. The SWMS must comply with the (company) Safe Work Method Statement requirements. 3. All personnel involved in carrying out the work activity must be consulted in identifying the safety and environmental hazards and determining the appropriate work methods. 4. Ongoing monitoring and review of the effectiveness of the SWMS must be undertaken when any significant changes to the work process or sequence or as a result of an incident, regardless, reviews are to be undertaken at least annually.. A signed record of all persons inducted into this SWMS. 6. Review and determination of the risk rating is undertaken via the risk matrix, and the hierarchy of controls are used to determine the appropriate control measures to be used i.e. Elimination, Substitution, Isolation, Engineering Controls, Administration Controls & Personal Protective Equipment PART 4: PREPARATION, REVIEW AND APPROVAL SIGN OFF REV O Date: Nov./2012 Prepared: John Albury Reviewed: Approved: John Albury (First Issue) REV 1 Date: Prepared: (Sign) Reviewed: (Sign) Approved: (Sign) / / Description of Changes: REV 2 Date: / / Prepared: (Sign) Reviewed: (Sign) Approved: (Sign) Description of Changes:
Workplace Address: Page 2 of PART : PERSONS / OHS REPRESENTATIVES INVOLVED IN DEVELOPMENT OF SWMS Ref # Family Name First Name Job Description (Trade/Classification) Signature 02 03 04 0 PART 6: SAFETY AND ENVIRONMENTAL ANALYSIS AND DETERMINATION OF WORK METHODS Client:
Workplace Address: Page 3 of Step No Process Steps List the steps needed to do the job in the sequence to be done. Specify plant, equipment and materials to be used. Potential Hazard/s Against each step list potential hazards that could cause injury, health impacts and/or environmental harm. Risk Rating Hazard Control Measures For each hazard identify control measures to eliminate or control the risk of injury, health impacts and/or environmental harm. Identify licencing, training and competency requirements for work crew. Residual Risk Action by Person responsible for Monitoring and Reviewing effectiveness of controls 1 Arrive at site Slips, trips, and falls 2 Go directly to site office. Ensure site specific induction. Verify competency evidence and SWMS training sign off. 2 Performing general water Spray could get blown into eyes Shut down water blaster at handle before moving or walking blasting activities and onto other workers 2 Performing general water blasting activities Noise and personal injuries such as cuts, strains, sprains 2 Personnel are competent in operating water blaster. Keep hands away from water blaster nozzle when turned on. Ensure operator is wearing appropriate PPE (i.e. Ear plugs, eye protection, steel cap boots and deflective shield when necessary). 3 Moving water blaster pumping unit Manual Handling Personal injury, slips, trips, falls Strains 2 Use fellow worker to help relocate water blaster to the next working area. Use sound manual lifting and handling technique. Bend knees, not back, lift with your legs 4 Refuelling water blaster Personal injury, burns, scalds, 2 Preferably machine should be fuelled off site when cool. Shut off water blaster and let it sit for 2 mins. Refuel and replace lid. Put fuel container back where it belongs and at least 3 metres from any other motors or naked flames Wear gloves, safety glasses and protective clothing
Workplace Address: Page 4 of PART 7: RISK MATRIX/RISK SCORE ASSESSMENT LIKELIHOOD How likely is it that someone will get hurt? Kill or cause permanent disability CONSEQUENCES How severely could someone get hurt? Long term illness or serious injury Medical attention and several days off work First aid needed Very Likely 1 1 2 3 Likely Unlikely 1 2 3 4 2 3 4 Very Unlikely 3 4 6 1 High 2 Medium 3, 4, or 6 Low Do something about these risks immediately Do something about these risks as soon as possible These risks may not need immediate attention To obtain the level of risk score: Cross reference the Likelihood & Consequence - The higher the risks score the greater priority to control the hazard. Prioritising Hazards Risk Description Action HIGH - A HIGH risk requires immediate action to control the hazard as detailed in the hierarchy of control. Actions taken must be documented on the risk assessment form including date for completion. MEDIUM - A MEDIUM risk requires a planned approach to controlling the hazard and applies temporary measure if required. Actions taken must be documented on the risk assessment form including date for completion. LOW - A risk identified as LOW may be considered as acceptable and further reduction may not be necessary. However, if the risk can be resolved quickly and efficiently, control measures should be implemented and recorded.
Workplace Address: Page of Name of Person/s Supervising Works: Print Name: Signature: Date: Print Name: Signature: Date: PART 8: RECORD OF CONSULTATION AND INDUCTION INTO SAFE WORK METHOD STATEMENT I am fully aware of, understand and agree to abide by my obligations under the Work Health and Safety Act 2011 and Environmental Protection Act. As an employee and /or worker, I understand and agree to follow the procedures in the attached Safe Work Method Statement. As a PCBU, Subcontractor and/or ABN holder, I understand and agree to fully adopt and follow the procedures in the attached SWMS. Ref # Family Name First Name Job Description (Trade/Classification) Signature Date of Induction Induction Verified By 01 02 03 04 0 Monitoring & Review of SWMS Use and Effectiveness Observation Log 01 02 03 04 0 06 Initial: Date: