PCBU: ALL TRADES ABSEILING ABN: 42 137 576 035 PO Box 774 NEWPORT NSW 2106 LIC: 123517C P: 0412 227 578 Principal Contractor (PC): Date SWMS provided to PC: Work activity: Workplace location: High risk construction work: (Check all that are applicable) Person responsible for ensuring compliance with SWMS: Person responsible for reviewing SWMS control measures: Risk of a person falling more than 2 metres. Temporary load-bearing support for structural alterations or repairs Work in an area with movement of powered mobile plant Work on a telecommunication tower Demolition of load-bearing structure Likely to involve disturbing asbestos Tilt-up or precast concrete elements Work in or near a confined space Work on or near energised electrical installations or services Work on or near chemical, fuel or refrigerant lines Work on, in or adjacent to a road, railway, shipping lane or other traffic corridor in use by traffic other than pedestrians Work in or near a shaft or trench deeper than 1.5 m or a tunnel Work in an area that may have a contaminated or flammable atmosphere Date SWMS received: Date SWMS received by reviewer: Work on or near pressurised gas mains or piping Work in or near water or other liquid that involves a risk of drowning What measures are in place to ensure compliance with the SWMS? How will the SWMS control measures be reviewed? Review date: Reviewer s signature: Page 1
NOTE: Assessment based on: IRATA International code of practice for industrial rope access (ICOP 2013); AS/NZS 4488.1: Industrial rope access systems: Part 1: Specifications; AS 1891: Fall Arrest Systems; AS/NZS 4488.2: Industrial rope access systems, Part 2: Selection, use and maintenance; WHS legislation and safe work practices. ROPE ACCESS CHECKLIST (Select all applicable) WORKERS EQUIPMENT LIST (Select all applicable) GEAR CHECKLIST OTHER ITEM CHECKLIST Abseiling equipment including: Setup access equipment in accordance with the Australian Standard AS/NZS 4488.1 for workers to access the structure to carry out rope access maintenance works. Barricades/signage to be erected in areas where the safety of any workers and/or the public could be impacted. Full Body harness securely fastened with a single rope descender (i.e. PETZL I D) Back-up descending device (i.e. PETZL Grigri) Knife (in preparation for rescue at all times) Worker(s) to be attached at two independent points of attachment to a secured anchor rated to 120kg SWL. Building management notified of worker(s) abseiling on building externals. Notification made to the public as applicable. Appropriate P.P.E for the given task at hand (i.e. gloves, ear protection, eye protection) Worker(s) to be suspended with Kernmantle rope, an industrial twin core rope with a protective sheath (two parts to fail in case of abrasion). All personnel to be supervised by other Level II abseiler at all times. (Buddy spotting system) Safety helmet worn and secured when abseiling All equipment to be checked on site before each decent, and to be attached to the one working. All tools as well as any other loose items to be attached to a rated safety lanyard to prevent falling objects. 2 way radio and/or mobile phone securely attached Safety fall arrest shock absorbing rope grab device to be attached to the backup safety line in case of gear failure to prevent further shock load in case of a fall. Rope protectors to be laid over any edges that ropes may come into contact with. Both ropes must extend all the way to the ground or to a safe landing area at all times and noted down. Page 2
RISK ASSESSMENT Applicable (Tick) Activity / Hazard Associated Risks Pre-controlled Risk Assessment Controls Break the job down into steps that involve any potential hazards Identify the risks associated with each step. Examine each to find Possibilities that could lead to an accident or adverse environmental impact Likelihood* Consequence* Risk Class* What actions are necessary to eliminate or minimize the hazards that could lead to an accident, injury or occupational illness. Post Controls Risk Assessment Risk Class* Remaining Action List any of the reactive control measures that will be implemented in the event of an accident / incident (i.e. Emergency response procedures,). 1. ARRIVAL AT SITE/SITE INDUCTION OVERHEAD OBJECTS / POSSIBLE MOD HIGH P.P.E, BEING HELMET, GLOVES, EYES, EARS AND SKIN PROTECTION IMPLEMENTED SITE EMERGENCY UNLIKELY MOD KNOWLEDGE OF SITE EVACUATION PROCEDURES REVIEW AND DOCUMENT 2. MOVE EQUIPMENT TO WORK AREA OVERHEAD OBJECTS / UNLIKELY MOD AS PER ITEM 1. ENSURE THE EQUIPMENT IS STORED IN A SAFE AND MANAGABLE AREA. ENSURE SAFE MANUAL HANDLING AT ALL TIMES REPORT AND DOCUMENT ANY INJURIES. CEASE WORK IMIATELY IF INJURED. DOCTOR REFERRAL INJURY FROM LIFTING POSSIBLE MOD HIGH 2 PERSONS TO LIFT ANYTHING ABOUVE 20 KG AS PER ATA HOUSE RULES 3. SETTING UP OF WORK AREA AT GROUND LEVEL (BARRICADES AND CLEAR SIGNAGE BE WORK AREA) OVERHEAD OBJECTS / UNLIKELY MOD AS FOR ITEM 1. INSPECT PATHS OF TRAVEL FOR BUMP AND TRIP HAZARDS REPORT AND DOCUMENT ANY INJURIES. CEASE WORK IMIATELY IF INJURED. DOCTOR REFERRAL INJURY FROM LIFTING POSSIBLE MOD HIGH 2 PERSONS TO LIFT ANYTHING ABOUVE 20 KG AS PER ATA HOUSE RULES FALLING OBJECTS UNLIKELY MAJ HIGH AS FOR ITEM 1. EXCLUSION ZONE WITH BARRICADES AND SIGNAGE BE WORK AREA OBTAIN PERMISSIONS FOR PATHWAY BARRICADING SYSTEM 4. SETTING UP FOR RIGGING OF ROPES (USING CERTIFIED ANCHOR POINTS ON THE ROOF OR COUNTER WEIGHTS) OVERHEAD OBJECTS / UNLIKELY MOD AS FOR ITEM 1. INSPECT PATHS OF TRAVEL FOR BUMP AND TRIP HAZARDS REPORT AND DOCUMENT ANY INJURIES. CEASE WORK IMIATELY IF INJURED. DOCTOR REFERRAL INJURY FROM LIFTING POSSIBLE MOD HIGH 2 PERSONS TO LIFT ANYTHING ABOUVE 20 KG AS PER ATA HOUSE RULES FALL POTENTIAL POSSIBLE CAT EXTREME WORKER HARNESSED AND CONNECTED WITHIN 3 METRES OF ANY EDGE. ALL ROPES TO BE RIGGED IN ACCORDANCE WITH AS4488.1&2 AND IN ACCORDANCE WITH WHS ACT 2011 ENSURE ROOF WORKPLACE REMAINS TDY AND FREE FROM TRIP HAZARDS. ENSURE ANCHOR POINTS ARE TESTED EVERY 12 MONTHS. ONGOING TRAINING PROCEDURES THROUGH IRATA QUALIFICATION OR SIMILAR Page 3
Applicable (Tick) Activity / Hazard Associated Risks Pre-controlled Risk Assessment Controls Break the job down into steps that involve any potential hazards Identify the risks associated with each step. Examine each to find Possibilities that could lead to an accident or adverse environmental impact Likelihood* Consequence* Risk Class* What actions are necessary to eliminate or minimize the hazards that could lead to an accident, injury or occupational illness. Post Controls Risk Assessment Risk Class* Remaining Action List any of the reactive control measures that will be implemented in the event of an accident / incident (i.e. Emergency response procedures,). 5. ENTER ROPE SYSTEM FALL POTENTIAL UNLIKELY CAT EXTREME WORKERS TO CONNECT TO ROPES IN ACCORDANCE WITH AS4488.1&2 AND SUITABLE FUL BODY HARNESS AND HELETS TO BE WORN. ALL WORK IN ACCORDANCE WITH WHS ACT 2011 COMMUNICATION BETWEEN WORKERS TO ENSURE CLEAR AND SAFE WORK. EACH WORKER TO REVIEW THE OTHERS ROPE SYSTEM BEFORE DESCENSION DROPPING EQUIPMENT POSSIBLE MAJ VERY HIGH ALL TOOLS TO BE CONNECTED TO THE WORKER WITH A DAMAGE TO FACADE POSSIBLE MAJ VERY HIGH EXTREME CARE WHEN ENTERING SYSTEM AND DESCENDING TO ENSURE NO DAMAGE OCCURS TO FAÇADE COMMUNICATION BETWEEN WORKERS TO ENSURE CLEAR AND SAFE WORK 6. DESCENDING FAÇADE BEFORE COMMENCING ANY MAINTENACE WORK (ABSEILING PROCEDURE) SCRAPES, GRAZES OR HAND BURN FROM ROPE FRICTION POSSIBLE MOD HIGH AS FOR ITEM 1 DISTURBANCE OF LOOSE MATERIAL POSSIBLE MAJ VERY HIGH INSPECT FAÇADE TO SEE THE CONDITION OF LOOSE MATERIALS DURING ABSEILING. DESCEND AT A CONTROLLED PACE DURING DESCENSION INSPECT EITHER SIDE OF DROP FOR POTENTIAL HAZARDS DURING THE NEXT DROP 7. COMMENCE WORK : ROPE ACCESS CLEAN WINDOWS WITH MOP AND SQUEEGEE AND WIPE DOWN FRAMES WITH RAGS MINOR SITE RELATED HAZARDS, BEING OPEN GLASS PANELS / SHARP EDGES / FALLS POSSIBLE MOD HIGH AS FOR ITEM 1 DROP TOOLS POSSIBLE MAJ VERY HIGH ALL TOOLS TO BE CONNECTED TO THE WORKER WITH A ONGOING TRAINING PROCEDURES THROUGH IRATA QUALIFICATION OR SIMILAR FALL POTENTIAL UNLIKELY CAT EXTREME ENSURE ROPES ARE NOT GOING TO BE CUT, SNAGGED OR DAMAGED IN ANY WAY, USE ROPE PROTECTERS WHERE NEEDED. ALL PERSONELL MUST BE TRAINED IN ROPE ACCESS RESCUE PROCEDURES. HAVE AN EXIT STRATERGY IN CASE OF EMERGENCY ONGOING TRAINING IN RESCUE PROCEDURES THROUGH IRATA QUALIFICATION AND/OR SIMILAR. DOCUMENT ANY NEAR MISSES Page 4
Applicable (Tick) Activity / Hazard Associated Risks Pre-controlled Risk Assessment Controls Break the job down into steps that involve any potential hazards Identify the risks associated with each step. Examine each to find Possibilities that could lead to an accident or adverse environmental impact Likelihood* Consequence* Risk Class* What actions are necessary to eliminate or minimize the hazards that could lead to an accident, injury or occupational illness. Post Controls Risk Assessment Risk Class* Remaining Action List any of the reactive control measures that will be implemented in the event of an accident / incident (i.e. Emergency response procedures,). 8. COMMENCE WORK: ANY ROPE ACCESS MAINTENACE WORK INVOLVING THE USE OF NON- POWERED TOOLS MINOR SITE RELATED HAZARDS, BEING OPEN GLASS PANELS / SHARP EDGES / FALLS CUTS FROM BLADES AND CHIZELS ETC POSSIBLE MOD HIGH AS FOR ITEM 1. WORKERS TRAINED IN THE USE OF SPECIFIC HAND TOOLS DROP TOOLS POSSIBLE MAJ VERY HIGH ALL TOOLS TO BE CONNECTED TO THE WORKER WITH A ONGOING TRAINING PROCEDURES THROUGH IRATA QUALIFICATION OR SIMILAR FALL POTENTIAL UNLIKELY CAT EXTREME ENSURE ROPES ARE NOT GOING TO BE CUT, SNAGGED OR DAMAGED IN ANY WAY, USE ROPE PROTECTERS WHERE NEEDED. ALL PERSONELL MUST BE TRAINED IN ROPE ACCESS RESCUE PROCEDURES. HAVE AN EXIT STRATERGY IN CASE OF EMERGENCY ONGOING TRAINING IN RESCUE PROCEDURES THROUGH IRATA QUALIFICATION AND/OR SIMILAR. DOCUMENT ANY NEAR MISSES 9. COMMENCE WORK: ANY MAINTENACE WORK INVOLVING THE USE OF POWERED TOOLS MINOR SITE RELATED HAZARDS, BEING OPEN GLASS PANELS / SHARP EDGES / FALLS POSSIBLE MOD HIGH AS FOR ITEM 1. WORKERS TRAINED IN THE USE OF SPECIFIC HAND TOOLS DROP TOOLS POSSIBLE MAJ VERY HIGH ALL TOOLS TO BE CONNECTED TO THE WORKER WITH A ONGOING TRAINING PROCEDURES THROUGH IRATA QUALIFICATION OR SIMILAR FALL POTENTIAL UNLIKELY CAT EXTREME ENSURE ROPES ARE NOT GOING TO BE CUT, SNAGGED OR DAMAGED IN ANY WAY, USE ROPE PROTECTERS WHERE NEEDED. ALL PERSONELL MUST BE TRAINED IN ROPE ACCESS RESCUE PROCEDURES. HAVE AN EXIT STRATERGY IN CASE OF EMERGENCY ONGOING TRAINING IN RESCUE PROCEDURES THROUGH IRATA QUALIFICATION AND/OR SIMILAR. DOCUMENT ANY NEAR MISSES ELECTRICUTION POSSIBLE MAJ VERY HIGH ANY POWER TOOLS TESTED AND TAGGED. USE SURGE PROTECTED POWER BOX WHEN CONNECTING ANY ELECTRICAL TOLS ONGOING TESTING AND TAGGING OF POWER TOOLS. REVIEW ALL POWER TOOLS TO ENSURE ALL DEVICES ARE SAFE. Page 5
RISK MATRIX As a priority, any Extreme, Very High or High risks identified need to be re-evaluated and addressed after additional control measures have been implemented to reduce any hazards. If the residual risk is still rated as Extreme or Very High then no work is permitted to proceed. PLEASE USE THIS MATRIX AS A GUIDE TO ASSESS THE RISK ASSESSMENT TABLE LIKELIHOOD CONSEQUENCE Almost certain Likely Possible Unlikely Rare Catastrophic (CAT) EXTREME EXTREME EXTREME VERY HIGH HIGH Major (MAJ) EXTREME EXTREME VERY HIGH HIGH IUM Moderate (MOD) VERY HIGH HIGH HIGH IUM Minor (MIN) IUM IUM IUM Insignificant (INS) IUM RISK CLASS LEGEND LIKELIHOOD EXTREME Extreme Risk: No work to proceed Almost Certain 75% - 100% Expected to occur in most circumstances VERY HIGH Very High Risk: No work to proceed Likely 60% - 75% Will probably occur in most circumstances HIGH High Risk: Additional task review required Possible 40% - 60% Might occur at some time in the future IUM Medium Risk: Manage by routine procedures Unlikely 20% - 40% Could occur but doubtful Low Risk: Manage by routine procedures Rare 0% - 20% May occur but only in exceptional circumstances Page 6
Catastrophic - The hazard has the potential to: Major - The hazard has the potential to: Moderate - The hazard has the potential to: Minor - The hazard has the potential to: Insignificant - The hazard has the potential to: CONSEQUENCE Permanently disable or kill Cause severe damage to the structure Have significant impact on the surrounding population and environment Temporarily disable or very serious injury Cause major damage to the structure Serious breach of the site boundary and pollution of the local environment Temporarily disable or serious injury Cause moderate damage to the structure Breach the site boundary and minor pollution to the local environment Moderate injury Cause minor damage to the structure Be contained within the site boundary Cause minor injury (first aid) Insignificant impact contained within the site boundary Name of Worker(s) (Check applicable workers) Worker(s) Title Worker Signature(s) Date SWMS received by workers: NOTE: Work must be performed in accordance with this Safe Work Method Statement (SWMS). This SWMS must be kept and be available for inspection until the high risk construction work to which this SWMS relates is completed. If the SWMS is revised, all versions should be kept. If a notifiable incident occurs in relation to the high risk construction work in this SWMS, the SWMS must be kept for at least 2 years from the date of the notifiable incident. Page 7