"Safe Work Method Statement Template"

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Safe Work Method Statement (SWMS)
ORGANISATION DETAILS
Principal Contractor:
Contact number:
Project Manager or Supervisor:
Contact number:
Other PCBU’s:
Contact number:
Person completing the SWMS:
Contact number:
Position:
Reviewed by:
Date prepared:
Review date:
PROJECT DETAILS
What is the scope of the work
Who else was consulted/involved
in preparing this SWMS?
What high risk work activities are
covered by this SWMS?
References: Legislation,
Australian Standards, Codes of
Practice, MSDS & SOP’s
Plant and equipment involved in
the scope of work
What “high risk” licence classes
will be required to do the work?
Safe Work Method Statement (SWMS)
ORGANISATION DETAILS
Principal Contractor:
Contact number:
Project Manager or Supervisor:
Contact number:
Other PCBU’s:
Contact number:
Person completing the SWMS:
Contact number:
Position:
Reviewed by:
Date prepared:
Review date:
PROJECT DETAILS
What is the scope of the work
Who else was consulted/involved
in preparing this SWMS?
What high risk work activities are
covered by this SWMS?
References: Legislation,
Australian Standards, Codes of
Practice, MSDS & SOP’s
Plant and equipment involved in
the scope of work
What “high risk” licence classes
will be required to do the work?
Identify each task in
Specify the hazards you
What are the risks to
Describe your control measures, list as many as
Who is responsible for
order
have identified.
health and safety?
possible.
Implementing and
monitoring the controls?
This SWMS has been developed in consultation and has been read, understood and signed by all workers undertaking the scope of works:
Print Names:
Signatures:
Dates: