Simtars Workplace Health and Safety

Safe Work Method Statement (SWMS) **insert job / project name here**
All work undertaken at the Simtars’ Redbank or Mackay facility must be performed in accordance with your organisation’s Safe Work Method Statement
(SWMS). This template is provided if you do not currently have an organisational SWMS. This SWMS must be kept and be available for inspection until the work
to which this SWMS relates to, is completed. If the SWMS is revised, all versions should be kept. If a notifiable incident occurs in relation to the work in this
SWMS, the SWMS must be kept for at least two years from the date of the notifiable incident.

Simtars’ contact person: Contractor’s name:

Simtars’ contact number: Contractor’s contact number:

Date this SWMS was provided to Location where work is to be

Simtars: performed at Simtars:
Description of work to be
undertaken:

Please tick all that are applicable or identify other hazards that might apply:
☐Y Risk of a person falling more than two ☐Y Temporary load-bearing support for ☐Y Demolition of load-bearing structure
☐N metres ☐N structural alterations or repairs ☐N

☐Y Work in or near a shaft or trench deeper ☐Y Work in or near a confined space ☐Y Work on or near pressurised gas cylinders
☐N than 1.5 m or a tunnel ☐N ☐N or lines

☐Y Work on or near chemical, fuel or ☐Y Work on or near energised electrical ☐Y Work in an area that may have
☐N refrigerant lines ☐N installations or services ☐N contaminated or flammable atmosphere

☐Y Does any equipment or machinery require ☐Y Exposure to mobile plant or vehicles ☐Y Work in an area with movement of
☐N electrical or mechanical isolation? ☐N ☐N powered mobile plant

☐Y Work in areas with artificial extremes of ☐Y Work in or near water or other liquid that ☐Y Work outside of the hours of 6am – 6pm
☐N temperature ☐N involves risk of drowning, e.g. tanks ☐N

☐Y Hot work (welding, grinding, cutting) ☐Y Vibration (whole body, hand, arm etc) ☐Y Excessive noise
☐N ☐N ☐N

☐Y Dust generation ☐Y Machinery or entrapment sources ☐Y Does the work or equipment to be used
☐N ☐N ☐N require a specific licence (Provide detail in
the table below)?

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 Simtars Workplace Health and Safety
☐Y Are any dangerous goods or hazardous ☐Y Radiation (UV, welding flash, ionising) ☐Y Potential exposure to pollutants, toxic
☐N substances being used? ☐N ☐N gases or vapours

☐Y Power tools / explosive tools ☐Y Compressed gas or air / hydraulic ☐Y Manual Handling / lifting
☐N ☐N equipment ☐N

☐Y Repetitive movement ☐Y Environmental hazards, e.g. snakes ☐Y Has electrical equipment been tested and
☐N ☐N ☐N tagged (i.e. is it current)

☐Y Other (specify) ☐Y Other (specify) ☐Y Other (specify)

☐N ☐N ☐N

What are the tasks involved? What are the hazards and risks? What are the control measures? Risk rating?
Refer to the tasks identified and ticked Identify the hazards and risks associated with Describe what will be done to control the risk. Refer to the risk matrix
‘Y’ in the table above. List these work the tasks identified ’Y’ in the table above and What will you do to make the activity as safe in the Analysis of Risk
tasks in a logical order. that may cause harm to workers or the as possible? Consider the Hierarchy of pages below and rate
public. Control – see diagram in Analysis of Risk the risks Low, Medium
pages below. or High

☐ Low
Overall Risk Rating for this work: ☐ Medium
☐ High

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 Simtars Workplace Health and Safety
SWMS sign off by workers: This SWMS has been developed is consultation and cooperation with workers and relevant organisation representatives. I have read the
above SWMS, and I understand its content. I confirm that I have the skills and training, including relevant certification, to conduct the tasks described. I agree to comply
with safety requirements within this SWMS, including risk control measures, safe work instructions and PPE described.
Relevant license details
Worker/s
Name of worker/s Date
Type Class Number Expiry date signature

Name of contractor
responsible for ensuring
Signature: Date:
compliance of workers
with this SWMS:
Name of Simtars’ person Approved:
Simtars approver’s
approving the use of this ☐ Yes Date:
signature:
SWMS: ☐ No

If not approved, please

provide the reasons:

Notes:

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 Simtars Workplace Health and Safety
ANALYSIS OF RISK

RISK LEVEL DESCRIPTORS

RISK LEVEL VALUES

Likelihood
Risk Level Rating
Rare Unlikely Possible Likely Almost certain

Catastrophic Medium High High High High

Major Medium Medium High High High

Severity

Moderate Low Medium Medium Medium High

Minor Low Low Low Medium Medium

Negligible Low Low Low Low Medium

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 Simtars Workplace Health and Safety
HIERARCHY OF CONTROLS

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