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Construction Method Statement Template

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Construction Method Statement Template

Inspection

Take or Attach Photo of Site

Job Title

Description of Work (overview list of planned activities)

Supervision of Task

Click '+' and add personnel in charge of task supervision (e.g site supervisor, safety officer, foreman, etc.)

Name

Role

Contact No.

Employees Involved

Name of personnel

Role

Methodology

In this section, provide step-by-step instruction as to how the work activity should be safely carried out and completed

Sequence of Operations

Plant & Equipment to be used

Specific Staff Training

Select the type of hazard associated with the planned activities below

Hazard

Please specify

Control Measures

PPE (select the required ppe)

Please specify

Emergency Procedures

Name of Person with Health & Safety Responsibility

Emergency Contact Details (include mobile no.)

First Aid Provision - in the event of an emergency, the following procedures should be executed:

Welfare Requirements

Services to be Supplied by Others

Completion

Other Information & Comments

Prepared by (provide name & signature)

Reviewed by (provide name & signature)

Method Statement Briefing Record

Briefing delivered by

Position

Date

We (the undersigned) have read and understood the attached method statement and will comply with the specified requirements and control measures. If the work activity changes or deviates from that originally envisaged, we will seek further advice and request an amended method statement.

Name & Signature

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.