Templates
Rope Access Risk Assessment Template

Rope Access Risk Assessment Template

All workers should go through this rope access risk assessment template before starting work.

Use this template
or download pdf
Rope Access Risk Assessment Template

All workers should go through this rope access risk assessment template before starting work.

Use this template
or download pdf

About the Rope Access Risk Assessment Template

A rope access risk assessment template is a document used to assess the hazards and risks associated with working at height using rope access techniques. It outlines the necessary steps and precautions to be taken to ensure the safety of workers, equipment, and the surrounding environment. The template includes items such as hazard identification, risk assessment, emergency procedures, and PPE requirements.

What Is a Rope Access Risk Assessment Template and How Is It Used?

A rope access risk assessment template is a document that is used to assess the hazards and risks associated with working at height using rope access techniques. It is an important tool for ensuring the safety of workers who are working at height, as well as for the safety of the surrounding environment.

The risk assessment template typically includes a list of hazards that are associated with rope access work, such as falls from height, falling objects, and equipment failure. It also includes a list of risk control measures that can be taken to minimize the risks associated with these hazards.

The template can be used by rope access technicians, supervisors, and safety professionals to ensure that all necessary safety precautions are taken before work begins. It can also be used to help identify and evaluate potential hazards and risks that may not have been previously considered.


Related categories

Preview of the template
My Company Details
Business Name:
Business Address:
Business Contact:
ABN:
Phone No:
SWMS APPROVAL
SWMS APPROVED BY: (Employer/PCBU/Director/Owner)
Date:
Name and Signature of person responsible for ensuring compliance with SWMS:
Person/s Responsible for Reviewing the SWMS:
SWMS amendments must be approved by
Name and Signature:
ALL PERSONS INVOLVED IN TASK MUST HAVE THIS SWMS COMMUNICATED TO THEM PRIOR TO WORK COMMENCING: - Daily Tool Box Talks will be undertaken to identify, control and communicate additional site hazards. - Work must cease immediately if incident or near miss occurs. SWMS must be amended in consultation with relevant persons. - Amendments must be approved by nominated persons and communicated to all affected workers before work resumes. - SWMS must be made available for inspection or review as required by WHS legislation. - Record of SWMS must be kept as required by WHS legislation (until job is complete or for 2 years if involved in a notifiable incident).
Relevant Workers
Relevant workers must be consulted in the development, approval and communication of this SWMS.
Workers to be consulted:
Name and Signature:
Job Title:
Part 1: Principal Contractor Details
Principal Contractor details
The builder or the organisation you are working for.
Principal Contractor Company Name:
Project Name:
Job Address:
Project Manager Name and Signature:
Date SWMS provided to Principal Contractor:
High Risk Construction Work & PPE
SWMS Scope
This SWMS provides guidance on steel fixing including setting and tying steel reinforcing bar for concrete construction.
High Risk Construction Work
This work activity involves the following "High Risk Construction Work"
Confined Space
Mobile Plan
Demolition
Asbestos
Using explosives
Diving work
Artificial extremes of temperature
Tilt up or pre-cast concrete
Pressurised gas distribution mains or piping chemical, fuel or refrigerant lines energised electrical installations or services
Structures or buildings involving structural alterations or repairs that require temporary support to prevent collapse
Involves a risk of a person falling more than 2m, including work on telecommunications towers
Working at depths greater than 1.5 Metres, including tunnels or mines
Work in an area that may have a contaminated or flammable atmosphere
Work carried out adjacent to a road, railway or shipping lane, traffic corridor
In or near water or other liquid that involves risk of drowning
Risk Assessment Matrix & Controls
Personal Protective Equipment (PPE)
Ensure all PPE meets relevant Australian Standards. Inspect and replace PPE as needed.
Foot Protection
Hearing Protection
High Visibility
Head Protection
Eye Protection
Face Protection
Hand Protection
Breathing Protection
Protective Clothing
Fall Arrest
Sun Protection: Broad brimmed hat, UV rated clothing, SPF 30+ sunscreen, tinted safety glasses with adequate UV protection
Rings, watches, jewellery that may become entangled in machines must not be worn. Long and loose hair must be tied back.
Planning & Preparation
Potential Hazard
Lack of consultation with potential outcomes for personal injury, property damage &/or environmental incident.
Risk-Rating (IR) before control measures have been put in place
Control Measures to Reduce Risk
Liaise with Principal Contractor to establish the following on-site systems and procedures are in place and take note of: · Health and Safety rules · Induction for all workers – site specific and toolbox meetings · Supervisory arrangements · Communication arrangements · All relevant workers are appraised for required competencies & for any pre-existing medical conditions if working in remote or isolated locations. · PPE required · Site plans – showing no go zones for pedestrians · Traffic Management Plan · Exclusion Zones · Risk Assessments · SWMS and JSA’s · Injury reporting procedures · Hazard reporting procedures.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Training & Capabilities
Potential Hazard
Lack of training or the assessment of capability may lead to personal injury, property damage &/or environmental incident.
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure all persons entering site have a General Construction Induction Card (white card) If working on EWPs or scaffolding, for this task, ensure there are separate, dedicated EWP/Scaffolding SWMS and that all workers/employees have relevant training and licensing. Ensure all relevant workers have undertaken training and/or received instruction in the use of control measures. Include: · Reporting procedures for incidents · Correct use of equipment including selecting, fitting, use, care of and maintenance · Correct use of all tools used · Use of supervision where required (e.g. new starters or new equipment) · Ensure supervisors, foremen etc. are suitably experienced in the type work to be conducted · All workers are trained in this SWMS.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Assess onsite conditions
Potential Hazard
Lack of a clear assessment may lead to personal injury, property damage &/or environmental incident.
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Assess conditions at site on arrival. Ensure: · Ensure site-specific induction is undertaken (include location of amenities, first aid facilities, emergency plans and evacuation points, incident reporting, communication, contact persons etc.) · Assess mobile phone reception’ (alternative emergency communications procedures in place if no reception available) · Work site is exactly as detailed in Terms of Agreement or contract · Suitable weather conditions (do not work outside in low visibility, heavy rain, high winds etc.) · Suitable access for all equipment required · Suitable space for operation of equipment · Suitable lighting, including night-works (include flood lighting and operator head lamps as applicable). Conduct risk assessment to identify potential hazards such as: · Work at heights (above 2m) · Lighting · Ventilation · Dust · Presence of hazardous materials such as asbestos, lead, silica etc. · Location of existing services (heating, water, pipes, electrical leads) · Temperature etc. · Exposed electrical switchboards/power points · Duration of manual handling tasks (such as vacuuming, working with arms above shoulder height) · Load bearing capacity of support structures
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Work area setup
Potential Hazard
Muscular stress / musculoskeletal disorder (MSD)
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Ensure materials /equipment is as close to work area as possible.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Work adjacent to road & public safety
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Park working vehicle in driveway or allocated parking to avoid travelling across roads when delivery working equipment · If setting up roadside – comply with local laws and permits · Erect any barriers & signage necessary to keep others safe and aware. · Adequate walkways are provided around the perimeter of any steelwork and barricaded to prevent accidental ‘Brush past’ injuries (contact with sharp ends of cut steel bars) · All non-essential persons are removed from area and no-go zone established for pedestrians during loading /unloading operations · Reversing vehicles guided by another person if visibility is restricted (ensure guiding person wears high visibility clothing).
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Property Damage
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Ensure equipment is not placed in areas where they may be run over, damaged or exposed to water (unless rated for wet environments). Keep power leads up off the ground and out of the way.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Contact with electricity
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· All power tools and leads are Tested and Tagged and are current · Pre-inspect equipment · If equipment is damaged, do not use. Take out of service, apply Lock-out/tag-out (LOTO) procedures and inform supervisor immediately. · Electric leads/extension cords are not placed in areas where they could be damaged, run-over or pose a tripping hazard · Residual Current Devices/safety switches are provided for electrical equipment.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Contact with hazardous chemicals / substances
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Ensure current Material/Safety Data Sheets (M/SDS) are obtained for all hazardous chemicals/substances and accessible on site e.g. oxy-acetylene cylinders.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Lifting steel by crane
Potential Hazard
Struck / crushed by falling objects
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Licensed crane driver · Licensed dogman used to sling and direct operation · All slings, chains and other lifting equipment checked continuously during operation for condition · Correct lifting container for smaller items (do not use drums, boxes or other containers not specifically designed for lifting) · Do not lift items over people below · Dogman warns steel-fixers and others when placing steel work surface · Hard hats are worn.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Muscular stress / musculoskeletal disorder (MSD)
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Steel is bundled for lift so that larger, heavier bars are on bottom and worker does not need to lift heavy bars to access bars below. · Steel is bundled for lift in way that workers can access scheduled steel after placing (i.e. the next components to tie are not on the bottom of stack).
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Lifting steel by hand
Potential Hazard
Muscular stress / musculoskeletal disorder (MSD)
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Avoid long periods of repetitive movements · Avoid awkward and sustained positions when lifting or carrying steel · Use mechanical lifting aids when possible · Use two or more people for lifting & moving heavy / awkward lengths · Take Regular breaks · Always ensure both people walk forward for team lift.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Setting Steel
Potential Hazard
Muscular stress / musculoskeletal disorder (MSD)
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Setting Steel. Ensure: · Assess condition of banks/ walls of excavation for stability if applicable · Two persons to carry larger diameter bars · Do not carry to many bars at once · Use caution when dragging bars (Do not walk backwards). Ensure: · Place steel as per design specifications · Use two persons where necessary for vertical sections to avoid steel falling over/ dropping (one to hold and one to tie if necessary) · Do not walk on bars others are tying · Workers should communicate prior to sudden movements of the bar.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Cuts, lacerations and abrasions
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Always wear flexible leather gloves when handling steel · Do not handle ends of bars (sharp edges).
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Hypothermia, heat exhaustion
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Suitable protective clothing · Sun brim on hard hat · Safety glasses - UV Rated · Use 30+ sunscreen on exposed skin areas · Adequate drinking water · Access to shade during breaks · Adequate breaks · Check weather conditions – do not work in extreme weather
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Falls causing impalement
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure all exposed rebar ends, star pickets ends and other protrusions are fitted with suitable end-caps. Ensure: · Correct size for bar/picket · Fitted correctly · Regular inspections are undertaken to check condition of end caps and to ensure no caps are missing and correctly fitted. Note: End-caps do not provide adequate protection against impalement. Safe systems of work must be in place to prevent persons falling onto rebar/ picket ends (capped or not).
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Falling objects
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Always be aware of work overhead · Wear hardhats if any work on site is higher than head height · Do not work under others on walls or decks · If working at height secure tools to prevent dropping (lanyard etc.)
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Tying Steel
Potential Hazard
Muscular stress / musculoskeletal disorder (MSD)
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Do not use excess pressure when twisting wire manually (may break and cause unintended movement/off balance or kick back of nips) · Always maintain control of free end of wire (Do not let it hang out of wire reel or other, always retract and tie off or bend back ends) Automatic Tying tools. Ensure: · Keep hands/feet clear of feed arm, curl guide and tie wire reel. · Ensure least amount of wire is kept on operator at all times. (Avoid carrying excess wire – may contribute to manual handling injury from high force, or working in awkward postures under stress) · Ensure correct tie-wire is used · Follow manufacturer’s manual for operation of tying tool · Ensure finger is removed from trigger when not in use · When leaving tool unattended, switch to off and lock trigger · Remove battery pack when replacing wire · Use extension handle to reduce over-reaching or bending. DO NOT: · Use tying tool in rain or near water · Point tool at anyone · Modify tool
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Cuts, lacerations
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Bend over wire tips after tying to avoid sharp wire ends · Cut wire square with nips (angled cuts require more pressure to cut and leave razor sharp ends).
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Cutting Steel (grinder / metal drop saw)
Potential Hazard
Fire causing personal injury, property damage &/or environmental incident
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure not within 15m of: · Grass/vegetation/timber and other combustibles · Flammables storages · Gas maintenance access points · Pressure vessels and tanks (including pipelines, flanges, vents and valves) · Check weather requirements · Do not use grinders in high temperatures, high winds or on days of Total Fire Bans. · Check continuously for sparks or fire outbreak. Use Spotter if required · Ensure there is a fire extinguisher available · Do not lean into work. Ensure head (breathing zone) remains clear of possible contaminants or sparks · Direct sparks away from body and other persons · PPE – face shield, hearing protection is worn.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Hearing loss
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Wear hearing protection, ensure it is: · Worn by all persons throughout the period of exposure to noise · Suitable for the type of working environment and the work tasks · Comfortable and correctly fitting for the worker · Regularly inspected and maintained to ensure it remains in good, clean condition.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Cuts, lacerations
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Always ensure that the grinder/saw is switched off and power isolated before pre-start check, adjusting, changing set-ups or repairing. Allow the blade to reach full speed before cutting, do not force the blade and always start the cut gently. NEVER: · Operate the grinder/saw with the trigger tied on · Place hands under the steel being cut · Ensure the switch is in the “off” position before plugging it in to avoid accidental starting. · Ensure the blade has fully stopped turning before placing the grinder down. NOTE: Large off-cuts can be unstable, can affect the cut and result in operator injury. Ensure large off-cuts are supported and removed safely. · Stay alert – concentrate on what you are doing at all times and be aware of kickback · You must keep your off hand out of the path of the grinder/saw in any case. NOTE: Always turn off the grinder /saw when not in use.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Electric and manual reinforcing bar cutters /benders
Potential Hazard
Cuts, amputations
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Electric and manual reinforcing bar cutters/benders, ensure: · Follow operating instructions · Always wear safety glasses · Do not carry with finger on starting switch · Switch is in off position before plugging in lead · Use only on material tool is designed for · Keep all body parts away from blades/ bending zone during operation · Do not attempt to exceed rated capacity of cutters
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Using Oxy –acetylene equipment
Potential Hazard
Burns
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure: · Correct PPE (gloves long sleeve pants and shirt, face protection) are worn · Hot off-cuts are constrained · Extended nozzles are not used for work in tight areas. · Check for damage to hoses or equipment regularly · Ensure flashback arresters are fitted.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Fire causing personal injury, property damage &/or environmental incident
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Do not use Oxy - acetylene equipment (naked flame) near: · Grass/vegetation/timber and other combustibles · Flammables storages · Gas maintenance access points · Pressure vessels and tanks (including pipelines, flanges, vents and valves) · Check continuously for sparks or fire outbreak. Use Spotter if required · Ensure there is a fire extinguisher available
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Working adjacent to mobile plant or passing vehicles
Potential Hazard
Contact with mobile plant or passing vehicle
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Check constantly for changing hazards while working and monitor work position at all times. Ensure: · High visibility clothing worn at all times · Do not stand behind reversing vehicles · Allow sufficient distance from plant during operation (allow sufficient room for equipment failure – such as arm/boom failure or plant rollover) · No work is conducted in established “no go zones” for pedestrians · Alertness at all times. Listen for: · Reversing alarms/beepers · Calls from Plant Operators · Safety/warning signs, Spotters, traffic barriers etc. must be obeyed as required · Work positions should be in clear sight of plant operators · Follow traffic management plan requirements. NOTE: Some traffic management plans may say that pedestrians have right-of-way. Never assume this. Make visual and verbal contact with plant operator as required.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Working at elevated positions
Potential Hazard
Slips, trips, falls causing injury
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Identify all hazards. Consider: · Use all height-access equipment as per manufacturer’s instructions and for its designed purpose. · Ground/floor surface condition · Where ground surfaces may change level · Experience of workers · Weather conditions (rain, wind loads, fog, dew) · Check design to ensure that the equipment will support a specified load – or ‘duty rating’. This must be clearly stated on the item.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Fall from ladder
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Work positioning. Ensure: · Load rating of at least 120kg · Correct size and length for job · No damage, clean and dry · Secured to work site (base and top) · Metallic, wire- reinforced or conductive ladders should be avoided around live electrical equipment · Face ladder when ascending/descending. Ensure 3 points of contact remain on ladder at all times · Ensure only 1 person working from each ladder. DO NOT: · Attempt to move or extend ladder when on it · Slide down stiles · Step up or down two or more rungs at a time
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Fall from platform ladder
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure: · Trestle back undamaged · If unfolding type, chains, rivets etc. are undamaged and functional · Suitable height hand rail (900mm) · Triangular flat plate bracing · Correct size for job (platform level) · Non-slip treads · Large feet with non-slip mouldings · Non-slip platform of sufficient strength for persons, tools and equipment · Industrial rating.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Fall from trestle
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Trestles must: · Be rated for proposed weight and span · Have an overhang of at least 150 mm and not more than 250mm at each end and be “locked” together. Example - clamped near the centre span to prevent individual movement. · Have an unobstructed surface width of at least 450mm (two planks wide) · Must be matched pairs i.e. the rungs should be equivalent heights and spacing
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Falls from suspended deck
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Scaffold is complete and where relevant, has certification · All decks are complete · Perimeter protection provided · All penetrations are covered · Suitable access · Ladders tied/secured · Sufficient room for fixer and equipment · Work platforms clear of debris/stored items · Catch scaffold provided if necessary
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Site specific hazards
Have you identified any further hazards on the job site?
What job step does this hazard relate to?
Potential Hazard
Risk-Rating (IR) before control measures have been put in place
Control Measures to Reduce Risk
Control measures used to reduce risk
Risk-Rating (RR) after control measures have been put in place.
Person responsible to implement control measures:
On completion
Potential Hazard
Slips, trips, falls causing injury
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Clean up tools and any waste ensuring the site is left in clean and tidy condition · Clean debris and ensure larger cut-offs are removed from area.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Contact with electricity
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· Disconnect power tool/extension leads from power point before winding up, so that you don’t get a shock if the lead is damaged · Inspect leads and power equipment for damage · If safe to do so, remove isolation locks/tags and test appliance for function.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Contamination of waterways and water catchment
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
Ensure: · Dispose of off-cut materials in bins provided onsite · Do not wash out tools or containers where residue can enter waterways or drains.
Risk-Rating (RR) after control measures have been put in place
Potential Hazard
Public Safety
Risk-Rating before control measures have been implemented
Control Measures to Reduce Risk
· If acceptable, remove or add barricades as appropriate, contact supervisor and return as agreed.
Risk-Rating (RR) after control measures have been put in place
Person responsible to implement control measures:
Emergency Response
Emergency Response - CALL 000 IMMEDIATELY.
If work is to be conducted on a construction site (or a site controlled by another Employer / PCBU) follow the site-specific Emergency Management Plan. Ensure: · Adequate numbers of first aid trained staff are on site when working at heights occurs · First aiders are trained and competent in managing injuries associated with demolition until emergency services arrive · All rescue equipment is in good condition, available for use and in close proximity to the work site.
Ensure workers have access to: · First aid kit/supplies · First Aid trained personnel familiar with Resuscitation and emergency response for electric shock · M/SDS · Communication devices (check mobile phones will have service in area) · Suitable fire protection equipment.
Part 2: Relevant Legislation & Codes of Practice
Relevant Legislation:
Note: Retain only the legislation references applicable to your state of operation for this SWMS.
Commonwealth, NSW, QLD, ACT
· Work Health and Safety Act 2011 · Work Health and Safety Regulations 2011
Northern Territory
· Work Health and Safety (National Uniform Legislation) Act 2011 · Work Health and Safety (National Uniform Legislation) Regulations 2011
SA, Tasmania
· Work Health and Safety Act 2012 · Work Health and Safety Regulations 2012
Victoria
· Occupational Health & Safety Act 2004 · Occupational Health & Safety Regulations 2007 Compliance Codes: WorkSafe Victoria (2008): Compliance Code: Communicating OHS Across Languages First Aid in the Workplace Prevention of Falls in General Construction Workplace Amenities and Work Environment
Western Australia
· Occupational Safety & Health Act 1984 · Occupational Safety & Health Regulations 1996
Codes of Practice
Commonwealth, NSW, QLD, ACT, NT, SA, Tas.
Safe Work Australia (2011): · Construction Work · First Aid in the Workplace · Managing the Risk of Falls at Workplaces · Managing the Risk of Plant in the Workplace · Managing Noise and Preventing Hearing Loss in the Workplace · How to Manage Work Health and Safety Risks · Hazardous Manual Tasks · Managing Electrical Risks in the Workplace · Managing the Work Environment and Facilities · WHS Consultation, Cooperation & Coordination
Victoria
WorkSafe Victoria (1990): No. 13: Building and Construction Workplaces (2000): No. 25: Manual Handling (1995): No. 19: Plant (1998): No. 23: Plant (Amendment No. 1) (2004): No. 29: Prevention of Falls in Housing Construction (2000): No. 24: Hazardous Substances
Reference Documents
Have you referred to any documents?
References referred to:
Training, Permits, Tools, Supervisory Arrangements
Training and Licences Required For Workers Undertaking This Task. Select those relevant
Are any training or licences required to complete this task?
Licence to Perform High Risk Work (operating certain plant, equipment)
Licence details
Photo of relevant licences
TAFE or other recognised training organisation
Licence details
Photo of relevant licences
Construction Induction Card (or equivalent)
Licence details
Photo of relevant licences
PPE
Licence details
Photo of relevant licences
Traffic Management Plans
Details
Relevant images
Other
Licences/training
Licence details
Photo of relevant licences
Plant/Tools/Equipment Required For The Job
Plant / Tools / Equipment are required to complete this job:
Plant / tools / equipment required:
Make & Model
Plant/macinery photo
Details of Supervisory Arrangements for Workers Undertaking This Task:
Supervisory arrangements for this task:
List other licences/training relevant
Enter relevant information
Details of Regulatory Permits / Licenses / Engineering Details / Certificates / Work Cover Approvals:
Are there any Regulatory Permits / Licenses / Engineering Details / Certificates / Work Cover Approvals?
Applicable permits / licenses etc
Item
Item Details
Take a photo of relevant licenses / permits where possible
Part 3: Worker / Employee Sign Off
Overall Risk Rating After Controls
Select Risk Rating
Worker Sign-off
This SWMS has been developed in consultation and cooperation with employee/workers and relevant Employer/Persons Conducting Business or Undertaking (PCBU). I have read the above SWMS and I understand its contents. I confirm that I have the skills and training, including relevant certification to conduct the task as described. I agree to comply with safety requirements within this SWMS including risk control measures, safe work instructions and Personal Protective Equipment described.
Employee/Worker Name and Signature:
Job Role/Position
Employer/PCBU/Supervisor:
Review & Monitor
To ensure controls are implemented and monitored effectively: • Toolbox /pre-work meetings will be undertaken • Relevant persons will be consulted on hazards and contents of SWMS, work plans and other applicable information • Control measures will be monitored throughout works: o Spot checks o Consultation o Scheduled audits • Corrective actions will be recorded and rectified in a timely manner SWMS will be reviewed and updated accordingly (in consultation with relevant persons)
Ensure all controls are reviewed as per the following: • If controls fail to reduce risk adequately • When changes to the workplace or work activity occur that create new / different risks where controls may no longer be effective • New hazards identified • After an incident involving work activities relevant to this SWMS • During consultation with relevant persons indicate review is needed • A Health and Safety Representative (HSR) requests a review in line with the requirements of the legislation.
Review Number
Name & Initials
Date
This template was downloaded 155 times
This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.