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Safe Work Method Statement Review Form

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Safe Work Method Statement Review Form


A) Verification Item.

1. Is the date on the SWMS current? (Date needs to current and relative to when the contract was awarded to the contractor).
2. Are legislative and other requirements documented. (Have relevant legislation and other requirements been documented in the SWMS so far as they relate to the activity so identified? For clarification refer PMP Risk Assessment).
3. Where electrical contractors are involved, does their SWMS include lock-out and Tag-out controls of isolation points and testing to prove de-energisation, and are they familiar with Lion requirements.
4. Are details of the task or processes being assessed recorded step by step. (Need to ensure that the task / processes are aligned to the activity / scope of works).
5. Have hazards (OHS & Environmental) been identified for each task or process and are they specific to the project? ( the reviewer is not expected to determine if all the hazards are identified, but as the reviewer, you should ensure any hazards identified during the task process review or hazards resulting from other contractors works are incorporated into their assessment).
6. Are the control measures documented in the assessment the most practical in accordance with the hierarchy of controls? I.e. 1- Elimination, 2- Substitution, 3- Isolation / engineering, 4- Administrative, 5- PPE. ( Ensure the appropriate controls are chosen based on the level of risk. Several control options are often used in combination. The higher in the hierarchy of controls, the better and more reliable the control is).
7. Where work at heights is being undertaken, are control measures practical in accordance with the "National Code of Practice" (NCOP) - prevention of falls in the construction industry? I.e. Level 1 ( highest), Level 5 ( lowest).
8. Does the assessment identify the individuals who are responsible for ensuring compliance with the assessment? ( look for the employee or sub-contractor employee's names or positions).
9. Has the assessment been signed off by all party's who have a responsibility for the task. ( look for employee or sub-contractor employees name, signature and date - documented in ink not grey lead).
10. Have LION team members or contractor team members qualifications / competences relevant to the work task been documented and copies of competences, licenses attached to the assessment? ( examples include but not limited to. - working at heights, scaffold, EWP, crane,boom pump etc)
Other information
Approval to commence works
Reviewed by:

B) SWMS evaluation ( for implementation and effectiveness ). This evaluation is to be carried out in the presence of the employee / sub-contractor involved in the activity being evaluated.

1. The SWMS addresses the activity /scope of works being performed.
2. Have all personnel involved with the task has signed onto the SWMS?
3. Are all the identified controls implemented?
4. Are all the identified controls effective?
5. Was an employee or sub-contractor representative involved in the evaluation?
Comments: if No to any of the above criteria, list additional requirements including communication methods to site personnel.
Approval to continue works:
LION Representative:
Company Representative:
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