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The aim of this Project Safety Plan (PSP) is to introduce information to Staff, Workforce and
Subcontractors that will ensure that they understand that personal Health and Safety is one of
the main priorities (your company / business name).

(your company / business name) primary obligation in safety management is to prevent
accidents in the workplace, we will do this by providing all necessary information, instruction,
training and supervision to staff and employees. We will ensure that employees are provided
with information, instruction, training and safe systems of work.

(your company / business name) will only achieve this aim through with the input, support and
commitment from all personnel.

This safety plan will be continually reviewed and updated through consultation with staff and
workforce and will be kept in line with relevant legislative.

This safety plan will adhere to the provisions of The National Work Health and Safety Act 2011
(WHS Act)


The safety plan will be prepared by the Director in consultation with key members of the
project team. The safety plan will be authorised by the Project Manager / WHOSO (where
applicable) who will sign off on the safety plan.


To ensure adequate control of this safety plan the distribution of the plan will be as follows:

(your company name / business name) Project Foreman (Held on Site)
Client or Client Representative


(your company name / business name will ensure health and safety forms an integral part of every
position. The key roles and responsibilities of our managers and supervisors, regarding safety, are
outlined below.


The Directors are ultimately responsible for Workplace/Occupational Health Safety and Injury
Management (WHS/OHS & IM) and their duties include:

Defining the WHS/OHS & IM responsibilities for key position holders in the organisation.
Implementing (your company name / business name WHS/OHS & IM procedures.
Managing compliance with WHS/OHS & IM legislation, regulations, standards and codes of
Ensuring that all staff are adequately trained in WHS/OHS & IM.
Establish WHS/OHS standards for (your company name / business name)
Provide the resources to implement WHS/OHS practices effectively
Monitoring and reviewing the WHS/OHS & IM System annually

Project Foreman: _________________________

Project Foreman's WHS/OHS & IM responsibilities on site projects include:

Undertaking a Risk Assessment of all major activities prior to new work commencing and
determining which activities require Safe Work Method Statements or Safe Work Procedures
to be developed
Developing site specific safety plans and safety rules.
Identifying safety training needs for employees.
Ensuring the workplace abides with WHS/OHS&R legislative requirements.
Disseminating WHS/OHS & IM information to personnel.
Ensuring safe equipment and plant is provided and maintained.
Facilitating an agreed method of consultation with employees.
Investigating all accidents and ensuring that corrective actions are undertaken.
Reviewing Safe Work Method Statements issued by sub-contractors.
Assessing of sub-contractors' abilities to comply with corrective and/or preventative control
Developing and implementing emergency procedures.
Stimulating a high level of safety awareness at all times.
Preparing and participating in safety meetings and safety programs.
Reporting all accidents/incidents/near misses to the Managing Director.
Ensuring valid certificates of currency (for Workers Compensation) are provided by all
subcontractors prior to commencing work on site.
Supporting and assisting with the rehabilitation of employees who have been injured at work,
by encouraging their early return to normality through work based return to work programs.
Notify Management of all injuries.
Safety Representative: ______________________________

is responsible for safety on the project and duties include:

assisting the Site Supervisor to develop and implement the Workplace/Occupational Health
Safety and Rehabilitation procedures
communicating safety performance to the Site Foreman;
providing advice and assistance on OH&S to all employees;
monitoring OH&S legislative requirements for the trade package;
monitoring compliance with safe work procedures;
co-coordinating rehabilitation / return to work for injured employees;
reviewing safety reports and inspections;
preparing and participating in safety meetings and programs;
facilitating Tool Box Talks on a regular basis;
insisting on correct and safe practices at all times;
preparing and conducting project safety inductions;
investigating and developing new OH&S initiatives for the trade;
conducting accident/incident investigations;
leading by example and promoting OH&S at every opportunity;
communicating with the WHS/OHS&R Site Manager on matters relating to health and safety;
facilitating the maintenance of all records as required under this system participating in
regular workplace inspections and ensure that any improvements resulting from


All employees on site have responsibilities in relation to safety. The responsibilities include:

Performing all duties in a manner which will ensure the health and safety of themselves and
of others
Observing all safety rules and regulations
Being alert at all times to potential hazards
Participation in the identification and elimination of hazards
Immediately reporting any injury, hazard or equipment defect to the supervisor
Participate in safety toolbox meetings
Participate in a return to work plan in the event of an injury
Co-operate with authorities investigating an incident
Not tampering or removing any safety device or guard that is provided in the interests of
health and safety
Wear the appropriate personal protective equipment
Contractors All contractors that are engaged to carry out work for (your company name /
business name shall:
Comply with all statutory requirements
Comply with the WHS/OHS & IM System

A certificate of currency and safe work method statement will be requested for any contract work
carried out by a contractor. If a contractor is found to not co-operate with these requirements they
may be asked to leave the premises or stop work immediately.

First-Aid facilities are located____________________________

All work injuries and illnesses are to be reported to one of the following:

- First Aider
- Supervisor
- Office

Initial first-aid treatment is only to be applied by the First-Aid Officer
First-aid officer is to evaluate the seriousness of the work injury or illness and determine
whether further treatment is necessary offsite.
If further treatment is necessary determine how the patient is to be moved.
Management to arrange or take the patient to the doctor or hospital for treatment
Or ambulance required to take the patient to hospital

(your company name / business name will follow the Principle Builders emergency
procedures as explained at the site induction.


This Policy is a statement of (your company name / business name commitment to provide a
safe and healthy workplace for our employees, and others who may be affected by our work,
with the objective of preventing work related injuries and illnesses. Managers and supervisors
have the responsibility for implementing this Policy as an integral part of their accountabilities;
they may delegate their WHS/OHS duties and activities, but not their responsibilities.

(your company name / business name) is also committed to protecting employees by
complying with WHS/OHS legislation , demonstrating due diligence and the application of
industry-based WHS/OHS procedures. For all people who may be affected by our work, safety
will always take precedence over job expediency.

Our other key objectives with this Management System are:
Implementing proactive health and safety management strategies,

Integrating WHS/OHS management at the planning stage,

Controlling the risks from hazards by the risk management process of hazard
identification, risk assessment and risk control,

Monitoring and reviewing risk controls to ensure they remain effective,

Involving our employees in the decision making process through structured
communication, consultation and training,

Providing ongoing education and learning for our employees to enable them to work in
the safest way possible,

Requiring employees to comply with their legislated and company WHS/OHS/

Implementing continuous improvement strategies, and

Providing effective injury management and rehabilitation strategies.

The objectives of this policy will be achieved by committed and demonstrated leadership from
all managers and supervisors and the involvement of all employees. Appropriate support and
resources will be provided by (your company name / business name to facilitate this process.

Signed: ................................................. Date: .....................................

This Project Safety Plan has been prepared by:


Signature: _______________________


Project Foreman / WHOSO (where applicable)


Signature: _______________________


Submitted for Client Approval

Approved by Client Representative

Name: ______________________________

Position: _____________________________

Signature: ____________________________

Date: ________________________________

Project Safety Plan Distribution

Company / Name Date Signature

Project Details

Scope of Works

Key Project Personnel

Position Name Contact Details


The risk identification, assessment and control process requires regular monitoring to ensure the
implemented control measures perform as originally intended and continue to prevent or adequately
control the risk of injury.

Control measures should also be checked carefully to ensure that new hazards are not created, directly or
indirectly, by the original control measures.

Safe Work Method Statements will also include a description of the equipment used in the work, the
standards or codes to be complied with, the qualifications of the personnel doing the work and the
training required to do the work.
Safe Work Method Statements will be developed in consultation with the relevant employees.


Safe Work Method Statements will be developed for all activities. Safe Work Method Statements will
include the following:
(a) description of how work is to be carried out, and
(b) identification of the work activities assessed as having safety risks, and (c) identification the safety
risks, and
(d) a description of the control measures that will be applied to the work activities,

* The following forms for a safe work method statement must be filled in for the job at hand and
revised for each job, risk assessments, safe operating procedures and MSDS sheets must also be
attached to make this safety plan effective.



All electrical fittings to comply with AS 3000 wiring rules.
All temporary electrical fittings must be fitted with an earth leakage device/residual
current device, i.e. portable generators.
All plant and equipment must be checked monthly (distribution boards etc) as per Code
of Practice.
Amenities, site office, must be checked every three months by a licensed electrician,
with a register to be kept on site.
All electrical items and leads must be tagged monthly and submitted to (your company
name / business name) for recoding.
All fittings to extension cords to be either non-rewirable (moulded) or transparent.
All leads and power cables to be supported above any work area and. passageway to
provide clear access for personnel and vehicles.
Only approved portable multi-boards are to be used. No double adaptors/piggy back
plugs to be used.
Every core balance earth leakage device on site must be trip tested monthly and subjected to a
calibration test by a licensed electrician every three months from time of installation with a
register kept.


An adequate number (and relevant type of fire extinguishers) will be available and located in
the immediate vicinity of any work that may create a fire risk. This requirement will apply
without exception to any hot work such as welding. (your company name / business name will
ensure all personnel carrying out hot work are fully trained in the use of extinguishers.

All mobile plant shall be fitted with an appropriate fire extinguisher.
The fire extinguishers are to be serviced and maintained by competent persons and a record
completed and maintained in accordance with Australian Standard 1851.

Combustible materials shall not be allowed to accumulate in work areas so as to prevent a fire
risk. All personnel shall be made aware of the project emergency procedure and emergency
service phone numbers shall be clearly displayed at a central phone location.


Material Safety Data Sheets will be obtained for the all substances. No substances will be
brought on site without first obtaining the correct MSDS.
All storage and use of hazardous substances will be in accordance with the MSDS. Hazardous
substances of any quantity shall not be stored in crib rooms or offices. All hazardous substances
will be stored in their original containers with the label in tact at all times.
Prior to using the hazardous substance all workers involved in its use will be provided with
information and training to allow a safe completion of the task. All hazardous substances will
be documented on a register.


Any mobile plant that may be required to be brought onto the site will be listed on register. The
listed plant will not be operated, unless a Safety Checklist for Major Plant has been completed
satisfactorily and referred to (your company name / business name. This form will be submitted
on the first of every month where plant is on-site for more than one month.

Static plant is any stationary plant. Examples of stationary plant are scaffolding or hoists.
Where static plant is brought onto or erected on-site, (your company name / business name
will ensure that it has been maintained and directed to the required standard.

All tools and equipment will be verified as meeting the relevant standards and guidelines and
will be maintained as per the same.


Dust masks, safety glasses, face shields, gloves, harness, ear plugs, ear muffs, etc, will be made
available where ever there is a requirement.
Personal Protective Equipment is to be looked after- if it is damaged, it does not do it's job
properly and does not protect you.
UV cream, hat brims, shirts and eye protection (clear & tinted) will be supplied to all employees
as required. It is recommended to use all U.V. protection whilst working in the sun.
If you are not sure how to use the Personal Protective Equipment supplied to you, ask you
All workers will be instructed in the use of personal protective equipment, especially hearing
They are also supplied with and are instructed on the use of the following:

5.1 Safety Helmet To be worn on site when necessary, ie working
below overhead cranes, working in an open area underneath
other trades, around the site where there may be a danger of
falling objects.
5.2 Safety boots To be worn at all times on site.
5.3 Safety Glasses When using drills or hazardous chemicals and all
listed power tools and machinery [AS 1337].
5.4 Glove type *insert AS standard for your industry type! comfortable
work gloves.
5.5 Respiratory Type *insert AS standard for your industry type! A class P1 or
P2 replaceable filter or
disposable face-piece respirator together with safety glasses or
non-fogging goggles
5.6 Eye Safety Glasses or non-fogging goggles {AS1337} should
be worn when sawing, drilling or sanding.
5.7 Hearing protection When using cut off wheels, hammer drills or
where associated background noise is above normal levels.
5.8 Safety vests When working around plant and machinery.
5.9 Explosive Power
Tools Follow safe working practice when using explosive power tools,
erect safety warning sign and make other tradesmen aware of the
tools use.
5.10 Overhead Work: Take great care to ensure materials and tools cannot
be displaced. Where a danger of falling materials exists, a suitable
barrier fence must be erected directly below the work and Men
Working Above signs placed. Materials should be lowered from
elevated places in a safe manner. Do not throw objects or
materials from heights. When working at a height of 1.8m or
above, you are required to wear an approved safety harness with
attached lanyard.


Any defect in any item of safety equipment or protective clothing shall be reported to the
supervisor immediately.


(your company name / business name) and his Employee's / Subcontractors endeavour to
ensure that they;
Provide and maintain plant and systems of work that are safe.
Ensure safety and absence of risk to health and safety in connection with plant and
Maintain a workplace that is a safe environment.
Provide adequate training and information for their purposes.
Maintain all protective clothing and equipment in a tradesman like condition.
Ensure that power leads and power tools will be tagged and kept off the ground as
Instruct all Employee's / Subcontractors as to correct procedures for lifting and
materials handling.
Provide adequate ventilation when working in confined or enclosed spaces.


Report all injuries.
Call for a first aid officer / supervisor for medical attention.
Report all safety hazards to the project health and safety office, health and safety
representative or the safety committee representative or the supervisor.


Not using toilets provided.
Removal of guard rails without approval or alternative protection.
Removal of machinery guards without approval or alternative protection.
Fighting on site.
Refusal to act on safety instructions from the health and safety officer or site
Repeated safety breaches.


All rubbish and off-cuts will be removed and or stored correctly so as to provide a safe and
clean working environment.
An untidy work area causes accidents, inefficiency, and creates fire and other hazards. Use
receptacles provided and remember that there is a place for everything and everything belongs
in its place. Do not throw materials or equipment of any kind down from elevated work areas.
Do not leave it lying around working areas for it may cause someone to trip and cause injury.


All work should be carried out in such a way as to minimise the generation of dust, gas and
vapours. Under site conditions, sawing, drilling, sanding, etc. should be done with equipment
fitted with exhaust devices capable of removing dust, gas and vapour at source. Hand power
tools should be used in well-ventilated areas so as to avoid the spread of dust, gas and vapour.
Work areas should be cleaned at least daily, and dust removed by vacuum cleaning or wet
sweeping method.


When handling hot or sharp objects wear gloves to avoid cuts or burns.
Before lifting ensure footing is stable and keep feet shoulder width apart.
TO PREVENT BACK INJURY keep your back straight, hold the load close to your body,
bend your knees and use the strength in your legs to lift and don't twist your body when
Plan your lift and if too heavy or too long, always seek assistance (it doesn't hurt to ask,
but it will hurt if you over lift)
When lifting repetitively, regularly take a break and rest your back to avoid repetitive
Never over lift and always look for other options such as trolleys, forklifts and cranes.
All employees are instructed in the methods of manual handling as per the attached
guidelines for manual handling.


Noise assessments will be arranged to determine noise levels workers will be exposed to, and
appropriate P.P.E., in conjunction with training, will be organised.


Any person having to perform works above 1.8 metres must be supplied with and operate from
a fully completed scaffold. Scaffold over 4 metres must be erected by a ticketed scaffolder.


Safety signs and barricades must be supplied and used on site in accordance with the
occupational workplace health and safety regulations.


All vehicular movements, traffic routes, restrictions and requirements will be as per
development consent conditions; if not specified, local council and RTA regulations will
be implemented into a traffic management plan.


Contractors are responsible for ensuring any trenches or holes they create are made safe
and are protected using suitable means. All excavations more than 1.5 metres deep
must be shored or battered.


When in charge of company plant or vehicles, you must always observe road safety and
company rules and policies.
Never sacrifice safe operation for any reason.
Never leave plant or vehicles unattended with motor running.
Never overload vehicles.
Always stop before refuelling. Smoking when refuelling is prohibited.
Report all defective plants and vehicles.
Always park plant and vehicles clear off traffic ways, access ways and work areas.
Report any accident to plant and vehicles.


WHS R 291; Meaning of high risk construction work in this chapter, high risk construction work
means construction work that

(a) involves a risk of a person falling more than 2m; or
(b) is carried out on a telecommunication tower; or
(c) involves demolition of an element of a structure that is load-bearing or otherwise
related to the physical integrity of the structure; or
(d) involves, or is likely to involve, the disturbance of asbestos; or
(e) involves structural alterations or repairs that require temporary support to prevent
collapse; or
(f) is carried out in or near a confined space; or
(g) is carried out in or near
(i) a shaft or trench with an excavated depth greater
than 1.5m; or
(ii) a tunnel; or
(h) involves the use of explosives; or
Work Health and Safety Regulation 2011 Chapter 6 Construction work
Part 6.1 Preliminary Page 232 2011 SL No. 240
(i) is carried out on or near pressurised gas distribution mains or piping; or
(j) is carried out on or near chemical, fuel or refrigerant lines; or
(k) is carried out on or near energised electrical installations or services; or
(l) is carried out in an area that may have a contaminated or flammable atmosphere;
(m) involves tilt-up or precast concrete; or
(n) is carried out on, in or adjacent to a road, railway, shipping lane or other traffic
corridor that is in use by traffic other than pedestrians; or
(o) is carried out in an area at a workplace in which there is any movement of powered
mobile plant; or
(p) is carried out in an area in which there are artificial extremes of temperature; or
(q) is carried out in or near water or other liquid that involves a risk of drowning; or
(r) involves diving work.



Relevant workers are to conduct a risk assessment of the proposed task
Most and/or workplace using the;
Effective Hierarchy of Control;

This is the procedure set out in OH&S Legislation as best practice for the
Elimination of Hazards or the control of the risks they pose;

It outlines that workplace safety can generally be managed by these five
basic steps:

Identify Hazards

Assess Risks

Decide on Control Measures

Implement Control Measures

Monitor and Review the effectiveness of the control measures;

Elimination: Removal of the hazard altogether; (ideal)

Control Measures:

Substitution: Use a less hazardous substance, material or process, e. g.
Work off a scaffold instead of a ladder;

Redesign: Involves changing the design of the workplace or the work
process, e. g. use a screeding machine instead of a hand screed;

Isolation: Is to isolate the hazard from the workers or the workers from the
hazard; e.g. establish exclusion zones to prevent unauthorised entry;

Administration: Is to minimise the risk through procedures or instructions
e. g. job rotation, safety instructions, training and warning signs;

Personal Protective Equipment (PPE): is the equipment worn by people as a final barrier
between themselves and the hazard.
(Least effective)

CONSEQUENCE: How severely could someone be hurt
Catastrophic death or permanent disability to one or more workers
Major hospital admission required
Moderate medical treatment required
Minor first aid required
Insignificant injuries not requiring first aid

LIKELIHOOD: How likely are those consequences?
Almost certain expected to occur in most circumstances
Likely will probably occur in most circumstances
Possible could occur at some time
Unlikely is not likely to occur in normal circumstances
Rare may occur only in exceptional circumstances


CONSEQUENCE Rare Unlikely Possible Likely Almost Certain
1 2 3 4 5

Risk level Required action
Act immediately:
The proposed task or process activity must not proceed. Steps must be
taken to lower the risk level to as low as reasonably practicable using the
hierarchy of risk controls.
Act today:
The proposed activity can only proceed, provided that:
(i) the risk level has been reduced to as low as reasonably practicable using
the hierarchy of risk controls;
(ii) the risk controls must include those identified in legislation, Standards,
Codes of Practice etc.
(iii) the risk assessment has been reviewed and approved by the Supervisor
(iv) The supervisor must review and document the effectiveness of the
implemented risk controls.
Act this week:
The proposed task or process can proceed, provided that:
Medium (i) the risk level has been reduced to as low as reasonably practicable using
the hierarchy of risk controls;
(ii) the risk assessment has been reviewed and approved by the Supervisor.
Act this month:
Low Managed by local documented routine procedures which must include
application of the hierarchy of controls.


Hazard/Risk: Control Methods: Risk
001 Planning: Senior and site management shall develop a hazard/risk H
Uncontrolled register that is specific to this workplace and based on
exposure to known and potential risk. The hazard identification, Senior & Site
risk hazard/risk assessment and control of hazard /risk shall Mngt
cover products and service over which the company has
control or influence, including products and services of
PCBUs and suppliers.
The methodology for our hazard identification,
hazard/risk assessment and control of hazard/risks,
is based on our operational experience and our
commitment to eliminate workplace illness and
injury or control the risks.
This methodology must be kept up to date with our
legal and other responsibilities.
002 Design: Senior and project management shall ensure that the H
Changes: Risk: buildability and constructability of structures is not
Changes affected by design changes. Senior & Site
affecting the Requests For Information (RFIs) shall request the Mngt
workplace not PCBUs (Designer and / or Engineer) to identify any
identified potential or real risks to the health and safety or
CoP: Safe persons affected by the proposed design changes
Design of Design changes shall be reviewed by senior and
buildings & project management to ensure potential OHS
Structures hazards/risks are identified at the design stage and
either eliminated or controlled. Design changes shall
be documented and traceable, obsolete documents
shall be removed and stamped accordingly.
003 Site PCBUs in control of powered mobile plant must H
Establishment verify the operators competency
: Verification of Competency (VOC) to be recorded by Site
Working with head PCBU before allowing work to commence Manager & Foreman
or near PCBUs to ensure Plant operators/owners provide
powered their site specific SWMS
mobile plant. Persons working with or near powered mobile plant
Working at are to wear the appropriate PPE
height Information on location of underground services to
be provided to relevant PCBUs
PCBUs undertaking work near energised services
must provide their SWMS prior to commencement
004 Before starting work onsite, PCBU will provide the L
Consultation: Principal Contractor (PC) with evidence of consultation
Risks: and communication with each of their workers and Site
Untrained contractors on safety matters such as evidence of; Manager & Foreman
and/or poorly Current General Induction Cards
trained Safe Work Method Statement Induction
personnel; Ongoing training for specific tasks.
Statements of attainment
Refer To; High Risk Licenses
WH&S Regs
2011 Site Specific Inductions:
CoP: The signing of the Site Specific Induction form by the
Consultation, worker verifies that the worker understands and
Communicatio agrees to comply with the site rules, conditions &
n & Co- procedures set down in the PCs Work Health and
operation Safety Management Plan (WHSMP).
2011 Each PCBU shall ensure their workers are made
aware of the contents of the PCs WHSMP, site rules,
mandatory PPE requirements prior to

005 PCBUs are required to provide site management with a L
PCBUs Safety current copy of their Safe Work Method Statement
Plans: (SWMS) and all relevant documentation prior to onsite Site
Risks: Unsafe commencement. Manager & Foreman
work Including but not restricted to a copy of HSRs &
methods, Workers Signoff covering the contents of their
improvisation; SWMS signed and dated by all team members.
Death or PCBUs will ensure that procedures outlined in their
serious injury; SWMSs are understood followed and monitored for
their effectiveness.
Workers are to comply with their agreed safe work
Task specific PPE will be used as prescribed in the

006 Before starting work onsite, contractors must provide VL
Insurances: the PC with copies of their Certificates of currency for;
Risks: Workers Compensation and Public Liability Site
Uninsured for their workers Manager & Foreman
workers; Where the contractor is operating as a sole trader,
evidence of sickness & accident insurance and
medical benefits, equivalent to workers
Public liability amount to be stipulated by the PC
prior to contracts being signed

Before selecting an item of Worker Protective Equipment (PPE) consider what type of PPE is best suited to the
Tick the relevant boxes for each item of PPE selected to carry out the job/activity in a safe manner.
Each worker will be issued with Personal Protective Equipment (PPE) with which to complete their work in a
PPE will be made available when identified by a risk assessment.
Issue of PPE is to be recorded in the Company PPE Register.






The Principal Contractor has a legal obligation under s276 WHSRs 2008 to erect and maintain
appropriate safety warning signs at each site entry and specific areas of the workplace.

Site management is responsible for continually monitoring the condition and appropriateness
of their signage


Central to our business culture is our commitment to the health and safety of our workers and
everyone who visits our workplaces. Where a work related injury/illness occurs, we are
committed to assisting the injured/ill worker to recover from their injury/illness and developing
a Return to Work (RTW) Plan which will facilitate a return to their normal job whenever
possible. Rehabilitation shall be provided in accordance with current legislative requirements.

Providing a safe and healthy work environment, but in the event of an injury or an
illness, endeavouring to arrange that workplace rehabilitation is started as soon as
possible in accordance with medical advice.
Endeavouring to arrange suitable duties for injured or ill workers to facilitate their safe
and early return to work. These duties must be medically approved and will be time

Respecting the confidential nature of medical information and ensuring there will be
both verbal and written confidentiality.

Making workers aware that, in the event of injury or illness, they will wherever possible
be consulted to develop their rehabilitation plan for a structured and safe return to
work that will not disadvantage them.

Workers and their PCBUs recognise they have an important role to play in rehabilitation
and the need for mutual cooperation in all aspect of the RTW Plan.

We shall arrange for rehabilitation to commence at the time of injury or when
treatment is first started, whichever is the most practical.

Complying with legislative obligations with respect to rehabilitation.

Adopting a multidisciplinary approach to rehabilitation as required.

Reviewing this policy and procedures to ensure it continues to meet legislative
requirements and the needs of all parties.

This policy will be reviewed at least once a year to ensure it meets our ongoing commitment to
rehabilitation and injured workers and in particular ensuring a safe workplace.

Senior Management: .. //.
Signature Date

Policy Review Date: ..

(A signed copy of this policy is to be provided to each workplace)
Safe Work Method Statement
Made under the provisions of The QLD Work Health and Safety Act 2011

Company Name: Project Name / Number:

Work Activity / Task: Principal Contractor:

Date: Note: Sign off to be provided at toolbox talk.

Prepared By:

Item Job Step Potential Hazard Controls Person

Break down the job into steps What can harm What are you Who will
you? going to do to ensure this
make the job as happens
safe as possible

Reviewed By:

______________________________ __________________________
Principal Contractor Representative Position

______________________________ ______/______/______
Signature Date
Safe Work Method Statement (cont.)
Made under the provisions of The QLD Work Health and Safety Act 2011

Item Job Step Potential Hazard Controls Person
Break down the job into steps What can harm What are you Who will
you? going to do to ensure this
make the job as happens
safe as possible

Reviewed By:

______________________________ __________________________
Principal Contractor Representative Position

______________________________ ______/______/______
Signature Date