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1. Contractor Name : DANWAY 3. Trades / Disciplines Involved In Work :

2. Work Location: Machinary house MCC Supervisor, Electricians and Helpers.

Proposed Starting Date :

4. Brief Description Of Work To Be Undertaken : 5. Tools / Substance

Installation of Stainless steel label on the 10Kva
Portable Tools
Hand Electrical Pneumatic
Hazardous Substances
Toxic Flammable Corrosive
Harmful Irritant
Environment Impact
Health & Hygiene Effect

Environmental Impact Health & Hygiene

Yes No Yes No
Hazardous waste x Significant Dust Generation
x x
Emissions Noise (above 85 DbA)
x x
Discharge to sea or drains Hazardous substances (if yes attach list)
If answer to any of the above is yes, please circulate to If answer to any of the above is yes, please circulate to
Manager, Environmental Affairs Senior Occupational Hygienist

6. Person Completing The Work Method Statement :

Name : Position : SUPERVISOR Company : DANWAY

Signature : Date :

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7. Approvals

Contractors Site Rep. Name SULFEEK H Signature : Date :

EMAL Representative Name Signature : Date :

Area Owner Name Signature : Date :

Name Signature: Date:

EMAL EHS Department

The completed Work Method Statement must be submitted at least seven full working days prior to the
commencement of activities.
Where the Work Method Statement indicates the use of Hazardous Substances, a Material Hazard Data
Sheet must be attached.
After the Area Owners approval the Work Method Statement shall be forwarded to EHS department for
The approved Work Method Statement must be attached to the permit(s) to work and all persons involved
in the job instructed in its requirements.


The Risk Estimator chart should be used as an assistant for filling out the work
method statement.

Probability Low x1 Medium x 2 High x3

Low x1 Low Probability x Low Severity LP x MS LP x HS

1x1=1 1x2 = 2 1x3 =3
Medium x2 MP x LS MP X MS MP x HS
2x1 =2 2x2 =4
2x3 =6
High x3 HP x LS HP X HS HP x HS
3 x 1 =3 3x2 = 6 3x3=9

Significant Risk = High Risk (6-9) or Medium Risk (3-4) in terms of probability and severity
Tolerable Risk = Risk reduced to an acceptable level = Low Risk (1-2)
Residual Risk = Risk remaining after implementing recommended control actions (usually very minor).

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8. Safety Analysis

Severity x Probability =
Individual Activities To Identified Hazard(s) Persons Exposed To Precautions and Plan of actions To Be Taken
Complete Work. List In Residual Risk
Associated With Activity Hazard To Remove / Control Hazards
Sequence of Activity (Use Risk Estimator

PREPARATION. Slips, trips and fall at Maintain housekeeping around in the

Emal rep., Engr.,
the same level. working area.
Supv. Elec, and 2x2=4
Hot environment All personnel involve in the activity must be
aware of heat stress, supervisor to ensure
drinking cold water is available.

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Start work after getting permit from Emal.

APPROVAL(Permit to Client coordination Emal rep., Engr.,
Supv. Elec, helpers Engineer / supervisor must ensure that the
work from EMAL) fails, job stopped, work
unapproved. work permit is valid for the date and time
All work force are inducted by EMAL
Operatives should be All personnel involve in the activities must
aware of emergency wear the required PPEs at all times (hard
procedure of EMAL hat, Clear safety glass, safety shoes, hand
gloves, dust mask, cover all))
Advance planning by contractor considering
the time consumption to recive the permit
from EMAL.
Emergency procedure must be displayed at
prominent location and cascade to
operatives on regular interval and recorded. 2x2=4
Ensure the operatives must be go through
EMAL and DANWAY safety induction.
Conduct tool box talk to explain procedures
and risks involved in the work to the crew.

All hand tools to be used must be in

INSTALLATION OF SS Using damaged hand Electricians & Helpers good condition. 2 x 1 =2
LABEL. tools. Inspect before use, periodically

Competent workers to be deployed,

Incompetent workers. Electricians & Helpers 2 x 1 =2
supervisor to check the competency of the
Electricians ,
Slips, trips and fall at Maintain housekeeping around the 2 x 1 =2
supervisor & Helpers
the same level. working area.
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Using damaged Battery operated drill machine must be in

Electricians & Helpers 3x1=3
battery operated drill good condition with color coding inspection
machine. tag.

Unauthorized using of Electricians & Helpers Only competent and authorized worker for 3x1=3
battery operated drill the using of battery operated drill machine.

Maintain housekeeping within the

Emal rep., Engr.,
working area 2 x 1 =2
Poor housekeeping Supv. Elec, Helpers.
Walkway and gangway to be kept
free of obstruction.

Wear P.P.E.'s at all times (hard hat, Clear

Emal rep., Engr.,
safety glass, safety shoes, hand gloves, 2x2=4
Not using P.P.E.'s Supv. Elec, Helpers.
dust mask, fire retardant long sleeve shirt /
Only competent and authorized person to
Unauthorized workers Other workers nearby do the inspection, ensure notified the client 1x3=3
with all necessary documents.

This sheet must be properly completed detailing all of the steps required to complete the job along with the sequence of events and each of the hazards
arising. Failure to properly complete the form will result in non-approval.
(Additional sheets to be used as required)

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9. Chemical Analysis (This form to be used as required)

Product Name

MSDS supplied Yes / No

Dangerous Goods Class

Hazardous Material Yes / No

Nature of Hazard Irritation / Carcinogen / Corrosive / Toxic / Other

Form Solid /Liquid / Gas / Dust / Vapour / Mist

Exposure Route Inhalation / Skin / Eye / Ingestion

Number of People Exposed

Duration of Exposure

Frequency of Exposure

Controls to be implemented

Estimate of Exposure Negligible / Marginal / High

This sheet must be properly completed detailing all the necessary information. Failure to properly complete the form will result in non-approval.

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