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Job Safety and Environmental Analysis (JSEA) / Safe Work Method Statement (SWMS)
The Sample Company Pty Ltd

PL
Part 1: Project and Task Identification
Process Initiators of SWMSs are responsible for consulting the Project Supervisor, Quality WHS Manager or other persons directly in charge of the work and other personnel involved in the execution of the task (as
appropriate) for input into the SWMS. Other persons may be consulted for technical advice or review of the SWMS to see that proposed measures are effective and workable. The task is to be broken up into steps.
For each step, the safety hazards are identified. For each of the hazards identified, corrective action, precautions, equipment are identified to reduce the hazard. All involved in the task must review and sign this
SWMS form.

Client: TotalTrack Pty Ltd

Site: The Sample University, 99 Example Way Melbourne VIC 3000

Contact Name Job Title Phone Mobile FAX Email
Scott LeBlanc

SWMS Initiated By
Director

M 08 8351 1540

Date:
0408 831 550 08 8261 9977

SWMS No. 2
scott@totaltrack.com.au

Rev: 0 Rev. Date: 29/06/2018

SA
Sample Guy
Work Locations/Areas:
Supervisor Review Date: Riverside Precinct – section 2
Sample Guy

Management Review Date:

Sample Guy

Description of Work Delivery and unloading of mobile plant

to be Undertaken:

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JSEAsy SWMS - Delivery and unloading of mobile plant
 First, identify and assess the risks, then decide the best way to control them by applying the Hierarchy of Control as follows:

LEVEL CONTROL DEFINITION

Level 1 Elimination Controlling the Hazard at source
Level 2 Substitution Replacing one substance or Activity with a less hazardous one
Isolation Separating the hazard from the person
Engineering Installing Guards on machinery

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Level 3 Administration Implementing policies and procedures for safe work practices
Personal Protective Equipment Use of safety glasses, hardhats, protective clothing, etc.

Hierarchy of Controls

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Effectiveness
Eliminate the hazard

Substitute the hazard

M Isolate the hazard

Use engineering controls

Use administrative
SA
controls

Use PPE

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JSEAsy SWMS - Delivery and unloading of mobile plant
 Part 2: Worker Qualifications and Induction Record The Sample Company Pty Ltd

Personal Qualifications and Experience
Required To Carry Out the Works:
The ability to work unsupervised and part of a team
Completion of White Card Induction
Duties and Responsibilities of Personnel
Completing the Task:
Adherence to company's and the site's WH&S policies
and procedures
Maintain adequate house-keeping on site
Formal or Specialised Training or
Licenses Required to Complete Work or
Operate Specific Plant or Equipment:
Heavy Vehicle Drivers licence with a class equal to or
greater than the required for the mass of the truck
Load Restraint Training (TLIA107C)

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Reporting of any injuries / incidents to your Project
Supervisor
Operate safely and perform daily pre-shift inspections
Take reasonable care for your own health and safety
Take reasonable care for the health and safety of others

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Comply with any reasonable instruction by the PCBU
(Person conducting a business or undertaking)
Cooperate with any reasonable policies and procedures
of the PCBU
SWMS Sign Off – Your signature below indicates that you have been consulted in development of
the SWMS and accept and will implement the requirements of the SWMS and control measures
No. Name Classification Employed By Signature Date
1 Sample Guy Driver The Sample Company Pty Ltd

2
3
4
5
6
M
SA
7

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JSEAsy SWMS - Delivery and unloading of mobile plant
 Part 3: Hazard Analysis, Control and Legislation Worksheet The Sample Company Pty Ltd

Job Safety and Environmental Analysis (JSEA) Safe Work Method Statement (SWMS)
Process Steps Potential Hazard(s) Hazard Control Measures New
Risk
Step List the steps needed to do the job Rating
Risk Action By
Against each step list potential hazards that For each hazard, identify control measures
No. in the sequence to be done. Rating
could cause injury when the job is done. to eliminate or minimise the risk of injury.

1 Undertake Clients general all sites online induction

1.1 Undertake a site induction Unfamiliarity with emergency procedures 14 Listen and ensure you obtain information and 1 All
site emergency and evacuation procedures

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Unawareness of site specific hazards 14 Listen and ensure you obtain information 1 All
about any and all site hazards
Unawareness of restricted areas 18 Listen and ensure you obtain information 1 All
about any restricted areas

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Unawareness of other operations or hazardous 9 Listen and ensure you obtain information 5 All
activities being undertaken on site about any other activities being undertaken
on site

2 Inspect and drive truck

2.1 Pre-operation Inspection Faulty equipment machine failure 14 Examine Tires and wheels for following 1 Driver
hazards: lug nuts, cracked rims, cuts, tire
pressure
Check all hydraulic rams and lines, controls 3 Driver
for leaks
Check all safety devices 3 Operator

2.2 Board truck

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Falling from truck 13
Check rear view mirrors are present and in
good condition
Ensure Safe Working Limit is displayed and
legible
Use hand hold and steps when
entering/exiting cabin
Do not jump from cabin
1

1
Driver

Driver

All

All
SA
2.3 Start the truck Vehicle running into objects and or persons 7 Ensure parking brake is on and operational 1 Driver
Before starting motor, ensure transmission is 1 Driver
in neutral and check throttle for proper
operation
2.4 Drive the truck Legislation Breach 18 Ensure seatbelt is worn 2 All
Only persons with the appropriate licence are 1 Driver
to dive the vehicle
Do not drive or operate the vehicle while 2 Driver
under the influence of drugs or alcohol
Ensure the load does not exceed the safe 1 Driver

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JSEAsy SWMS - Delivery and unloading of mobile plant
 Job Safety and Environmental Analysis (JSEA) Safe Work Method Statement (SWMS)
Process Steps Potential Hazard(s) Hazard Control Measures New
Risk
Step List the steps needed to do the job Rating
Risk Action By
Against each step list potential hazards that For each hazard, identify control measures
No. in the sequence to be done. Rating
could cause injury when the job is done. to eliminate or minimise the risk of injury.
work load/ limit of the vehicle
Obey the road rules and speed limits of the 2 Operator
state or territory at all times
Unsecured load 15 Ensure load is secure with rated restraints 1 Driver
Striking Overhead Tree branches 13 Ensure path of travel is clear of low-lying tree 2 Driver

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limbs
Striking structure or overhead members 25 Check for clear head room 3 Driver
Injury to people, damage to product or 13 Be aware of increased braking/stopping 2 Driver
equipment from running into or over distance when carrying loads

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2.5 Reversing the truck Reversing/ Running over people and equipment 22 Make sure that your back up alarm is working 5 Driver
and not very good visual Use a spotter when reversing in the vicinity of 2 Driver
other people or in congested areas

3 Claim Work Area

3.1 Access the site Breaching minimum site PPE requirements 13 HI visibility clothing must be worn at all times 1 All
whilst on site
Steel toe safety boots must be worn at all 1 All
times whilst on site
Safety glasses must either be worn or carried 1 All
at all times whilst on site

3.2 Establish safe perimeter M

Breaching site rules or requirements

People entering work area

13

25
NO SMOKING on site-designated smoking
area will be available and ALL butts to be
placed in bin
Progressive housekeeping clean as you go

Post signage
1

1
All

All

Driver
SA
4 Delivery and unloading of mobile plant
4.1 Direct delivery vehicle Running into objects and or persons 13 Place “spotter” to watch path of truck 3 Site Supervisor

4.2 Activate or place ramps in position Ramps may strike personnel 7 Stop operations if a 15m exclusion zone is 1 Driver
breached
4.3 Release machine restraints Machine may move 4 Ensure machine is stable before tie down 1 Driver
tension is released
Ensure truck is parked on level hard surface 1 Driver
Due care by personnel 5 All

4.4 Board the Machine Falling from machine 14 Gain access and egress from the 2 Operator
manufactured entry/ exit opening only

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JSEAsy SWMS - Delivery and unloading of mobile plant
 Job Safety and Environmental Analysis (JSEA) Safe Work Method Statement (SWMS)
Process Steps Potential Hazard(s) Hazard Control Measures New
Risk
Step List the steps needed to do the job Rating
Risk Action By
Against each step list potential hazards that For each hazard, identify control measures
No. in the sequence to be done. Rating
could cause injury when the job is done. to eliminate or minimise the risk of injury.
Keep three points of contact during access 2 Operator
and egress
4.5 Unload and drive machine to ground Machine can tip, slip or fall down ramps 9 Ensure firm ground 3 Operator
Experienced and competent operator with 5 Operator
VOC to perform task

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4.6 Moving or driving the machine Injury to people, damage to product or 13 Only trained and authorised employees with 3 Driver
equipment from running into or over VOC may operate this equipment

5 Monitoring and Review of SWMS

5.1 Monitor the SWMS Ineffective SWMS 4 Review the SWMS at a minimum of 3 monthly 1 Supervisor
intervals

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Monitor and complete an inspection of a 1 Supervisor
minimum of 2 task observations
SWMS Failure 13 Stop Work 1 All
In conjunction with workers, review and 1 Supervisor
formulate a new SWMS
Implement new controls 1 All
Conduct a toolbox meeting with all personnel 1 Supervisor
involved with work activity

M
SA

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JSEAsy SWMS - Delivery and unloading of mobile plant
 The Sample Company Pty Ltd
Part 4: Hazard Analysis, Control and Legislation Worksheet - Site modifications, additions or alterations

Job Safety and Environmental Analysis (JSEA) Safe Work Method Statement (SWMS)
Process Steps Potential Hazard(s) Hazard Control Measures New
Risk
Step List the steps needed to do the job Rating
Risk Action By
Against each step list potential hazards that For each hazard, identify control measures
No. in the sequence to be done. Rating
could cause injury when the job is done. to eliminate or minimise the risk of injury.

E
PL
M
SA

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JSEAsy SWMS - Delivery and unloading of mobile plant
Reference and Detail Applicable Sections of: Legislation Codes Of Practice Project WHS Site WHS Manufacturer Or Supplier Recommendations

Australian Road Rules 1999 under the Road Traffic Act 1961
Occupational Health and Safety Regulations 2007 under the Occupational Health and Safety Act 2004 (VIC)

Plant and Equipment to be used for task: Plant, Equipment and Area Safety Inspections:
Truck Vehicle Pre Operational checks
Warning signs and bunting as required

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PL
M
SA

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JSEAsy SWMS - Delivery and unloading of mobile plant
PPE Requirements for Task: The Sample Company Pty Ltd

ELECTRICAL TAGGING COLOURS:

Hi Visibility Vests or Clothing
RED - December to February GREEN - March to May
BLUE - June to August - September to November

Safety Boots

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PL
M
SA
Acronyms and Abbreviations:
LTI - Lost Time Injury
PPE - Personal Protection Equipment
PTD - Permanent and Total Disability

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JSEAsy SWMS - Delivery and unloading of mobile plant