Scaffolding JSA
Scaffolding JSA
Scaffolding JSA
This SWMS has been developed and authorised by: Scott Butlin Position: Manager Date: 27th February 2009
DESCRIPTION OF WORK ACTIVITY: Supply and erection of scaffold and accessories
COMPANY:
CONTACT NAME:
SITE ADDRESS:
PROJECT DESCRIPTION:
SITE ADDRESS:
COMPANY:
NAME:
POSITION:
SIGNATURE:
DATE:
PHONE NUMBER:
MOBILE NUMBER:
List plant,
equipment and
tools to be used
eg Electric
generator
List hazardous
substances to be
used or handled
eg Unleaded petrol
MSDS available?
(Tick)
(Tick)
List hazards to
consider
Hard hat
Safety boots
High Visy
Gloves
Contact with
(Tick)
Hearing
Falling objects
Safety glasses
Collapse
UV cream
Dust masks
Manual handling
Other (specify):
Exposure to noise
Struck by moving
Inhalation of dust
Cuts
Other (specify):
RISK TABLE
Death or permanent
disability
Very likely
(could happen
anytime)
Likely
(could happen
sometimes)
Unlikely
(could happen, but
only rarely)
Very unlikely
(could happen, but
probably never will)
Medical attention
and several days off
work
List the step-by-step sequence of tasks required to carry out a work activity from
start to finish.
List the potential hazards associated with each step, and the related OHS risks.
List what controls you will implement to reduce the risks to the lowest possible
level.
Rate the level of risk once those controls have been implemented (must be 4-6
before you can start work).
List the names or positions of the persons responsible for ensuring that the
General Planning
Inadequate training,
consultation, planning
& improvisation.
Sub contractor.
Sub contractor.
Overload of scaffold
components.
Sub contractor.
Initial risk
Rating (1 6)
Job Activity
(Tasks)
Person who
will ensure this
will happen.
Unstable or incorrect
erection of scaffold.
Supplier, sub
contractor &
workers onsite.
Planning by
principal
contractor or
subcontractor.
Electric shock or
electrocution.
Head
contractor, sub
contractor &
workers onsite.
Erection of base
frames, standards
and bracing.
Unsupported frames or
standards being
erected at ground level.
Sub contractor
& workers
onsite.
Erection of 2nd
level frames,
standards and
bracing.
Climbing unbraced
scaffold during
erection.
Sub contractor
& workers
onsite.
Erection of working
platforms
Erection of edge
protection, ladder
and toe boards.
Instability / collapse of
scaffold causing fall.
Sub contractor
&
workers
onsite.
Sub contractor
& workers
onsite.
Manual handling.
Sub contractor
& workers
onsite.
Sub contractor
& workers
onsite.
Scaffold moves
unexpectedly or tips over
causing fall.
Sub contractor
& workers
onsite.
Movement of scaffold.
Sub contractor
& workers
onsite.
Edge protection
incomplete.
Sub contractor
& workers
onsite.
Sub contractor
& workers
onsite.
Inappropriate access to
working deck.
Sub contractor
& workers
onsite
I the undersigned have read and fully understand the Australian Scaffold Pty Ltd Rubbish Chute Installation SWMS. If at any time I feel
that the SWMS is not being adhered to, or that my safety is being compromised, I will bring it to the attention of Australian Scaffold the
first practical opportunity and will discuss the matter with the intention of finding a solution to the problem. I will at all times abide by
and use this SWMS in carrying out my duties while working at this site. I will help Australian Scaffold Pty and its workers in reviewing
any additions to this SWMS by making constructive suggestions at toolbox meetings or any other site meeting regarding safety.
This work method statement was not intended just to meet O.H&S regulations. Its principal design is to ensure the health and safety of
workers on site. Please use it as intended.
Declaration by contractors and workers
I have been consulted and have assisted in the development of this SWMS.
I have been given the opportunity to comment on the content of this SWMS.
I have read and understand how I am to carry out the activities listed in this SWMS.
I have been supplied with the personal protective equipment identified on this SWMS and I have been given training in the safe use of this equipment.
I have read and understand the requirements set out in the material safety data sheets for the hazardous substances identified in this SWMS
Name
Signature
Date
Green Card
QUALIFICATIONS:
TRAINING: