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Contains
•	Organisational details
•	Project details
•	Risk risk assessment
•	Qualifications and skill requirements
•	Workers sign off form
•	How to use this form

Organisation Details	
Organisation Name:		
Contact Name		Phone		
ACN/ABN		
Address		
City/Suburb		Postcode		

Project
Project Details	
Project		
Area		
Activity		

This SWMS has been developed in consultation with:

Reviewed by: ________________________  Position: __________________ Date: _ / __ /

Resources / Trades Involved:	

Equipment Used:	

Maintenance checks:	

Materials Used:	

Occupational Health Safety or Environmental Legislation:	

Training required	

Codes or Standards applicable to the works:	

Risk ranking chart 
To be used in conjunction with the risk assessment table below
Level	Description of Consequence or Impact	Consequence	Likelihood / Probability	
			L
Likely	M
Moderate	U
Unlikely	
H (1)
(High level of harm)	Potential death, permanent disability or major structural failure/damage. Off site environmental discharge/release not contained and significant long term environmental harm.	H (1)
(High)	1	1	2	
M (2)
(Medium level of harm)	Potential temporary disability or minor structural failure/damage.
On site environmental discharge/release contained, minor remediation required, short term environmental harm.	M (2)
(Medium)	1	2	3	
L (3)
(Low level of harm)	Incident that has the potential to cause persons to require first aid.
On site environmental discharge/release immediately contained, minor level clean up with no short term environmental harm.	L (3)
(Low)	2	3	3	
Level	Likelihood / Probability	
Likely	Could happen frequently	
Moderate	Could happen occasionally	
Unlikely	May occur only in exceptional circumstances	

Pre-Start Risk Assessment 

Job Item		Risk class ranking	
			
Identified Hazards	Control Measures	

Name of persons responsible for work		

Job Item		Risk class ranking	
			
Identified Hazards	Control Measures	

Name of persons responsible for work		

Job Item		Risk class ranking	
			
Identified Hazards	Control Measures	

Name of persons responsible for work		

Job Item		Risk class ranking	
			
Identified Hazards	Control Measures	

Name of persons responsible for work		

Job Item		Risk class ranking	
			
Identified Hazards	Control Measures	

Name of persons responsible for work		

Qualifications and skill requirements
Qualifications and experience required to complete the task	Personnel, Duties and Responsibilities
(Supervisory staff and others)	Training Required to Complete Work	

			

			

			

			

Sign off form 

This SWMS has been developed through consultation with our employees and has been read, understood and signed by all employees undertaking the works:
	
Print Names:	Signatures:	Dates:	

			

			

			

			

			

Using the SWMS template
1.	Consult with all workers involved, contractors and health and safety representatives involved with the high risk construction work, the activities involved, and associated hazards, risks and controls.
2.	In the ‘Identified hazards’ column, identify the high risk construction work for the construction work activity that will be undertaken.
3.	Identify the workplace circumstances that may affect the way in the high risk work will be done.
Examples of workplace circumstances that may impact on the hazards and risks include:
a.	information relating to the design of the structure, the workplace (e.g. location, access, transport), and information contained in the WHS Management Plan
b.	information on any ‘essential services’ located on or near the workplace 
c.	confirmation that the regulator has been advised of any ‘notifiable work’ (e.g. demolition work involving explosives)
d.	safe work methods and plant to be used.
4.	In the ‘Control measures’ column, select an appropriate control or combination of controls by working through the hierarchy of controls. It is important that you are able to justify why the selected control measure is reasonably practicable for the specific workplace.  

Control measures
1.	Eliminate the risks so far as is reasonable practicable
2.	If this is not reasonably practicable, minimise them so far as reasonably practicable by applying the following hierarchy of control measures:
a.	minimise the risk by doing one or more of the following:
i.	substituting the hazard
ii.	isolating the hazard
iii.	implementing engineering controls
b.	if the risk still remains, minimise the remaining risk by implementing administrative controls
c.	if the risk still remains, minimise the remaining risk by ensuring the provision and use of suitable personal protective equipment (PPE).

SWMS implementation and compliance (information, monitoring and review)
1.	Brief each team member on the SWMS before commencing work. Ensure team knows work is to stop if the SWMS is not followed.
a.	Observe the work being carried out and monitor compliance with the SWMS. Review risk controls regularly:
b.	before a change occurs to the work itself, the system of work or the work location
c.	if a new hazard associated with the work is identified
d.	when new or additional information about the hazard becomes available
e.	when a notifiable incident occurs in relation to the work
f.	when risk controls are inadequate or the SWMS is not being followed.
In all of the above situations stop the work, review the SWMS, adjust as required and re-brief the team. 
Keep the SWMS in a readily available location for the duration of the high risk construction work and for at least 2 years after a notifiable incident occurs.