Client:

Date Prepared:

Project:

Site Address:

– Contact Information:

Local Address:

Office Telephone:

Contact Names / Position:

Contact Telephone

Contact Mobile Tel

–

Purpose:

The purpose of this method statement is to define the safe methods and procedures to be used by ——-

———— and subcontractor personnel for this noted project places the highest priority on

ensuring full compliance with all applicable safety procedures on every project. While jobsite safety is of paramount importance to on an ethical level, it is also apparent that jobs with the best

overall safety records tend to be the most profitable.

This method statement will apply to all persons associated with the works at the referenced site and to all persons who by nature of their involvement with this project interface directly or indirectly with this work.

Safety Responsibilities

· All persons will;

· All Project Management will ensure;

Competent Person:

The term “competent person” is used in many OSHA standards. The definition of a competent person, by OSHA standards, is one who “is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them”. (29 CFR 1926.32(f)). While there are specific standards which require a specially trained individual designated to oversee a specific work practice as a “competent person”, all employees must be trained in hazard recognition techniques and all have the authority to stop work in the event of a hazardous situation.

The activities which a designated and DOCUMENTED competent person according to OSHA standards will be assigned are as follows:

·

Responsible Person

Additionally, assigned “responsible” persons will be assigned for the following activities: 1.

These “Responsible Persons” will have documentation that they possess the training, knowledge, skills and abilities to perform the assigned functions.

Logical Sequence of Task:

1.

SPECIFIC SITE SAFETY RULES:

1.

Schedule:

Proposed Start Date:

Duration:

Working Hours:

Overtime Hours:

Access to Work Area:

Resources Required to Undertake Works:

Contractor, Equipment, Materials:



Inspections / Documentation Required:

· .

Personal Protective Equipment (PPE):

All employees and subcontractor employees will use and wear approved PPE as follows :

·

Disposal of contaminated PPE



First Aid, Emergency and Treatment Arrangements:

1.

Medical Facilities Identified for this Project:

Occupational Clinic Name:

Address:

Telephone:

Working Hours:

~ Map~

Emergency Medical Facilities Identified for this Project:

Emergency Hospital Name:

Address:

Telephone:

Working Hours:

~Map~

Monitoring & Compliance

Monitoring and compliance of the work by ———

Subject

Required

Specific & detailed information / description required for all questions.

List OSHA Standard Number

Yes

No

Compressed Gas:

N/A

Will cylinders be brought on site?

Are there plans for safe use and storage on site?

Will portable torch sets be required?

(All gas cylinders and welding machines must be left outside of excavations and

long enough leads provided.)

Subject

Required

Specific & detailed information / description required for all

questions. List OSHA Standard Number

Yes

No

Ladders:

N/A

Will ladders be required?

(All ladders – min 300 lb. rating.)

The ladder chosen must be long enough to provide access to the work area without necessitating standing

on the top two steps of a stepladder

or the top three rungs of a straight ladder.