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S A M P L E: Method Statement

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Ali Raza
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46 views

S A M P L E: Method Statement

sample

Uploaded by

Ali Raza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

S

<<Company Name>> Method Statement

Site Address <<enter text here and the cell will expand accordingly>>
Precise Location <<enter text here and the cell will expand accordingly>>

Start Date <<date>> Completion Date <<date>>

BRIEF DESCRIPTION OF THE WORKS, TASK OR PROCESS:

A
<<enter text here and the cell will expand accordingly>>

SEQUENCE OF OPERATIONS:

<<enter text here and the cell will expand accordingly>>

EQUIPMENT AND PROCEDURES:

Plant/Tools needed

PPE required
Delete and/or add as
appropriate:
Hard Hat

Safety Footwear
M
Hi-Vis Jacket/Vest
Gloves (Specify)

Hearing Protection
Eye Protection
Face Protection
Breathing Aids
Dust Masks
Harness/Fall Arrest

P
Other – give details

Materials to be used

Operatives required

Specific Training
needed – give

L
details

Permits to Work Hot Works


needed Confined Space
Delete and/or add as Live Working
appropriate: Work at Height
Other – give details

Machinery
Shutdown and

E
Lock-Off
Procedures

© Simply-docs – HS.MS.01 Blank Method Statement


Is Electricity needed

Mobile Phone use –


any Restricted
Areas

Means of protection
to other people
Hoarding
Barriers
S
<<e.g. 110/240. RCD used>>

A
Delete and/or add as Tape/Rope
appropriate: Other – give details

Site Access and


Egress

Access to Works
Area

M
Material Handling

Means of Access to Scaffold


Height Mobile Tower
Delete and/or add as MEWP/Scissor Lift/Cherry Picker
appropriate: Ladders
Steps
Hop Up’s

P
Fall Prevention
Measures

COSHH Assessment
Carried Out

Suitable Welfare
Arrangements –
give details

Traffic Management
in Place

First Aid Cover –


give details

Accident
Procedures – give
L
E
details

© Simply-docs – HS.MS.01 Blank Method Statement


S
Overhead Power
Cables – are
goalposts in place

Noise Issues

Dust Control

A
Vibration Control

Fire Plan in Place

Site Contact Details


including
Emergency
Numbers Etc

M
P
L
© Simply-docs – HS.MS.01 Blank Method Statement E
S
ISSUED TO:

Name Signature Date

A
M
P
L
© Simply-docs – HS.MS.01 Blank Method Statement E

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