Safe Work Method Statement

Project Name: ServiceNow Address: Hyderabad

Company Name: Vayucon Systems Pvt. Ltd. Activity/Trade: Thermal and Acoustics Insulation
Address: B-9, Raheja Mindspace, Hitec City, Hyderabad, TS-81 Office Contact No: Nil
Prepared by: Mr. Raviteja Contact No: 7997598829
Procedure (in steps) Possible Hazards Risk Control Measures Contr Person who will
Rating (Describe what action or procedure will be taken to eliminate or minimise the risk of injury or olled ensure this
(Break the job down into steps. (Identify the hazards associated with each step. Examine each to (See damage. Use the Hierarchy of Controls below as a guide Risk happens
Each step should accomplish some find possibilities that could lead to an accident or potential harm below) 1. Eliminate the Hazard Score
major task and be in logical arising.) 2. Substitute the material or equipment
sequence.) 3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE

 Standard Operating Procedures (SOP) must be followed as per State / M

Most common symptoms:
Union Govt directions VSPL – EHS
 Fever Team and
 Medical Examination to be done for all the employees (staff, workers,
 dry cough PM
visitors, drivers etc.)
 tiredness
 Ensure Body Temp. Screening & recording at the time of gate entry/
 Less common symptoms: exit (temp should be less than 98 degree C).
 aches and pains  After Screening, eligible employees must be allowed to work at site
 sore throat  Ensure Social distancing (min 6ft person to person) in all the
 diarrhoea movements (During site Entry/ Exit, Stores, security check post, Rest
 conjunctivitis & Dining, Work place, while travelling, TBT, Training sessions etc.)
Covid Precautions  headache H
 PPE's must wear all times: (Nose Mask)
 loss of taste or smell  Ensure Frequent Hand wash/ hand Sanitization
 a rash on skin, or discoloration of  COVID19 Awareness Posters must be displayed in site premises
fingers or toes  Must be displayed Emergency Contact no’s and Nearest COVID
 Serious symptoms: treatment hospital details
 difficulty breathing or shortness of  Initial Disinfection to be done at site all the locations (like stores,
breath materials, tools & tackles etc.)
 chest pain or pressure  Incoming Materials has to disinfect in the designated location
 loss of speech or movement  COVID19 awareness training to be conducted for all the employees
 Only Vaccinated person should be allowed to site.

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps) Possible Hazards Risk Control Measures Contr Person who will
Rating (Describe what action or procedure will be taken to eliminate or minimise the risk of injury or olled ensure this
(Break the job down into steps. (Identify the hazards associated with each step. Examine each to (See damage. Use the Hierarchy of Controls below as a guide Risk happens
Each step should accomplish some find possibilities that could lead to an accident or potential harm below) 1. Eliminate the Hazard Score
major task and be in logical arising.) 2. Substitute the material or equipment
sequence.) 3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE

Project Engineer &

1. Gather tools and Body ergonomics while transporting M
Use trolleys for transport of insulation rolls and adhesive gum. L Safety Officer
material to the work insulation material and adhesive. Wear gloves all times.
area Muscle or back strain for lifting Bend and lift with legs/arms, not back.
insulation rolls The adhesive needs to collect in closed vessel.
Floor needs to be mopped regularly.
Using PPE’s
(Hard Hat, Safety shoes, Hi Visibility jackets, Hand Gloves,
Mask/face shield)
Project Engineer &
2. Cutting of thermal Tripping due to obstruction in your path. M Keep work area organized and free of surface obstructions L Safety Officer
and Acoustics seat in Finger cut observed. during task.
ground. Fire hazards due to chemical and waste. Inform others in area of ongoing works and Barricade the work
area.
Use cut resistance hand gloves and full sleeve shirt.
Use Stanley retractable utility Knife
Use full covered safety glass and use air purifying dust mask.
Keep ABC type fire extinguisher near work areas.
Segregation and removal of waste after completion of work.
Use plastic sheet at work area to facilitate better Housekeeping.
Using PPE’s
(Hard Hat, Safety shoes, Hi Visibility jackets, Hand Gloves,
Goggles, Mask/face shield)

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps) Possible Hazards Risk Control Measures Contr Person who will
Rating (Describe what action or procedure will be taken to eliminate or minimise the risk of injury or olled ensure this
(Break the job down into steps. (Identify the hazards associated with each step. Examine each to (See damage. Use the Hierarchy of Controls below as a guide Risk happens
Each step should accomplish some find possibilities that could lead to an accident or potential harm below) 1. Eliminate the Hazard Score
major task and be in logical arising.) 2. Substitute the material or equipment
sequence.) 3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE

H Project Engineer &

3. Apply of Adhesive to May get cramps, back injury while Bend and lift with legs/ arms, not back. L Safety Officer
the nitrile rubber reaching for material and while Check the condition of brush to apply adhesive.
insulation or Acoustic in application to the nitrile rubber/ Ensure the worker is using goggles and filter mask
ground Acoustics. Ensure the chemical adhesive is approved by EHS manager
Inhaling of adhesive smell and chance of before start of the work.
falling unconscious stage. Apply the material in small quantity.
Slipping on floor due to spillage of Ensure the worker is guided on the effects of adhesive gum.
adhesive gum on floor. Ensure the person is wearing full sleeves and long pants with
Fire hazards due to chemical and waste. glove.
Exposure of adhesive to skin can cause Ensure the worker is using goggles.
skin irritation. Nitrile gloves always while applying adhesive
Unwanted spillage to be mopped immediately and use required
amount of gum for the work.
Advisable to use PVC sheet at work area to facilitate better
housekeeping.
Keep ABC type fire extinguisher near work areas.
Segregation and removal of waste after completion of work.
Use plastic sheet at work area to facilitate better Housekeeping.
Using PPE’s
(Hard Hat, Safety shoes, Hi Visibility jackets, Hand Gloves,
Goggles, Mask/face shield)

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Safe Work Method Statement

Procedure (in steps) Possible Hazards Risk Control Measures Contr Person
Ratin (Describe what action or procedure will be taken to eliminate or minimise the risk of injury or olled who will
(Break the job down into steps. (Identify the hazards associated with each step. Examine each g damage. Use the Hierarchy of Controls below as a guide Risk ensure this
Each step should accomplish to find possibilities that could lead to an accident or potential (See 1. Eliminate the Hazard Score happens
some major task and be in harm arising.) below 2. Substitute the material or equipment
logical sequence.) ) 3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE

Project
4. Apply of Adhesive Men and materials fall from the height. M Scaffold must be inspected and tagged before use, by Safety L Engineer &
to the ducts and Cutting hazard while applying nitrile Officer. Safety
Officer
insulation or Acoustic rubber to the ducts. Work platform and toe guard to be fitted to mobile scaffold.
in ground and Height May get cramps while application to Need to ensure the working platform as per standard.
on mobile scaffold. the ducts. Inform others in area of ongoing works and Barricade the
work area.
Check the condition of brush to apply adhesive.
Nitrile gloves always while applying adhesive
Use cut resistance hand gloves and full sleeve shirt.
Use Stanley retractable utility Knife
Ensure to Wear mask and gloves always.
The coworker to be briefed on the steps of work and insist on
use of required PPE.
Bend and lift with legs/ arms, not back..
Using PPE’s
(Hard Hat, Safety shoes, Hi Visibility jackets, Hand Gloves,
Goggles, Mask/face shield)
Project
5. Clean area Tripping hazards while cleaning work M Keep work area clear off debris and remove tools/equipment’s L Engineer &
area. when not in use to eliminate trip hazards. Safety
Officer
Hazards while waste materials Ensure the waste is always filled up either in stable boxes or
handling. plastic bags.
Using PPE’s
(Hard Hat, Safety shoes, Hi Visibility jackets, Hand Gloves, Goggles, Mask/face
shield)

E - Extreme Risk: The hazard has the potential to kill or permanently disable a person H - High Risk: The hazard has the potential to cause a LTI ≥ 7 days
M - Medium Risk: The hazard has the potential to cause a LTI < 7 days L - Low Risk: The hazard has the potential to cause a minor injury that will not disable a person (ie: Nil LTI)
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 Personnel Summary
SUPERVISOR’S DETAILS
Supervisors Name & Qualifications: Name: Akhil
Experience: 3years
Qualifications: BE
Supervisor’s Responsibilities: In addition to the above, the supervisor is to provide training in the use of this WMS, issue PPE and provide training in the same, supervise the work,
ensure conformity with this WMS, amend the WMS when additional hazards are found (and if applicable, ensure all workers receive a tool-box talk
to discuss the control measures for the additional hazards).

DESCRIPTION OF TRAINING THAT HAS BEEN GIVEN TO PEOPLE INVOLVED WITH THE WORK

H&S GENERAL INDUCTION: All workers must have successfully completed industry induction training

WORK ACTIVITY TRAINING: All workers need to have been trained in the activities outlined in this safe work method statement.

SITE INDUCTION: All workers are to be site inducted by the Principal Contractor, prior to commencing work on site.

OTHER: (List other training undertaken by workers): (eg: Confined Space, Manual Handling, Traffic Control etc)

TICKETS, PERMITS or LICENCES REQUIRED to undertake this work (ie. Certificates of Competency, Confined Spaces etc):
N.B. - Copies of the above must be shown to the Principal Contractor during site induction.

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

All work to comply with the <insert location> H&S Acts and Regulations and amendments, Workplace Injury Management & Workers Compensation Acts

Additional Codes and Standards applicable to this trade:

 Equipment & Material Summary
PLANT and EQUIPMENT used and MAINTENANCE FREQUENCY:

Serial Plant/Equipment Contractor Government Plant Hazards Maintenance/service records and log books sighted
Registration No. identified and by Principle Contractor prior to equipment being
controlled within used on site?
(Where applicable)
WMS?
Yes No Sign Date

1
2
3

ELECTRICAL EQUIPMENT USED DURING THE WORKS (Attach Electrical Equipment Register if applicable):
Item Tag/Item Testers Name & Signature License Number Test Date Result Test Date Result
Number
____ /____ /____ ____ /____ /____
____ /____ /____ ____ /____ /____

HAZARDOUS SUBSTANCES or DANGEROUS GOODS USED IN THE WORKS and anticipated volumes (Attach MSDS if applicable):
MSDS
Purpose Location & Volume Used Controls
Date on Site Date Left Site Product Name MSDS Date Attached
(ie. Application on site) on Site (& PPE to be worn)
(Y/N)
/ / / / / /
/ / / / / /
/ / / / / /
N.B. - All workers must be trained in the safe use of all chemicals and provided with the PPE required when using and storing these chemicals. Disposal is to be as per the waste disposal methods in
the MSDS. Spillage and leaks are to be cleaned up as per the spill/leak procedures identified in the MSDS.

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We agree that we have been consulted in the hazards and control measures and agree to complete the work in accordance with our Work Method
Statement (WMS).
We have been provided with training in all tasks outlined in our WMS and in the Codes of Practice applicable to our work.

Employee / Worker Signature Date Employee / Worker Signature Date

1. 8.
/ / / /
2. / / 9. / /
3. / / 10. / /
4. / / 11. / /
5. / / 12. / /
6. / / 13. / /

Reviewed by: Signature: Date:

(Principal Contractor’s Representative)

Any changes, additions or deletions made to this WMS are to be covered with the above personnel and the Principal Contractor’s representative at a Toolbox
meeting (Record date and time of Toolbox meeting below):

Date: Time:
Comments:

A copy of the Toolbox Meeting must be attached to this WMS.

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