Safety Method Statement

Title: .

Safety Method Statement

1

By: Engr. Murtadha AlRuwaie

Safety Method Statement

2

By: Engr. Murtadha AlRuwaie

Completed Date:

Method Statement

(1) Project Details

Company
Office Address
Project
Planned schedule of Activity

Doc. No.

Rev No.

Tel No
Location

Scope of Work
Purpose
(2)Document References
Risk Assessment Ref. No
Work Permits Ref. No
Technical Specification Document Ref. No.
Drawing Ref. No.
(3) Role & Responsibilities for Persons Involved: Project Management and Name of Other Contractor/s:
Name
Contact No
Responsibilities
Project Manager
Site Supervisor
(4) Procedures:
4.1. Activity Procedures: How to do this activity safely?
No
Activity Steps
Safety Method Statement
3

How
By: Engr. Murtadha AlRuwaie

4.2. High-risk Identified in this Activity.

No
Hazard

Control Measure

(5) Resource Required

Details
a. Plant and Equipment: e.g. cranes, lifting tackle,
fork lift trucks, and excavators.
b. Access Equipment: e.g. Ladders and Scaffold.
c. Site Access/Egress: e.g. Road Footpath
Stairways.
d. Safety Accessories: e.g. fencing, barriers, cones,
chains, dangers notices, warning signs etc.
e. Work tools: hand tools (e.g. hammer and
screwdriver), power tools (e.g. drill and grinding
machine)
f. Hazardous Substances.
h. Personal Protective Equipment (PPE)
(6) Training requirements to complete work
6.1. Top Manpower:
Position title
Name

6.2. Required Certificate and license.

Position title
Name
Crane operator

Qualifications

Certificate/ license

Experience (yr)

Expiry Date

(7) Waste Disposal/Housekeeping and Environmental issues: Details waste disposal processes and or housekeeping
activities, Details of environmental impacts and control measures.

(8) Emergency Provisions

First Aider:
Location of nearest hospital
Location of fire extinguishers
Emergency telephone numbers
Emergency Rescue Team
(9) Appendices
- Inspection Reports
- Checklist

Safety Method Statement

4

Tel:
Tel:

By: Engr. Murtadha AlRuwaie

(10) Approval
Authorize person

Completed by & Date

Approved by & Date

Method Statement
(10) Commitment
I undersigned have read, discussed and fully understand the above method statement and risk assessment on activity
and will adhere to all method of work and condition set down.
Name

Safety Method Statement

5

Company

Position

By: Engr. Murtadha AlRuwaie

Date & Signature