Work activity Name:	SWMS No.:
JCU Representative:	Contact Phone:
NOTE: Work must be performed in accordance with the SWMS. This SWMS must be developed in consultation and cooperation with employee / workers and relevant Employer / Persons Conducting Business or Undertaking (PCBU). This SWMS must be kept and be available for inspection until the work to which this SWMS relates is completed. If the SWMS is revised, all versions should be kept. If an incident occurs in relation to the work in this SWMS, the SWMS must be attached to the incident in the JCU Risk Management System.
Who is using the SWMS ☐Principle Contactor ☐Contractor ☐JCU	Name:	Principal Contractor / Contractor Company Name:
Contact Details:	ABN (if applicable):
Date SWMS provided to Project Manager / Contractor:	Project Manager / Contractor Signature:	Date:
Person responsible for ensuring compliance with SWMS	Name:	Signature:	Date:
Date SWMS received:

SWMS Review
Person (s) responsible for reviewing SWMS control measure:	Name:	Date SWS received by reviewer:
Name:	Date SWS received by reviewer:
Name:	Date SWS received by reviewer:
To ensure controls are implemented and monitored effectively: ☐ Toolbox / pre-start work meetings will be undertaken ☐ Is there a PTW being used in conjunction with SWMS ☐ Relevant persons will be consulted on hazards and contents of SWMS, work plans and other applicable information ☐ Control measures will be monitored throughout works by: - Spot checks - Consultation - Scheduled audits ☐ Corrective actions will be recorded and rectified in a timely manner SWMS will be reviewed and updated accordingly (in consultation with relevant persons)	Ensure controls are reviewed if: ☐ Controls fail to reduce risk adequately ☐ Changes to the workplace or work activity occur that create new / different risks where controls may no longer be effective ☐ New hazards are identified ☐ An incident involving work activities relevant to this SWMS occurs ☐ During consultation with relevant persons they indicate review is needed ☐ A Health and Safety Representative (HSR) requests a review in line with the requirements of the legislation
List additional methods to implement and monitor controls if required: Click or tap here to enter text.	List additional methods to review controls if required:
Reviewer’s signature:	Review date:

Details of construction work
Work location	Physical location that the works are being performed:
Work activity	Description of work:
High risk construction work	☒ Risk of a person falling from more than 2 meters ☐ Likely to involve disturbing asbestos ☐ Work in or near a shaft or trench deeper than 1.5m or a tunnel ☐ Work on or near chemical, fuel or refrigerant lines ☐ Tilt-up or precast concrete elements ☐ Work in areas with artificial extremes of temperature	☐ Work on a telecommunication tower ☐ Temporary load-bearing support for structural alterations or repairs ☐ Use of explosives ☐ Work on or near energised electrical installations or services ☐ Work on, in or adjacent to a road, railway, shipping lane or other traffic corridor in use by traffic other than pedestrians ☐ Work in or near water or other liquid that involves a risk of drowning	☐ Demolition of load-bearing structure ☐ Work in or near a confined space ☐ Work on or near pressurised gas mains or piping ☐ Work in an area that may have a contaminated or flammable atmosphere ☐ Work in an area with movement of powered mobile plant ☐ Diving work

Tasks List the work tasks in a logical order	Hazards What can cause harm?	Risks What can happen?	Control measures Using the Hierarchy of Controls (HoC), nominate what controls are to be put in place to reduce the risk. Eliminate 1, Substitute 2, Isolate 3, Engineer 4, Admin 5, PPE 5 (Enter nominated Hierarchy of Control into HoC column)	HoC

Workers
NOTE: I have read the above SWMS and I understand its contents. I confirm that I have the skills and training, including relevant certification to conduct the task that I am directed to undertake as described. I agree to comply with safety requirements within this SWMS including risk control measures, safe work instructions and Personal Protective Equipment described.
Name	Signature	Date SWMS received