JSA - De-Shuttering

Work Method Statement Review : 01
Project Name: NMIMS Projects Address: Sarangpur, Chandigarh.
Company Name: Consort Builders Pvt Ltd. Activity/Trade: Reinforcement Steel Work
Address: Plot No: 05, Institution Park, Sarangpur, and Chandigarh. Office Contact No:
Supervisor Name: Mr. Balginder Singh Contact No:
Person who
Procedure (in steps) Possible Hazards Risk Rating Control Measures
will ensure
(Break the job down into steps. Each (Identify the hazards associated (See below) (Describe what action or procedure will be taken to eliminate or
minimise the risk of injury or damage. Use the Hierarchy of this
step should accomplish some major with each step. Examine each to happens
task and be in logical sequence.) find possibilities that could lead to Controls below as a guide
an accident or potential harm 1. Eliminate the Hazard
arising.) 2. Substitute the material or equipment
3. Isolate the hazard
4. Implement Engineering control
5. Implement Administrative control
6. PPE
1. Provide proper toolbox before work.
2. Proper trained person will be executes the work.
1.Slip & Trip Hazards 3. Check all points of De-shuttering work permit before
L works execute. Area In-
De shuttering of Footings 2. Person hit by De-Shutter
4. Barricade area where work should be executes. charge
Tools/material.
5. All de-shutter materials should be proper stage.
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)
Person who
will ensure
6. PPE
2. Deployment only experienced workmen.
3. Check all points of De-shuttering work permit before
works execute.
4. Barricade all area where de-shuttering work at
progress and display a caution sign.
1. Fall of person due to slip. 5. Provide proper scaffold working platform and
2. Fall of Materials implements tagging system. Area In-
De shuttering of Columns M
3. Slip & Trip Hazards 6. Working platform to be made for every 2.1m with charge
double railings and scaffolding staging ladder as
access.
7. Use of Double rope full body safety harness and one
point must be anchored at all times while ascending or
descending.
8. Use of safety shoes, Helmet with chin strip and hand
gloves
Person who
will ensure
6. PPE
1. Working platform to be made for every 2.1m with guard
railings and scaffolding staging ladder as access whose
rungs are not spaced greater than 500mm.
1. Fall of person due to slip. descending.
2. Fall of Materials 3. Deployment only experienced workmen.
Area In-
De shuttering of Beams 3. Slip & Trip Hazards H 4. Barricade the area below.
charge
5. Execute work as per work permit and methodology.
6. All the materials shall be lowered down properly.
7. All the loose materials shall be collected in a gunny bag.
8. Use of Double rope safety harness and it must be fixed
above the head height.
9. Movement of path is to be free from any obstruction.
10. Maintain proper housekeeping.
Person who
will ensure
6. PPE
railings and scaffolding staging ladder as access
whose rungs are not spaced greater than 500mm.
descending.
1. Fall of person due to slip. 3. Deployment only experienced workmen.
2. Fall of Materials. 4. Barricade the area below. Area In-
De shuttering of Slabs H
3. Slip & Trip Hazards 5. Execute work as per work permit and methodology. charge
11. Dedicated staff will be deployed to watch activity.
Person who
will ensure
6. PPE
works execute.
railings and scaffolding staging ladder as access whose
rungs are not spaced greater than 500mm.
1. Fall of person due to slip. point must be anchored at all times while ascending or
2. Fall of Materials. descending.
6. Deployment only experienced workmen. Area In-
De shuttering of Retaining Wall 3. Slip & Trip Hazards H
7. Barricade the area below. charge
8. Execute work as per work permit and methodology.
Person who
will ensure
6. PPE
works execute.
4. Barricade all area where de-shuttering work at
progress and display a caution sign.
5. Provide proper scaffold working platform and
implements tagging system.
6. Working platform to be made for every 2.1m with
1. Fall of Person double railings and scaffolding staging ladder as access
2. Fall of Materials whose rungs are not spaced greater than 500mm. Area In-
De shuttering under Ramp H
3. Slip & Trip 7. Use of Double rope full body safety harness and one point charge
must be anchored at all times while ascending or descending.
8. Use of safety shoes, Helmet with chin strip and hand gloves.
All the materials shall be lowered down properly.
Maintain proper housekeeping.
Person who
will ensure
6. PPE
Safe Work Method Statement
Personnel Summary
SUPERVISOR’S DETAILS
Supervisors Name & Qualifications: Name: Mr. Balginder Singh
Experience: 10 Years
Qualifications: 10+2
Supervisor’s Responsibilities: 1. Responsible to provide Tool Box to workers before work execute.
2. Responsible to provide proper PPE’s to workers as per job requirements.
3. Responsible to monitor all safety aspect during works.
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 Wooden Cutter Machine Mr. Rakesh Yes
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.
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.

JSA - De-Shuttering

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JSA - De-Shuttering

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Work Method Statement Review : 01

Project Name: NMIMS Projects Address: Sarangpur, Chandigarh.

LEGISLATION, CODES OF PRACTICE and GUIDELINES applicable to this work

Additional Codes and Standards applicable to this trade:

Equipment & Material Summary

1 Wooden Cutter Machine Mr. Rakesh Yes

Employee / Worker Signature Date Employee / Worker Signature Date

Reviewed by: Signature: Date:

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

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