SAFE WORK METHOD STATEMENT

(Job Safety Analysis Worksheet)

This Safe Work Method Statement is submitted to:

COMPANY: REFERENCE # SWMS – REFUELLING
SITE ADDRESS: JOB DETAILS:
CONTACT: REFUELLING PLANT & EQUIPMENT USING FUEL
CANS, TRAILER MOUNTED TANKS & BOWSERS.

This Safe Work Method Statement is approved by:

NAME: CHRIS BOND POSITION: WORKPLACE HEALTH & SAFETY ADVISOR

SIGNATURE: DATE: 10/12/2012 TIME:

PHONE NUMBER: 07 3456 4437 MOBILE NUMBER: 0409 067 467

This Safe Work Method Statement was prepared by:

NAME: JOHN YANNAKOPOULOS POSITION: CONSULTANT

SIGNATURE: DATE: 21/03/2008 TIME: 7AM

PHONE NUMBER: 07 34203484 MOBILE NUMBER: 0417669048

HAZARD IDENTIFICATION R
JOB SEQUENCE
(What can affect safety) I CONTROLS THAT WILL BE USED
(Outline each task to do the
ASSESS THE RISK S (Safe Work Procedures)
job)
(What could happen) K

Refuelling: High Temperature or Fire: • Operator/End User must shut the

5 engine of the Vehicle/Plant &
Vehicle/Plant and Refuelling: When refuelling, sparks, Equipment prior to refuelling.
Equipment flames, hot engine can ignite fuel.

Refuelling: High Temperature or Fire: • Refuelling must take place in a

well ventilated area.
Vehicle/Plant and Refuelling: When refuelling, sparks, 5
Equipment flames, hot engine can ignite fuel.
• Ensure that there are No Naked
Flames in the area

• DO NOT SMOKE

SWMS: REFUELLING Issue/Rev: A/1 Effective Date: 21/03/08 Rev Date 10/12/2012
 SAFE WORK METHOD STATEMENT (Page 2)

HAZARD IDENTIFICATION R
JOB SEQUENCE
(What can affect safety) I CONTROLS THAT WILL BE USED
(Outline each task to do
ASSESS THE RISK S (Safe Work Procedures)
the job)
(What could happen) K

• Avoid spilling fuel & clean up any

Refuelling: High Temperature or Fire: 5 fuel run off.
Refuelling: When refuelling, sparks,
Vehicle/Plant and flames, hot engine can ignite fuel.
Equipment

• Wear appropriate PPE i.e.

Refuelling: Skin/Eye Contact with Fuel 3 Protective gloves, Eye Protection.

Vehicle/Plant and
Equipment

SWMS: REFUELLING Issue/Rev: A/1 Effective Date: 21/03/08 Rev Date 10/12/2012
 SAFE WORK METHOD STATEMENT (Page 3)

Consequence
Likelihood Negligible Minor Moderate Major Catastrophic
Almost Certain Low Moderate High Extreme Extreme
Likely Low Low Moderate High Extreme
Possible Very Low Low Moderate High Extreme
Unlikely Very Low Low Low Moderate Extreme
Rare Very Low Very Low Very Low Moderate High

Risk Rating Table: - Risk Rating (RR) = Likelihood (L) x Consequence (C)

Risk Rating Action table

Risk Ranking Required Action

Stop The Job – Significant & Urgent Actions Are Required – Work Cannot Commence. Full risk assessment needs to
5- Extreme
be undertaken and risks eliminated

Consult with manager. Work cannot commence or continue until verification that control measures have effectively
4 - High
reduced risk severity ranking to as low as reasonably practical.

Consult supervisor. Additional control measures may be required to reduce risk severity ranking to as low as
3 - Moderate
reasonably practical before the job can commence.

2 - Low Exposure must be managed by using SOP, JSA or work instructions. Evaluate conformance

1 - Very Low Risk tolerable. No further actions required.

SWMS: REFUELLING Issue/Rev: A/1 Effective Date: 21/03/08 Rev Date 10/12/2012
 SAFE WORK METHOD STATEMENT (Page 4)

(Persons, Operators and Workers who will be involved in the Job Activity)
PERSONS INVOLVED IN QUALIFICATIONS
SIGNATURE
ACTIVITY EXPERIENCE / LICENCES

To be completed prior to Site Induction

The personnel listed above have been made aware of and understand the procedures, hazards and control
measures outlined in this Safe Work Method Statement. They will abide by the control measures outlined within
this Safe Work Method.

(Checklist of Items that may be required for the job activity)

WORKCOVER APPROVALS /
Check with Local Councils for Licensing requirements
CERTIFICATES

CODES OF PRACTICE /
OHS Act 1995 & OHS Regulation 1997
LEGISLATION APPLICABLE

PLANT & EQUIPMENT N/A

MAINTENANCE CHECKS Pre Operational Checks as per Manufacturers Recommendations

PERSONAL PROTECTIVE
EQUIPMENT

If Trailer-Mounted for use on public road make ensure it complies with

TRANSPORT PERMITS
the relevant State Transport Rules

SWMS: REFUELLING Issue/Rev: A/1 Effective Date: 21/03/08 Rev Date 10/12/2012