Safe Work Method Statement
Project Name: Bluestar Project Address: 14th floor,Godrej 2, Vikhroli-East
Company Name: ANA Designs Pvt. Ltd. Company Address: 1A New india Chambers, MIDC central Rd, Andheri east. Mumbai
Engineer Name: Velu M Contact No: 9137177375
Trade: Design & Build Work Location: 14th Floor
Description of work
Hazardous Work Activity:
(Please tick relevant work activity) Х Energised electrical installation / services. Х Structural alterations / repairs with a potential for structural collapse.
√ Coring / Chasing / Cutting (no electrical power in the area) Х Works involving asbestos. Х Demolition of a load-bearing element of a structure.
Х Roof Access √ Working at heights (risk of falling more than 2 metres). Х Works in or near a 1.5+ metre shaft / trench (excavation).
Demolition / Strip-Out Works (that does not involve disturbing a
Х load bearing structure) Х Use, transport or storage of chemical, fuel or refrigerant lines. Х Works in or near a tunnel.
Х Shop Front Works (including glazing) Х Works near to or use of moving mobile plant. Х Works in areas exposed to extreme temperature.
Х Fire Services Х Works in or near a confined space. Х Works in or near water or other liquids with a risk of drowning.
Structural Work (all structural works including steel posts, beams
Х and concrete works) Х Tilt-up or precast concrete work. Х Construction diving work.
Х Works in contaminated or flammable atmospheres / areas. Х Works involving traffic corridors or other non-pedestrian traffic. Х Use of explosives.
Hydraulics work (all mains, waste water, sewerage, storm water
Х and hydraulic supply) Х Works carried out on a tower. Х Works on or near pressurised gas / piping.
√ Mechanical Work (all works related to air conditioning and lift services; pumps, pipes and ductwork related to other services structural work) Х Other
Tick the Personal protective equipment (PPE) requirements. Emergency arrangement details
Other Job
Specific PPE
Head Foot Hi-vis vest Hand Eye Hearing Fall arrest Fire/evacuation First Aid Pollution/spill
Hazardous materials: Are hazardous materials to be used? Yes No Is MSDS Available
Mention Specific controls required as per MSDS:
Permit required (tick below)
Permit to work confined spaces Excavation Permit LOTO
Hot-work permit Night work permit Height Work Permit Other
Person responsible for ensuring compliance with SWMS: Date of SWMS review:
What measures are in place to ensure compliance with the SWMS?
Person responsible for reviewing the SWMS control measures: Date SWMS received by reviewer:
How will the SWMS control measures be reviewed?
(SWMS control measures to be reviewed (and revised if SWMS Monitoring Record Reviewed when scope of work changes
necessary) if work tasks / methods change or unexpected
issues arise)
Reviewed during weekly / regular contractor meetings Site Inspection observations
Review date: Reviewer's signature:
Safe Work Method Statement
Version: 01 01/28/2025 Page 4 844167238.xlsx
Inherent Risk Residual Risk
Potential Hazards / Risk Possible Control measures.
Description of Work Activity Risk before
Likelihood Consequences
Risk after
(What might go wrong?) Likelihood Consequences
controls (How do you stop it going wrong?) controls
Mobilization of manpower Personal injury, 1) Ensure Pre Medical Check-up done for all Staff &
Material damage Workers.
Likely Minor Moderate 2)Ensure Safety Induction Should be done for all Possible Insignificant Low
worker
3) Required PPEs (Safety Shoe, Helment,Reflective
Jacket) to be provided.
Material Shifting Slips trips, 1) Avoid obstruction (Cables, materials, waste etc.) in
Muscle strains, walkways
Lifting of Excessive Weight Manually, Likely Moderate High 2) Follow proper material handling techniques. Likely Minor Moderate
Fall of material. 3) Proper supervision.
4) Tool box talk to be given.
5) Ensure good housekeeping.
Marking of Support Personal injury, 1) Use of proper PPE (Nose mask, goggle).
Dust Inhalation 2) Proper supervision.
Fall of person from height. Slip trip and fall. Likely Moderate High 3)Safety belt should be used during height work Likely Minor Moderate
4) Ensure correct type of tool for the job.
5) Use Proper Scaffolding.
6) Access Should be free from Obstacles.
Drilling work and anchor fastener fixing Eye injury, 1. Use Safety Goggle & Nose mask
Irritation due to Noise, 2. Area should clean from combustible material.
Fall of person from height. Slip trip Unlikely Catastrophic High 3. Scaffold should be inspected. Likely Minor Moderate
and fall. 4. All Electrical cable should be routed from above 6ft
Injury to hand, Slip of height
Fastener or hammer. 5. Tools should be Secured Properly.
Welding of duct support/ Hot flying particles 1) Pre-post job inspection should be done.
Fumes and Heat 2) Un - Authorized entry should be restricted.
Ultra voilet rays. Unlikely Catastrophic High 3) Ensure use of PPE’S. Likely Minor Moderate
Exposed electrical cables & Defective equipment 4) Ensure hot work permit..
Stress & Ergonomic hazard 5) Ensure competent and skilled person.
Injuries. 6) Sufficient training should be given.
Fabrication of Duct Fall of material 1.Material must not be stacked more than 1.5mtr height
Noise 2.Use wooden hammer to fabricate the duct
Trip Unlikely Moderate Moderate 3.Use ear plugs / ear muffs Likely Minor Moderate
Entanglement & Crushing 4.Proper housekeeping to be done regularly
Mishandling of tools 5.Avoid loose clothing & make sure body is away from
Improper tools the nip points
Duct Joining Pinch point 1. Use hand leather gloves while fitting screws
Silicon 2. Use nose mask and PVC gloves while applying
Cut injury by Sharp edges Unlikely Moderate Moderate silicone gel Likely Minor Moderate
3. MSDS Should be Explain to All Worker.
4. Packing required for sharp edges
Duct lifting & fixing work Falling duct or Nut bolt. 1. Adequate Person should be present to hold the duct.
Falling of Person. 2. Proper Hand and mid
Unlikely Catastrophic High railing provide Along with full body harness. Likely Minor Moderate
3. Use required PPE’s for manual lifting of duct.
4. Provide adequate lighting while
working at night time.
Duct Insulation Personal injury, 1. Use of PPEs like safety belt is must for working at
Fall of man, height.
Fire. Unlikely Moderate Moderate 2. Good working platform to be provided. Likely Minor Moderate
Harmful substances & Fumes. 3. Proper Housekeeping Should be maintain
Respiratory disease & Skin diseases. 4. Ensure Fire Extinguisher should be placed at
workplace.
Copper Pipe Breezing & Installation Personal injury, 1) Pre-post job inspection should be done.
Material damage, 2) Only skilled or authorized person should be assigned
Fire, Unlikely Catastrophic High for task Likely Minor Moderate
Fall of man, material. 3) Ensure good housekeeping.
Harmful substances & Fumes 4) Provide Proper Scaffold with inspection tag.
Safe Work Method Statement
Inherent Risk Residual Risk
Potential Hazards / Risk Possible Control measures.
Description of Work Activity
Version: 01 01/28/2025 (What might go wrong?) Page 4 (How do you stop it going wrong?) 844167238.xlsx
Potential Hazards / Risk Possible Control measures.
Description of Work Activity Risk before
Likelihood Consequences
Risk after
(What might go wrong?) Likelihood Consequences
controls (How do you stop it going wrong?) controls
Cassette Unit Fixing Personal injury, 1)height work permit should be taken
Material damage, 2) all Required PPE’s (gloves, helmet, mask)Should be
Fall of material, Unlikely Major Moderate wear Unlikely Minor Low
Fall of man. 3)safety harness should de use during height work
4)access should be free from obstacles
5)proper supervision
Pressure Testing Personal injury, 1)Tool box talk should be given,
Material damage, 2)proper Supervision required,
Likely Moderate High 3)Area barricading should be done, Possible Moderate Moderate
4)All pressure gauges are in working condition and
provide safety cap for value,
5)Housekeeping
Housekeeping Scattered material, 1) Area defines for material stacking.
Dumping of scrap in unauthorized area, 2) Proper training & proper supervision.
injury Unlikely Moderate Moderate 3) Use of PPEs like pvc hand gloves, safety shoes / Unlikely Minor Low
Difficulty in gumboot, nose mask.
Breathing. 4) Display board.
5) Barrication, All duct & lift shaft close. Access to be
cleared.
Safe Work Method Statement
Workers briefed on the hazard associated for the activity and control measures on safe execution.
I understand and agree to adhere to the contents of this method statement. I have attended the briefing that explained the safe way to execute the activity as per recommended control measures.
ID No Name of Worker Worker Signature ID No Name of Worker Worker Signature
Version: 01 01/28/2025 Page 4 844167238.xlsx
Version: 01 01/28/2025 Page 4 844167238.xlsx
