Example of a safety method statement form

Appendix 6.3 - Example of a safety method statement form 

Site Details (Parking, Fuel Depot, Equipment Store, Welfare Facilities, Emergency Procedures) 

Hazards on Site (e.g. Power Lines, Buildings, Demolition, Flazardous Processes, Underground Services) 

How Task will Proceed Safe System of Work Signed . 

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Appendix 6.3 gives an example of a safety method statement form. The form should be produced electronically in the form of a table so that each section can be enlarged as required. 

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