[Click here and type company name]

A.C.N. :[Click

here and type company ACN No here]

Document No: 1.001 Edition: 1 Revision: 1 Date of Revision: [Click here and type latest revision date]

[Click here and insert company logo (optional)]

[Click here and type site name]

Site Specific OHS Management Plan

CLIENT: ADDRESS: CLIENT CONTACT:

Roads and Traffic Authority of NSW [Click here and type RTA (client) address] [Click here and type RTA contact name]

[Click here and type company name] [Click here and type site/project name]

CONTACT DETAILS:

Ph: (02)

[Click here and type contact's

telephone No]
Fax: (02)

[Click here and type contact's fax No]

Mobile: [Click here and type contact's mobile No] PROJECT: [Click here and type project name and description of works] [Click here and type site location name] Contract [Click here and type RTA contract No]

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TABLE OF CONTENTS

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1.

INTRODUCTION

This Site Specific Safety Management Plan is for use by all [Click here and type company name] employees and subcontractors during the life of this project. The project involves rehabilitation of the north approach to the [Click here and type site name] at [Click here and type site address or location] , (e.g. 4.6 kilometres north of Kangaroo Corner). The main activities to be carried out during the project are: Replacement of northern approach retaining wall [Click here and type company name] ) Replacement of northern approach guard railing [Click here and type company name] ) Resurfacing of asphalt on northern approach (Subcontractor [Click here and type company name] ) Linemarking (Subcontractor [Click here and type company name] ) This plan covers the following areas: Statement of responsibilities Occupational Health and Safety training Incident Management Site Safety Rules Safe Work Method Statements

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[Click here and type company name] [Click here and type site/project name]

2.

STATEMENT OF RESPONSIBILITIES

The following table outlines the responsibilities of nominated employees and/or subcontractors in relation to OHS&R issues for this project Activity
Hazard identification, assessment and control
(insert appropriate names & titles)

Who is responsible?
Operations Manager Quality Manager

Type of action and records

Hazard Identification Checklist Form No. PF. 001 Nonconformance/Improveme nt Request Form No PF 008 Surveillance and observation Nonconformance/Improveme nt Request Form No PF 008 Review of subcontractors Safe Work Method Statements Nonconformance/Improveme nt Request Form No PF 008 Register of Injuries Medical Certificates and Workers Compensation documents (held at head office) Site induction for all [Click here and type company name] employees and subcontractors Induction Recording Form Form No PF 006 OHS posters and pamphlets put up in the crib room Site induction for all employees and subcontractors Induction Recording Form Form No PF 006 All company vehicles carry first aid kits Register of qualified first aiders kept. Their names and contact numbers posted in the crib room and site office Subcontractors to provide name and contact details for their first aiders Site induction for all

Compliance with OHS&R legislation, regulations, standards, codes of practice and site safety rules Assessment of subcontractors OHS&R capabilities and performance on the job Workplace injury management and rehabilitation Communicate OHS&R information to all site personnel in the lead up to and during project

Operations Manager Quality Manager Quality Coordinator Operations Manager Quality Manager Quality Coordinator

Operations Manager Quality Manager Administration Manager Operations Manager Quality Manager OHS Officer

Provide general construction, work activity and site specific induction training to all site personnel Provide first aid and maintain first aid stocks

Operations Manager Quality Manager OHS Officer Operations Manager OHS Officer Subcontractors nominated person (TBA)

Manage accident and

Operations Manager

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[Click here and type company name] [Click here and type site/project name]
emergency procedures Quality Manager company employees, subcontractors and visitors. Periodic trials conducted

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[Click here and type company name] [Click here and type site/project name]

3. 3.1

OCCUPATIONAL HEALTH AND SAFETY TRAINING Site Induction

All [Click here and type company name] personnel will attend a Project Induction Meeting prior to the project commencing. The Operations Manager and the Quality Manager will conduct this meeting. The OHS Officer will co-ordinate the meeting. Topics covered at this meeting should at least cover the following: Site management Site Layout Job/Quality requirements Traffic Hazards General Hazards present at the site Hazardous materials control Personal Protective Equipment (PPE) Emergency procedures Location of fire extinguishers Identify of first aiders and location of first aid kits Any other relevant health and safety issues which become apparent during project start up will be included in this site induction. Each person attending this meeting must sign the attendance record as proof that they have attended a site induction briefing (Form No PF 006). Any staff who commence work during the life of the project must undergo the same site induction training. This will be provided by the on-site foreman or the OHS Officer. Only people who have attended this induction will be permitted onto the jobsite. Subcontractors and visitors to the site will be inducted along the lines of the topics listed above. This will take place at the project office on [Click here and type site name] and will be given by the on-site foreman or the OHS Officer. Induction must be given before a contractor is allowed to commence work on site. 3.2 Other Induction Requirements All [Click here and type company name] s employees working on the project have successfully undertaken the other parts of induction training: general construction work health and safety and work activity based safety. Records of this training are held by the Training and Staff Development Officer at [Click here and type company name] head office. These records can be viewed there.

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[Click here and type company name] [Click here and type site/project name] 3.3 Competency based training and assessment

[Click here and type company name] has a training and assessment program for its employees which are described in the [Click here and type company name] Management System. Employee skill levels are assessed against standards of competency and remedial training provided, where necessary. Copies of Structural Training Programs (STPs) and Training Needs Analysis (TNA) are available on request from the head office of [Click here and type company name] . Only operators with appropriate licenses or certificates are allowed to operate plant and equipment on [Click here and type company name] worksites. A register of certificated operators is kept at the site office.

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3.4

OHS Representatives/Committee

[Click here and type company name] is committed to maintaining sound OHS consultative arrangements with its clients, staff and visitors to the project. To this end, [Click here and type company name] refers to the requirements of the NSW OHS Consultation Code of Practice. An OHS representative will be elected for the project and will be briefed as to outcomes of each site management team meeting and consulted with at appropriate intervals Where there are 20 people or more on the project and an OHS Committee is requested by staff, a committee will be established as per OHS legislation. All persons acting as either an OHS representative or OHS Committee delegate will be trained in the WorkCover Consultation Training Course as required by legislation and relevant records maintained to illustrate the fact.

4.

INCIDENT MANAGEMENT

Operations Manager, [Click here and type person's name] , is the first point of contact when an incident or accident occurs. He/she can be contacted 24 hours a day on [Click here and type person's contact No] . Back up for the Operations Manager is provided by [Click here and type appropriate name/s & Nos] . The names and contact numbers for these three people will be given to all staff at their induction to the site. They will also be displayed in the site office and crib room. The management representative called out to the incident/accident will make sure that the Incident/Accident Report (PF 006) is completed. Any incident/accident which results in a lost time injury (LTI) must be reported to the Divisional Manager of [Click here and type company name] at the companys head office within 24 hours. A copy of the Incident/Accident Report must be sent to the companys head office for the Divisional Managers attention within seven days of the incident/accident.

5.

SITE SAFETY RULES

Minimum site safety rules for all [Click here and type company name] sites is attached at APPENDIX A of this site OHS plan. These site rules will be tailored to the site by ticking the appropriate rules that affect the site and these rules will become part of the site induction material. Every [Click here and type company name] employee, subcontractor, Superintendents Representative, suppliers and visitors to the [Click here and type site name] site must abide by the identified site safety rules. A copy of these rules will be given to everyone during induction to the site. The rules will also be displayed at the site office and in the crib room.

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[Click here and type company name] [Click here and type site/project name]

HAZARD CONTROL AND SAFE WORK METHOD STATEMENTS

[Click here and type company name] requires that a thorough hazard control process, comprising hazard identification, risk assessment and control analysis, be conducted before work commences in order to have appropriate hazard controls in place from the start of the project. The OHS risk management methodology adopted by [Click here and type company name] is detailed in APPENDIX B. This process should be documented using the Hazard Assessment Form (PF 001). In addition, the same hazard control process may need to be conducted during the project if the nature of the work significantly changes or if the conditions in which the work is being carried out change. A risk assessment calculator is reproduced on the next page to assist in prioritising risks according to their possible frequency and likely consequences. One outcome from this hazard control process will be the development of written safe work method statements (SWMS) for work tasks that are identified as having risk associated with them. All SWMS will be captured on the Safe Work Method Statement Form (PF 002). It is the responsibility of the Operations manager to ensure that the control measures adopted are monitored in both their implementation and also their ongoing adequacy for the activity. It is also the responsibility of those undertaking the work to inform management if suggested controls are inappropriate and the responsibility of those supervising the work to monitor the implementation of the control measures. The SWMS that are included in this section of the Site Safety Management Plan are relevant to the range of work activities that will be carried out on the [Click here and type site name] site. These SWMS have been developed in consultation with [Click here and type company name] employees and represent the safest and most practical way of carrying out the work activity.

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[Click here and type company name] [Click here and type site/project name]

6.

APPENDICES/FORMS

APPENDICES A B FORMS (We have included examples for you to do a risk assessment and write a safe system of work as required by the legislation, NSW Govt Guidelines and RTA contract specifications) PF 001 PF 002 Risk Assessment and Risk Control Work Sheet Safe Work Method Statement Work Sheet Minimum Site Safety Rules Risk Management Process

(other forms will also be required and this list is not all of them; it is only intended for guidance) PF 003 PF 004 PF 005 PF 006 PF 007 Site Safety Inspection Checklist Hazardous substances register Record of Induction Incident/Accident report Nonconformance/Improvement Request

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[Click here and type company name] [Click here and type site/project name] Appendix A - Minimum Site Safety Rules
This appendix comprises a minimum set of safety rules to be evaluated and adapted for use at each RTA premises, work sites or depots and incorporated, where appropriate into OHS management plans. These rules should be prominently displayed. Evaluation against risk profiles Use the checklist below to assess the need for, or circumstances where, the following safety rules must be adopted. Chec k Induction and Ancillary Site/Depot Inductions All staff must be inducted to the site/depot on initial commencement and following any significant changes to site/depot management arrangements. All contractors and visitors must be inducted to the site/depot on arrival and advised of site safety rules applicable to their activity while on site, hazardous work activities occurring at the site/depot and arrangements for first aid and emergencies.

Only staff who have completed general safety induction, work activity safety
induction and site-specific induction are permitted to work on a construction site. Safe Work Method Statements A safe work method statement (SWMS) must be prepared for work activities that have a medium or high risk rating and must be developed in consultation with staff who perform the work. Housekeeping High standards of housekeeping is the responsibility of all staff to ensure: o access and egress is maintained at all times, especially to emergency safety equipment including fire extinguishers, eyewash stations, emergency showers, first aid and emergency exits o the absence of combustible materials from work areas o the absence of trip or slip hazards and obstacles in travel paths o safe storage of materials and supplies. Incident Reporting

Report all near misses and incidents that occur in the work zone to your

immediate supervisor and to the OHS Incident Helpdesk on 1300 131 469.

Alcohol and Drugs Alcohol or illicit drugs are not to be consumed on RTA premises before or during working hours. Persons adversely affected by alcohol or drugs will be directed to leave RTA premises and work sites. RTA staff with alcohol or drug dependencies will be assisted in seeking treatment. Safety Awareness Follow safety rules as safe work methods, safety signs and instructions. Report hazards to your supervisor or OHS representative.

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[Click here and type company name] [Click here and type site/project name]

Never engage in horse play or practical jokes.

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Traffic, Vehicle and Plant Issues Traffic Control Traffic control is to be set up and taken down in accordance with approved traffic control plans. Traffic and Vehicle Movements Travel paths for general traffic and site vehicle movements must be clearly marked. Separate pedestrian travel paths should be marked in high traffic areas. Temporary changes to traffic movement, must be advised to all staff prior to the commencement of changed conditions (or similar) especially where major or arterial roads may be a cause of increased risk. Mobile Plant Work must not be carried out within 3 metres of mobile plant without a risk assessment and alternative controls such as an observer. Consideration must be given to the area around the mobile plant that may be affected by flying debris or other unintended impacts from the operation of the plant. All self-propelled plant, trucks and, where applicable, trailers must have reversing alarms use of observers should be considered for reversing plant on worksites and near pedestrian traffic. Beware of reversing trucks and plant. Listen for reversing alarms. Beware of overhead/underground power lines, other utilities and low branches when operating mobile plant. Plant and Equipment Plant and equipment must only be used for the purpose it is intended and in accordance with the manufacturers instructions.

Plant operators and truck drivers are to complete the daily pre-start inspection
checklist for all mobile plant and trucks.

Only licensed truck drivers are to be used to drive trucks. Only trained plant operators or trainees under supervision are to be used to
operate plant.

When entering/exiting trucks or plant use the steps and handrails provided and
have three points of contact at all times.

Plant operators are to wear a seatbelt where Rollover protection (ROPS) is fitted. Plant is to be parked on level ground and separated by a minimum of 3 metres. Never operate plant or equipment, which is tagged as being dangerous or out of
service, has its guards removed or is otherwise defective. Defect Report Book.

Any defect identified shall be reported to the site supervisor on the Fleet Items
Loading and unloading plant

When loading/unloading plant, the plant operator/float driver is to wear a

seatbelt if ROPS is fitted.

Load/unload plant on level ground using an observer. In wet conditions, check surface conditions to be driven on before loading.

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[Click here and type company name] [Click here and type site/project name]

Personal protection issues Personal protective equipment (PPE) will be worn in the following circumstances.

Where signage requires its use Where a site risk assessment or SWMS identifies a risk that requires its use.
Other considerations for specific PPE requirements are listed below. Eye Protection Eye protection must be worn whenever: o operating plant or equipment where there is a risk of flying objects or debris o when working in dusty conditions, or o near trees or vegetation with a risk of protrusions contacting the eye. UV protection should be provided for outdoor work. Hand Protection Safety gloves suitable to the task must be worn when handling any materials where there is a risk of cuts, abrasions, splinters or chemical exposure. Head Protection Safety helmets must be worn where: o there is a possibility that a person may be struck on the head by a falling object o a person may strike their head against a fixed or protruding object o accidental head contact may be made with electrical hazards, or o working within 1.5 times the length of a moving (traversing) boom. Hearing Protection Hearing protection must be worn in the vicinity of plant or equipment that, when operating, makes it necessary to raise your voice to talk to a person 1 metre away from you. Areas where this plant operates must be signposted (including on the plant itself) to advise hearing protection is required. High Visibility Clothing Approved fluorescent yellow safety clothing are to be worn by RTA staff during daylight hours whenever working in the vicinity of traffic or mobile plant. Yellow/white overalls with reflective striping or day/night vests are to be worn at night. Safety Footwear Approved safety footwear is required whenever: o working on a road construction or maintenance site o operating construction plant or working in the vicinity of such plant o wherever there is a risk of heavy objects falling. Lace-up safety boots are recommended for better ankle support. Elastic-sided boots or safety shoes must not be worn while working with hot products including bitumen products. Sun Protection Sun protection is required when working outdoors. Broad-brimmed hats, long sleeved shirts and UV protection cream must be worn. Brims for safety helmets must be worn where a safety helmet is required. Safety glasses with UV protection must be worn. A supply of drinking water must be available on site. Staff must take frequent drink breaks on hot days.

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Hazard Management Electrical Equipment All electrical equipment must be regularly inspected and tagged. Work on live electrical installations is prohibited except for the purpose of testing or in emergency situations following a risk assessment and approval by a manager. Manual Handling Manual handling is to be eliminated wherever possible. Wherever possible, use mechanical devices to lift heavy or awkward items.

Team lifting should only be used where mechanical lifting is absolutely not
practical. List tasks at your site/depot where manual handling is prohibited.

Mobile Phones Mobile phones must not be used by persons while o on foot in the vicinity of mobile plant, or o on a site using explosives. Only hands-free mobile phone devices may be used by persons driving RTA vehicles and only for short duration calls. Working at Heights Where there is the potential for a person or object to fall from a height greater than 2 metres, no work is to be carried out without fall protection or fall arrest systems in place. Fall arrest systems must be used where secure, fenced work areas cannot be provided. Ladders must be inspected for faults prior to use. They are to be used primarily as a means of access. Only short-term tasks may be carried out from a ladder using the third top rung and ensuring that three points of contact are maintained at all times. Use of Hazardous Substances Hazardous substances must not be used without reference to the material safety data sheet (MSDS) to ensure that use is in accordance with the manufacturers instructions taking particular account of recommendations for: o Precautions for use, especially requirements for ventilation and personal protection equipment, o Health effects including short and long term effects and risks associated with inhalation, ingestion and skin or eye contact o First aid and emergency requirements. MSDS must be readily accessible to users. All containers of hazardous substances including decanted containers must be labelled and carry the minimum set of risk phrases. Working in the vicinity of public utilities

All underground, above ground and overhead utilities must be identified and
every effort made to have services disconnected prior to work commencing where there is a risk of contact. on site.

All services must be clearly marked using a colour-coded system on plans used All underground services must be located using detection equipment and hand
digging techniques if necessary.

When working under power lines, minimum clearance distances are to be

observed. Where this is not possible, a qualified safety observer is to be appointed.

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[Click here and type company name] [Click here and type site/project name]

Only plant operators and truck drivers with current Plant and Crane Electrical
Safety qualifications are to work within minimum clearances.

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[Click here and type company name] [Click here and type site/project name] Appendix B - Risk Management Process The risk of a hazard is related to the severity of a single incident, and the frequency and duration of exposure. Also, the more hazards that you identify the greater the risk. STEP 1: To assess risk, consider the following:
HOW LIKELY HOW BAD

How many times in a

day/week is the task/activity performed? How many people would be exposed? How long is the exposure? Are engineering controls preventing exposure? Does the layout and condition of the workplace affect exposure? Are abnormal conditions reasonably foreseeable, resulting in a greater exposure? What are the results of any biological or atmospheric monitoring? Do workers have the appropriate skills and knowledge to perform their tasks? Do current work practices expose workers to a hazard? Are there other contributing factors?

What are the

consequences of exposure in the short term? consequences of exposure in the long term? injuries related to exposure of that hazard? to the hazard?

What are the

What is the history of

How close is the worker What is the energy level

of the hazard (ie weight, voltage, volume, amplitude, height above ground, concentration, aggressive state)? hazardous, what are the health effects associated with: o ingesting it; o inhaling it, or o absorbing it through the skin or the eyes.

If the substance is

STEP 2: Use the risk assessment reckoner to rate the risk to an individual staff member or group doing work

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[Click here and type company name] [Click here and type site/project name] that involves the identified hazards. The rating then forms the basis for what level of action is required.

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[Click here and type company name] [Click here and type site/project name] STEP 3: Complete the worksheet overleaf to develop effective control measures. Refer to Appendix C in selecting control measures. Activity/ Project
Example : Bitumen spraying during summer

Hazards

ho w sev ere ?
M

ho w like ly?

risk rati ng

What can be done to lessen the risk

Example : Hot weather

VL

Provide cool water; wear loose clothing with long sleeves; rest in the shade

Date: ____/____/____

Supervisors signature:

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Signatures of people involved in the risk assessment:

FORM PF001

Risk Assessment and Risk Control Work Sheet

LIKELIHOOD

HOW LIKELY IS IT TO HAPPEN AND HOW OFTEN?

CONSEQUENCE S

Very Likely could happen at any time

Likely could happen some time

Unlikely could happen, but rare

HOW BAD IS IT LIKELY TO BE?

VL

Very Unlikely could happen, but probably never will

VU

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Extreme - Kill or cause permanent disability or ill health

1 1

K
Major Long term illness or serious Injury

S
Moderate Medical attention and several days off work

M
Minor First aid needed

(Adapted from WorkCover's HAZPACK Worksheet)

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[Click here and type company name] [Click here and type site/project name] OHS RISK ASSESSMENT RECKONER

There will be times when risk assessments will need to be reviewed:

When a hazard is identified; When a risk assessment is no longer valid; When injury or illness results from exposure to a hazard, and
When a significant change is proposed in the place of work, or in work practices and procedures.

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FORM PF002

Safe Work Methods Statement Worksheet

Office Location: I approve the use of this Safe Work Method Statement: Name: Signature: ................................... ................................. Position: ............................ Date: ............................

COMPANY NAME
A.C.N. xxxxxxxxx
Description of Activity: Critical Steps in this Activity:

Local Reference No:....................

(SWMS) Activity Guide(s) used: ...............................................

Work Site/Project Depot: Potential Hazards: Safety Controls:

Training Required to Complete Activity:

List Codes of Practice, Legislation, Standards which apply to this Activity: 2. Training details are located on: Project file: L&D Training Data Base tick box tick box

1. List training required eg Hiab, First Aid, Traffic Control.

Other (specify) tick box (L&D Database includes trainers qualifications) List Plant/Equipment/Personal Protective Equipment required for this Activity: List Equipment Maintenance Checks required for this Activity: Engineering Certificates /Permits/Approvals required for this Activity eg road closure, utility shutdown, WorkCover notification, demolition licence. Type Reference/Docu ment

Person(s) Responsible for Supervising/Inspecting Work:

Person(s) responsible for supervising the work, inspecting and approving work areas, work methods, protective measures, plant equipment and power tools NB List of qualifications/experience is held on local files Name: ..................................................... Position: ................................................................. Signature: ........................................ Name: ..................................................... Position: ................................................................. Signature: ........................................ For list of names and signatures of staff instructed in this SWMS see local training records.