Task Specific Safe Work Method Statement Template

Type of Task:_____________________________________________

Date: Prepared By: Position:


Description of works:

Location of activity:

Approximate duration of the activity:




Risk Assessment Ref: Operations Controls Covered


Trades Employed:- (Insert type, who, number of operatives)

Schedule of Plant & Equipment / Authorized Users

(insert type of plant & equipment, authorized users)



(access to and from work area type, trained etc)


Personal Protective Equipment:

(Type of PPE to be used for task)

 Special Training Requirements:

(any special training required)


There are requirements under the COSHH (Control of substances hazardous to health) Regulation. The relevant COSHH information sheets are supplied as part of the method statement. If another contractors work is seen as creating a risk to personnel under the COSHH regulations, then contractor will ensure that adequate information is supplied / obtained from the contractor to enable information and if required control measures to be implemented to protect its employees.


Controls for the Safety of Third Parties:


Sequence of Events (Technical)/ Control Measures ( Safety ):


Special Considerations:


Emergency Procedures:

Insert any other emergency procedures specific to task

Monitoring Arrangements:

The Project Director / Manager will continuously monitor Health and Safety standards of the project through:

  • Management and Supervisory staff as part of their daily line management responsibility.
  • HSE Manager, during his visits to the site, shall, review and inspect, advise on all safety related matters and shall record these in a written safety report to the Project Director / Manager.
  • The Project Director / Manager shall regularly review Health and Safety inspection reports of HSE manager and ensure action is implemented accordingly. Such action shall be confirmed in writing as appropriate.
  • The Project Director / Manager shall be responsible for ensuring the successful operation or monitoring and reporting systems and taking action to remedy any shortcomings discovered. Copies of inspection reports shall where necessary, be forwarded to contractors who shall act promptly to remedy shortcomings.

Completed By………………………………………… Position…………………………………………

Information Provided to Operatives:

This method statement along with the associated Risk, COSHH, Noise, Manual Handling and PPE assessments must be submitted /communicated to all operatives involved with the task/process prior to the commencement of works. A name and signature of the person delivering the method statement to the workforce to ensure they have received the information/instruction provided.

Employee Name Signature Date Status







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