SAFE WORK PLAN

CONTRACTOR TEMPLATE

PROJECT / CONTRACT DETAILS: Principal Contractor / Client: Project Name / Title: (provide brief description / name) Work Site Address / Location at the Airport: Project / Contract Duration: (include dates) CONTRACTOR DETAILS: Contractor Company Name: Company Address: Company Contact Details: Safe Work Plan Author: REVIEW CONFIRMATION: Safe Work Plan Review: (BAC Representative) I have reviewed the Safe Work Plan, sighted and identified associated Work Method Statements and supporting documentation and sought clarification where appropriate with respect to the scope of work to which this plan relates. Phone: Name: Fax: Direct Contact Details: ABN: Brisbane Airport Corporation Pty Ltd

Name of Review Person (First & Last)

Signature

Date

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SAFE WORK PLAN

CONTRACTOR TEMPLATE

DESCRIPTION OF SERVICES TO BE PERORMED BY THE CONTRACTOR: Identify and provide a summarised description of all the services / work activities to be performed at the Brisbane Airport for the scope of this project / contract. Include any project schedule / plan (or reference thereof) that highlights the various activities to be performed.

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SAFE WORK PLAN

CONTRACTOR TEMPLATE

IDENTIFICATION OF SPECIFIC WORK ACTIVITIES Identify below whether work activities to be performed for the scope of this project / contract align to the specific work activity prompts contained in this Section. Tick all applicable work activity prompts. For additional explanatory information relating to the following work activity prompts refer to the OH&S Information section within the Working at Brisbane Airport website: www.workingatbrisbaneairport.com
Entry into a confined space Excavation or digging at a depth greater than 300mm, including the driving of objects into the ground Hot work outside of a designated workshop area Access or work at heights where a fall of 2m or more could occur, including access on any roof with a pitch steeper than 26o Electrical work on live plant / parts or work within an exclusion zone for an energised part or overhead line, excluding testing or basic low voltage fault finding A plant isolation involving lock-out and/or tag-out of plant (not including high voltage installations) is required High voltage (HV) electrical switching Use of a hazardous substance that requires health surveillance or that is also a dangerous good, or use of explosives Asbestos removal work or work on asbestos containing material (ACM) that includes maintenance, cleaning & repair activities that have the potential to disturb ACM Demolition work Work involving tilt-up and precast construction work Structural alterations that require temporary support to prevent collapse Work involving the movement of powered mobile plant at the workplace, (e.g. movement & use of mobile cranes, forklifts & interactions of heavy earthmoving plant) Work on a telecommunications tower Work in / over / adjacent to water where there is a risk of drowning Work on / adjacent to a road or railway Work on / near a pressurised gas distribution mains and consumer piping, or on /near a chemical, fuel or refrigerant line Work in an area that may have a contaminated or flammable atmosphere Work in an area where there are artificial extremes of temperature. Work in immediate proximity to members of the public (in / around buildings / terminals) where basic exclusion is not deemed adequate to manage the risks involved

Work Method Statement (WMS) Requirements For each of the above listed work activities identified, a Work Method Statement (WMS) must be developed and submitted as part of the Contractors Safe Work Plan. For those Contractors who do not have established Work Method Statements for the above activities or who require a WMS Template, refer to the OH&S Information section within the Working at Brisbane Airport website: www.workingatbrisbaneairport.com for a copy of the Contractor WMS Form Template.

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SAFE WORK PLAN

CONTRACTOR TEMPLATE

ADDITIONAL INFORMATION REQUIRED Plant & Equipment:

Provide a listing of plant / equipment items intended to be brought onto the site as part of the work scope.

Attach additional information listings if there is insufficient space below.

Hazardous Substances:
Provide a listing of hazardous substances intended to be brought onto the site as part of the work scope. Include a description of the location where MSDS and other relevant substance information will be located during the work.

First Aid, Fire & Emergency Response:

Provide summary details of specific first aid, fire, rescue or emergency response provisions intended to be supplied and made available on the site due to the work scope being undertaken.

Communication & Consultation:

Provide summary details of specific communication devices to be supplied as well as pre-work and ongoing consultation to be undertaken during the work scope.

Prescribed Occupation Holders:

Provide a listing of the prescribed occupations that workers will be performing as part of the work scope. Include worker names, prescribed occupation titles and licence / certification numbers.

Specific Training:
Provide summary details of specific training, inclusive of OHS related training / courses that specific on-site workers involved have undertaken.

Prescribed Activity Works:

For asbestos removal &/or demolition works, provide the following information: certificate number for performing the prescribed activity (a certificate to perform a prescribed activity must be submitted to BAC prior to work), detailed training arrangements (as per WH&S Regulation 2008 Part 4) detailed supervision arrangements (as per WH&S Regulation 2008 Part 4 - Section 50) Page 4 of 4