METHOD STATEMENT

Rev: A
SITE: JOB No: ANTICIPATED ACTIVITY
Start Date End Date
68 Tavistock Road
London TV001
W11 1AW June 2010 August 2010
NUMBER OF PERSONS INVOLVED IN
CONTRACTOR: PREPARED BY:
ACTIVITY:
CUBIC Design &
Quinton Schonknecht 1 Supervisor 2 Operatives
Development

DESCRIPTION OF THE ACTIVITY & SEQUENCE AND SAFE SYSTEM

OF WORK TO BE ADOPTED

Description:
Installation of the External Scaffold to facilitate the refurbishment works to the apartment block.

Sequence/Safe System of Work to be adopted:

Scaffold Erection:
• Only on approval of the Installation Method, the scaffold erection works will begin.
• A full Photographic survey is to take place prior to works commencement.
• All Scaffold Permits to be in place prior to commencement.
• The neighbours are to be notified of the scope of work along with durations.
• All work to be carried out by trained and competent operatives.
• Ensure all operatives are inducted and have read all the necessary H&S documentation and
understand the procedures.
• Ensure all operatives are wearing the correct PPE, i.e. Gloves, Hi-Visibility Vest, Hats, Safety
harness.
• All road closures/council permits (if required) are to be in place prior to parking vehicles.
• Road narrowing/pedestrian signage is to be installed along the foot path and traffic lane.
• Scaffold vehicles will be parked as close as possible to the site on All Saints Road.
• Materials will not be stored on site; all materials are to be installed directly after off-loading.
• Access routes are to be identified prior to the works start.
• Traffic routes are to be cordoned off to prevent passing public from injury.
• Pedestrian/Fire Escape routes are to be left clean and clear at all times.
• Delicate areas to be protected by plywood.
• All tubes to be kept away from windows during installation.
• All tubes to have protective end caps installed to prevent scratches and damage to the property.
• All materials will comply with current legislation.
• Scaffold standard positions are to be marked and only obstructing garden shrubs will be
carefully removed, shrubs to be relocated and replaced once works completed.
• Timber sole plates are to be used to spread load.
• A scaffold intruder alarm is to be installed around the perimeter to prevent access.
• Security Signage to be displayed.
• Standards are to have Hi-Visibility tape.
• Supervisor/s to be in attendance during scaffold loading out and installation.
• Standards to be positioned and connected together with ledgers, using load bearing fittings.
• Ledgers connected together using transoms.
• Sway bracing to be introduced at every 5m lift.
• Base lift of scaffold to have double board and polythene to protect passing public.
• Scaffold boards will hoisted up with the use of a rope & pulley.
• All loading hoisting areas will be screened off from pedestrian traffic.
• Scaffold loading will not exceed 2kn per m2
• Access/Egress will be via the existing fire emergency staircase.
• Scaffold to be anchored to building with Excalibur fixings.
• The Scaffold will not brace off the adjacent property 48 All Saints Road.
• Operatives are to ensure minimal disturbance to surrounding areas.
• Supervisor to inspect work areas before & after every shift, especially pedestrian routes.
• Supports are to be removed carefully whilst maintaining minimal disturbance to the surrounding
areas.

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 • Access ladders will be removed at the end of every shift and locked/stored to prevent access.
• Once scaffold struck out all fixing anchor points will be made good.
• Ensure site is clean and clear after works completed.

CONTINGENCY AND EMERGENCY PLANS:

Supervisors are First Aid trained.

Operatives to have mobile phones in attendance.
Dial 999 in case of emergency.
Emergency Services Displayed.

PLANT required: PLANT CERTIFICATION required: OPERATOR CERTIFICATION

required:

Small Hand Tools

Metal Grinder/Cutter Plant Inspection tickets Abrasive Wheels Certification.
Hand Wood Saw Toolbox Talks
Drills

PERMIT FROM - TO HAZARDOUS PPE TOOLBOX

REQUIREMENTS SUBSTANCES REQUIRED TALKS:

CUBIC PERMIT TO CSL to Tigon Dust Face Mask/ Yes

WORK Eye Protection

SCAFFOLD PERMIT Council N/A Traffic Signs Yes

CUBIC PERMIT TO
LOAD TEMPORARY CSL to Tigon N/A Hat/gloves/goggles Yes
WORKS

CUBIC ELECTRICAL NOMICO Electrocution Gloves

ISOLATION Installation
Certificate
PERMIT

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 ENVIRONMENTAL CONSIDERATION
(give details below and define the methods you wish to adopt to reduce impact and risk)

Reference should be made to the requirements of the construction phase Health Safety and Environmental
Management Plan where methods and techniques may be dictated to mitigate significant environmental
impact. These requirements must form part of the detailed method statement where activities form part of
these mitigation measures. Separate environmental risk assessments should be considered within this
method statement

LIST ANY OTHER SAFETY CONSIDERATIONS BELOW

(including methods to be adopted to reduce risks)
These considerations are included in the Cubic H&S Plan.
For works where no Cubic H&S Plan required the following should be considered:

• Welfare Facilities
• Names of appointed persons including qualified first aiders.
• Standard forms for such items as toolbox talks, risk assessment method statement inductions and
records

WILL YOUR ACTIVITIES AFFECT ANY OTHER CONTRACTORS WORK AREA ?

If so please give details below and define the methods you wish to adopt to reduce risk.

N/A

This method statement together with the risk assessment must be authorised by Cubic.
Once authorised by Cubic, the authorised method statement risk assessment is to be
registered and a copy kept in the site file.

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 OPERATIVES SIGNATURES:
Operatives who sign below hereby confirm that they fully understand the Works detailed
above:

Cubic Supervisor - Peter Steyn

Trade Supervisor -
Operative 1 -
Operative 2 -
Operative 3 -
Operative 4 -
Operative 5 -
Operative 6 -

ALTERARTIONS TO THE ABOVE SEQUENCE.

Alterations on Site:
To be altered on Site by Contractors Supervisor

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 In columns 3 and 8:
Probability 1 = extremely remote In columns 4 and 9: DIRECTIONS
Probability 2 = possible Severity 1 = negligible occurrence Complete cols 1-6
Probability 3 = likely Severity 2 = minor occurrence Eliminate hazard all together if reasonably practicable. For eliminated hazards enter 0 in column
Probability 4 = probable Severity 3 = significant occurrence 11. Reduce all other hazards if reasonably practicable.
Probability 5 = definite Severity 4 = major accident or injury Apply Control Measures to all greater than LOW in column 6
Probability levels 1 to 5 to be used in columns 3 and 8 Severity 5 = fatality Complete cols 7-11 and apply additional controls if Risk rating greater than LOW in col 11.
Severity levels 1 to 5 to be used in columns 4 and 9 Repeat until LOW.
ASSESSMENT OF RISK : H= High (risk rating 10-25), M =Medium (risk rating 5-10), L=Low (risk rating 1-5)
Risk rating = Probability x Severity

H, M, Lfor HarmPotential

= prob x sevRisk Rating

1-5Probability

1-5Severity

!-5Probability

1-5Severity

H, M, Lfor HarmPotential
= prob x sevRisk Rating
HAZARD Significant Risk CONTROL MEASURES

(H,M,L)H, M
Col Col Col Col Col Col Col Col
Column 1 Column 2 3 4 5 6 Column 7 8 9 10 11

Correct Safety Procedure, Toolbox

Height Falling, serious injury, even death. 3 5 15 H 1 5 5 L
Talks, Safety Trained, Safety Harness

Correct Safety Procedure, Toolbox

Electricity Electrocution, serious injury, even death 3 5 15 H 1 5 5 L
Talks, Safety Trained, Gloves

Correct Safety Procedure, Toolbox

Dust Damage to Eyes, Inhalation 2 3 6 M 2 2 4 L
Talks, Safety Goggles, Face Masks.

Correct Safety Procedure, Toolbox

Noise Damage to ears, neighbours disruption. 3 2 6 M 2 2 4 L
Talks, Safety Ear Defenders.

Correct Safety Procedures, Toolbox

Manual Handling Damage to back, strain injury. 2 5 10 M 2 2 4 L
Talks.
Adverse Correct Safety Procedure, Hazardous
Weather Wet surfaces, high winds, lightning strike 3 5 15 H works stop, Toolbox Talk, safety 1 5 5 L
Conditions trained

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Note: This risk assessment is an integral part of the Method Statement. Any revision to this risk assessment will require revision to the method statement in which it resides. Review and authorisation of this risk
assessment is an integral part of review and authorisation of this method statement. Risk assessments and assessments involving: noise, manual handling, COSHH, expectant and new mothers, display screen
equipment, young persons, PPE, should also be undertaken. For risk assessments involving lead, asbestos and radiological material the Project Manager should be immediately informed on their discovery and
consulted prior to any work taking place. This form can be used for risk assessments by groups which do not form part of a method statement in which case it must be authorised by CSL.