Generic Risk

Site Specific Risk

On-Site Risk Identified

Photo of Hazard

Other Risk 1

Other Risk 2

Other Risk 3

Type of Scaffold

Method Statement - Scope of Work

Design Drawing Reference Number

Location of Scaffold

Board Configuration

Number of Lifts Boarded as per SANS 10085

Bay Lengths

Lift Heights

Loading - This is not to be exceeded under any circumstances.

All Scaffold to be erected to SANS 10085?

Programme Start Date Date

Site Agent - A. Horsley HSEC Manager - S. Jansen van VuurenSenior Foreman - T. Jordao

Scaffolding tubing and couplers to be fit for use as prescribed by SANS 10085.All the above will be i

Standard Equipment is:- Safety Footwear, Safety Helmet, Safety Harnesses, high visibility vests and g

Work areas will be segregated by mean of physical barrier with signs designating such.Materials will

The contractor will comply with Clients site emergency procedures.The contractor to supply on-site fi

All Scaffolding materials will be removed from site upon completion of works.Any substances that are

Users of scaffold are directly responsible for ensuring that the scaffold is only used for its intend

Work Method / ProcedureErect tube and fitting Independent scaffolding as per SANS 10085 and site requ

Monitoring and complianceWorking Foreman will ensure that this Method Statement is adhered to by mean

I confirm that I have been instructed on the method of work, hazards and risks involved and the neces

Handover ProcedureFollowing completion of the scaffold a suitably qualified inspector will carry out

If contracted to do so, S&K will carry out statutory inspections in accordance with the Work at heigh

Handover Procedure

Add signature

Select date Date