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1、Lemminkinen (China) Co., Ltd SE Tiger Project莱木工程管理咨询（上海）有限公司 斯道拉恩索林浆纸一体化项目SUBMITTAL of Sub/Contractor SAFE WORK METHOD STATEMENT承 （分） 包 商 安 全 施 工 方 案 申 报 表Sub/Contractor Name承（分）包商名称（全称）核工业金华建设工程公司Brief Work Activity / Task简述工作内容及区域土石方工程工作标段Earthwork package surveyingDate Duration预计的工作周期2013/8/7-20
2、14/1/7（150天）SWMS Drafting Team安全施工方案编制小组殷晓灵、付凯锋、李建军、庞全宗Work Trade Involved列出涉及到的工种挖机司机、压路机司机，卡车司机、看护人、泥工、普工、安装工Material Used列出将使用的材料Equipment Used列出将使用的设备挖掘机、压路机、卡车、电动工具、振捣棒Maintenance Checks (e.g. inspection, testing, calibration, registration, etc.)列出所需的监管措施（如：检查、测试、校准、申报备案等）Drafting Team Review方案
3、编制小组组长审批CONTRACTOR REVIEWING of SAFE WORK METHOD STATEMENT承 包 商 安 全 施 工 方 案 审 批 表Reviewing By Contractor 承包商审核Department部门Signature审核人签名Comments审核意见Date日期Technician技术负责人Safety Mgr.安全经理Project Mgr项目经理下一层级审批/Next level review and approval Reviewed and approved by LMK 莱木审核与批准 Department部门Signature审核人签名
4、Comments审核意见Date日期Technician技术负责人Safety Mgr.安全经理Site Mgr.现场经理Project Mgr项目经理Jianli Com.监理单位Chief Supervisor Engineer Comments 总监理工程师审核意见：1. Is this SWMS need evaluation of expert? 2. Other:1.该方案是否需要进行专家论证? Y是N否 2.其它意见： Signature/Chop签章： Date日期：Safe Work Method Statement安全施工方案Page 2 of 10Issue dateSe
5、rial NumberRevision 2013-08-10SWMS-XXXXXX-0011Lemminkinen (China) Co., Ltd SE Tiger Project莱木工程管理咨询（上海）有限公司 斯道拉恩索林浆纸一体化项目To Be Completed By Designated LMK Representative由指定的LMK代表完成Please read carefully of these Safe Work Method Statement, if comply with these standards please remark “” Subcontractor
6、:分包商Contract Package:合同任务包SWMS Number /Revision No:安全施工方案编号/版次Designated LMK PE:LMK指定的项目工程师：Item 项目SWMS CRITERIA安全施工方案标准Complies符合（打勾）1.Sets out step by step how the work activity will be carried out 就如何开展施工工作进行逐步说明2.Identifies the impacts and hazards associated with each step of the work activity 逐
7、步地对与施工工作相关的影响及风险进行辨识3.Assesses the risks associated with each step of the work activity (eg class P1,P2,P3) 逐步地对与施工工作相关的风险进行评估（如P1，P2，P3级）4.Defines the controls to manage risks associated with each step (based on the hierarchy of controls - in order: Eliminate; Substitute; Isolate; Engineer; Adminis
8、trate; Personal Protective Equipment PPE)详细说明如何对每步相关的风险进行管理（根据控制的优先顺次消除；替代品；隔离；工程设计；管理；个人劳动防护用品PPE）5.Provides a description of the plant/equipment to be used (including maintenance & inspection checks done, certification of by qualified person and/or registration)使用的机械/设备应提供相关信息（包括维修保养及检查纪录，有资格人员以及/
9、或注册单位出具的相关证书。）6.Describes the qualifications and training of personnel carrying out the work, including supervisors experience/ competency, licenses, operators certification 从事该工作的人员资格和培训的有关信息，包括监督管理人员经验，资格能力，执照，操作员证书7.Notes and confirms compliance to relevant EHS Legislation, Standards, Codes, Regu
10、lations记录并确认符合相关的环安卫法律法规，标准，规范，规章，8.Includes design requirements, engineered details or certification for both temporary and permanent structures, platforms or access ways/ladders? 包括设计要求，工程详细说明或证明，包括临时结构，也包括永久性结构，平台或通道/梯子？9.Where PPE is nominated, the type of PPE is specifically listed and when it
11、is required. 在指明使用个人劳动保护用品之处，特别列出个人劳动保护用品的种类，以及何时需要佩戴。10.Defines who is responsible to ensure that the work activity is monitored and carried out in accordance with the SWMS 详细说明谁负责确保该施工工作受到监督，并且能严格按照安全施工方案开展工作。11.Includes the name and signature of the person who developed the SWMS, a current date a
12、nd revision number. 包括安全施工方案编制人员姓名，日期及版次编号。12.Defines method of consultation/communication used to develop & review SWMS 详细说明为编制及审核安全施工方案所采用的磋商/交流的方法13.Defines the process and frequency of reviews and methods for ensuring the work complies with the SWMS controls 详细说明审核程序及频率，以及确保该工作参照安全施工方案中的控制措施执行的方
13、法14.Identifies where any Subcontractors will be used, who is responsible to monitor and supervise works, and how hazards arising from interaction between trades will be communicated and managed (e.g. induction into more than 1 SWMS) 辨识出将要采用的每个承包商，谁负责监督及指导该工作，如何沟通及管理工种交叉产生的风险（如不止一个的安全施工方案的交底）15.Compl
14、ex or high risk work activities use photos/diagrams/sketches/summary to enhance SWMS (strongly recommended as best practice) where possible 为强化安全施工方案的作用，尽可能使用照片/图表/略图/总结等方式对复杂的或高风险作业进行说明（强烈推荐作为最优方法）16.The SWMS includes specific EHS controls for key high risk hazards as listed below 该安全施工方案已针对下列关键的高风险作业制定出相应的控制措施Tick all boxes relevant to tasks outlined in SWMS and ensure that they are addressed in SWMS请勾出该任务所涉及的高风险作业，确认其风险已在本方案中得到了充分的识别和控制Work at height, work n
