:
TURBO GENERADORES DEL PERU
Index / Date:
Project:
Santo Domingo de los Olleros
Appendix 4
SI-021.4
2016-09-21
Page:
1 of 5
Revision: 02
Contractors Name:
Date:2016-09-21
Scope of works:
Carguio, Traslado, Almacenamiento, y Montaje de estructuras metlicas y paneles para la instalacin del almacn
general.
Sequence of operations:
1.
2.
3.
4.
5.
6.
7.
8.
Izaje manual de Paneles 6.0 mts Altura x 1.0 mts Ancho Pared
9.
Instalacin de paneles de almacn 6.0 mts Altura x 1.0 mts Ancho Paredes del almacn
10.
Izaje manual de Paneles 6.0 mts Altura x 1.0 mts Ancho Techo
11.
Instalacin de paneles de almacn 6.0 mts Altura x 1.0 mts Ancho Techo del almacn
12.
13.
Pintado de paredes
Management structure:
Name:
Site Manager:
942125586
Site Supervisor:
977352431
Safety Advisor:
994885711
Manpower:
Supervisors (fulltime)
Yes
Machine Operators
Yes
Skilled Labours
Yes
Yes
Unskilled Labours
Yes
Yes
Yes
Mobile Platforms
N/A
Excavators, Caterpillars
N/A
Scaffolding (mobile/fixed)
Yes
Compressors
N/A
Ladders
Yes
Diesel Generators
N/A
Yes
342854061.doc
Document No.:
TURBO GENERADORES DEL PERU
SI-021.4
Index / Date:
Project:
Santo Domingo de los Olleros
Appendix 4
2016-09-21
Page:
2 of 5
Revision: 02
Contractors Name:
Date:2016-09-21
Welding Sets
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Entrapment
Hit by or against
Material falling
Machinery
Electricity
Asphyxiation
Hazard substances
Others (N/A)
N/A
Document No.:
TURBO GENERADORES DEL PERU
Index / Date:
Project:
Santo Domingo de los Olleros
Appendix 4
SI-021.4
2016-09-21
Page:
3 of 5
Revision: 02
Contractors Name:
Date:2016-09-21
Others
Yes
No
All the following activities are considered High Risk (Category VIII)
Heavy Complex lifts
Control rooms
Working at height.
Electrical switch rooms
Hazardous materials handling
Live manholes
Special Overhead Coordination
Demolitions
Pressure Testing
Steam / Air Blows
Work outside the site
Scaffolds over 20mts.
N/A
Permiso de Siemens
Manually y con grua
Boxes
Controlled
N/A
N/A
Certificados de operatividad
Acreditacion de operador Homologado.
Supervisor Andamiero homologado
Andamios certificados.
How will the public or other workers be protected? Delimitacin del rea de trabajo.
342854061.doc
Document No.:
TURBO GENERADORES DEL PERU
SI-021.4
Index / Date:
Project:
Santo Domingo de los Olleros
Appendix 4
2016-09-21
Page:
4 of 5
Revision: 02
Contractors Name:
Date:2016-09-21
Yes
No
Material Safety Data Sheet(s) available (to be attached to the method statement)
Material Safety Data Sheet(s) submitted to Siemens HSE department (for first aid station)
Risk assessment for use of hazardous substances done (to be attached to the method statement)
Special handling procedure available (to be attached to the method statement)
Yes
Yes
Yes
Yes
No
No
No
No
if yes, how:
if yes, how:
if yes, how:
if yes, how:
methods / informations:
/ No
Attachments:
1.
5.
6.
7.
8.
9.
10.
This method statement has to be read, understood and signed by all involved. The full content of this
Method Statement and Risk Assessment must be transfer to all involved working forces via tool box
talk or other training. A copy has to be retained on site at the work area.
WORK IS ONLY ALLOWED TO START IF ALL PRECONDITIONS HAVE BEEN FULFILLED
AS SPECIFIED IN THIS METHOD STATEMENT!
Prepared by
Name
Signature
Position / Trade
Date
Approved by
Name
Signature
Position / Trade
Date
Reviewed by Siemens
Name
Signature
Position / Trade
Date
Monitored by:
Signed:
Date:
Monitored by:
Signed:
Date:
Monitored by:
Signed:
Date:
Date
I confirm that I understand the contents of this Method Statement and Risk Assessment, and I will apply the
measures and requirements stated.
342854061.doc
Document No.:
TURBO GENERADORES DEL PERU
Index / Date:
Project:
Santo Domingo de los Olleros
Appendix 4
SI-021.4
2016-09-21
Page:
5 of 5
Revision: 02
Contractors Name:
Date:2016-09-21
Name
Company
Signature
342854061.doc