Lemmink?inen (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） Brief Work Activity / Task 简述工作内容及区域 Date Duration 预计的工作周期 SWMS Drafting Team 安全施工方案编制小组 Work Trade Involved 列出涉及到的工种 核工业集团金华建设有限公司 CONTRACTOR REVIEWING of SAFE WORK METHOD STATEMENT 承 包 商 安 全 施 工 方 案 审 批 表
Department 部门 Technician 技术负责人 Safety Mgr. 安全经理 Project Mgr 现场经理 Signature 审核人签名 Comments 审核意见 Date 日期 Reviewing By Contractor 承包商审核 临时营地搭设 Temporary camp erection 殷晓灵， 李建军，付凯锋 下一层级审批/Next level review and approval 架子工scaffolder，泥瓦工 plaster，挖机司机 excavator operator 莱木审核与批准 Department 部门 Technician 技术负责人 Safety Mgr. 安全经理 Site Mgr. 现场经理 Project Mgr 项目经理 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 审核人签名 Comments 审核意见 Date 日期 Reviewed and approved by LMK Material Used 列出将使用的材料 玻璃棉板 slab of glass wool， 混凝土 concrete， 砖 brick Equipment Used 列出将使用的设备 挖机 excavator， 电钻 drill 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） NA Drafting Team Review 方案编制小组组长审批 监理单位 Safe Work Method Statement 安全施工方案
Page 1 of 18 Issue date 2009-11-06 Jianli Com. Signature/Chop签章： Date日期： Serial Number SWMS-JINHUA-002 Revision 1
Lemmink?inen (China) Co., Ltd SE Tiger Project
莱木工程管理咨询（上海）有限公司 斯道拉恩索林纸一体化项目
To Be Completed By Designated LMK Representative 由指定的LMK代表完成 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？ Where PPE is nominated, the type of PPE is specifically listed and when it is required. 在指明使用个人9. 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。 Defines who is responsible to ensure that the work activity is monitored and carried out in accordance with 10. 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。 Includes the name and signature of the person who developed the SWMS, a current date and revision Item 项目 1. SWMS CRITERIA 安全施工方案标准 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 Identifies the impacts and hazards associated with each step of the work activity 逐步地对与施工工作2. 相关的影响及风险进行辨识 Assesses the risks associated with each step of the work activity (eg class P1,P2,P3) 逐步地对与施工工3. 作相关的风险进行评估（如P1，P2，P3级） Defines the controls to manage risks associated with each step (based on the hierarchy of controls - in order: Eliminate; Substitute; Isolate; Engineer; Administrate; Personal Protective Equipment {PPE})详细说明如何4. 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}） Provides a description of the plant/equipment to be used (including maintenance & inspection checks done, 5. 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/或注册单位出具的相关证书。） Describes the qualifications and training of personnel carrying out the work, including supervisors’ 6. experience/ competency, licenses, operator’s 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 Notes and confirms compliance to relevant EHS Legislation, Standards, Codes, Regulations 7. 记录并确认符合相关的环安卫法律法规，标准，规范，规章， 16. 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 15. 14. 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） Complex 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） 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 13. Complies 符合（打勾） Defines method of consultation/communication used to develop & review SWMS 详细说明为编制及审 12. 核安全施工方案所采用的磋商/交流的方法 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法 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 11. number. 包括安全施工方案编制人员姓名，日期及版次编号。 Please read carefully of these Safe Work Method Statement, if comply with these standards please remark “√” Subcontractor: 分包商 SWMS Number /Revision No: 安全施工方案编号/版次 Contract Package: 合同任务包 Designated LMK PE: LMK指定的项目工程师： Safe Work Method Statement 安全施工方案
Page 2 of 18 Issue date Serial Number SWMS-JINHUA-002 Revision 1
Lemmink?inen (China) Co., Ltd SE Tiger Project
莱木工程管理咨询（上海）有限公司 斯道拉恩索林纸一体化项目
Work at height, work near/with penetrations? 高空作业，靠近洞口/Description of Consequence or Impact 洞口作业？ Use of plant & equipment? 使用机械及设备？ Manual handling? 人共搬运？ 结果或影响描述 Work in a confined space? 在受限空间内作业？ Specialized work tasks? e.g. scuba, tunnels, railway.特定工作？如水下，隧道，铁路 Haz materials removal and disposal e.g. asbestos? 危害材料清理及处理，如石棉？ Hot work? 动火作业？ Excavation? 开挖？ Underground services? 地下设施？ Use of Haz Substances or Dangerous Goods? 使用有害物质或危险品？ Traffic and pedestrian segregation - Work site and public areas? e.g. traffic control.车辆及行人隔离 Overhead electrical services? 高架电气设施？ Demolition? 拆除？ Level 等级 L高 Objects falling/work at height? 高空落物/高空作业？ Electrical work? 电气作业？ Risk Level Chart 风险等级对照表
Likelihood / Probability 可能性/概率 M中 U低 Potential Death, Permanent Disability, or Major Structural Damage. Off-site release not contained, major remediation required with outside assistance, significant detrimental environmental impact. 存在死亡、永久伤残的风险；或者造成需要外界帮助才能修复的重大结构损坏；以及重大环境污染。 Potential Temporary, Disability, or Minor Structural Damage. On site release contained, minor remediation required with outside assistance, short-term detrimental environmental impacts. Any potential for exceeding a Statutory licence permit condition. 人身伤害程度为暂时功能障碍，包括严重到需要场外就医的情况；或者造成不必借助外界帮助即可修复的结构损坏；以及对环境造成短期的负面影响；再就是可能超出资质允许范围的活动。 Potential incident that has the potential to cause persons to require first aid. On-site release immediately contained, minor level clean up with no short-term environmental impacts. 可能导致伤害严重程度仅需要为在场内进行简单医务处理的潜在风险，包括在场内临时调换工种的风险；以及只需进行简单清理，不会对环境造成污染的风险。 Level 级别 Likely 可能 Moderate 中等 Unlikely 不太可能 H High 高 P1 P1 P2 M Medium 中 P1 P2 P3
Designated LMK PE Date
LMK指定的项目工程师签字： 日期： Safety Induction Record on Approved SWMS安全施工方案交底记录：
L Low 低 P2 P3 P3 Likelihood / probability 可能性/概率 Could happen frequently 可能经常发生 Could happen occasionally 可能偶尔发生 May occur only in exceptional circumstances 只有在异常的环境下才可能发生
Safe Work Method Statement 安全施工方案
Page 3 of 18 Issue date Serial Number SWMS-JINHUA-002 Revision 1
Lemmink?inen (China) Co., Ltd SE Tiger Project
莱木工程管理咨询（上海）有限公司 斯道拉恩索林纸一体化项目
Safe Work Method Statement
安 全 施 工 方 案 Task Description Location 位置: Temporary camp area 现场临时营区 工 作 概 况 Floor area占地面积: 640 square meter640平方米 Floor structure地面构造: 混凝土 Building type建筑物类型: Prefab houses 活动板房 Wall Material墙面材料: 50mm thick sandwich panel 50mm厚三明治板 Roof Material屋面材料: 50mm thick sandwich panel thick corrugated steel sheet50mm厚三明治板 厚波纹彩钢板 Site situation场地情况: Toilet, canteen and shower room area need to level and compact 现场卫生间、淋浴室、餐厅等区域需整平、压实 Material Manufacture材料加工: All light steel column, truss beam, sandwich panel, doors and windows were customized in factory, no need welding, cutting etc on site.所有的轻钢柱、珩架梁、三明治板和门窗为工厂定制，无需现场焊接、切割等 Item 序号 1 Job steps 工作步骤 Set line for site office 临时办公室测量放线定位 Construction requirement/method 施工要求及方法 Hazards 潜在风险 Level 风险等级 Controls Measures 控制措施 Responsible persons for work 指定负责人 Putty powder maybe P3 1.1 Adopt theodolite and steel tape ◆measure to survey and mark with harm worker’s eyes or white putty powder 用经纬仪和钢卷尺测量，并用白色双飞粉标识 respiration system 双飞粉可能伤害眼睛和呼吸系统 ◆Operators must wear safety glasses and wear respirator, and work at 李建军 downwind, in case of harm to eye by putty powder or respiration system.作业人员必须配戴安全眼睛和口罩，并在上风口作业，防止白石灰伤害人的眼睛和呼吸系统。 Safe Work Method Statement 安全施工方案
Page 4 of 18 Issue date Serial Number SWMS-JINHUA-002 Revision 1
Lemmink?inen (China) Co., Ltd SE Tiger Project
莱木工程管理咨询（上海）有限公司 斯道拉恩索林纸一体化项目 Item 序号 2 Job steps 工作步骤 Level and compact the room, canteen etc. area平整、压实厕所、淋浴间、餐厅等所需场地场地. Construction requirement/method 施工要求及方法 Hazards 潜在风险 hazard Level 风险等级 from P1 Controls Measures 控制措施 Responsible persons for work 指定负责人 李建军 Traffic 2.1 Dig off the unwanted soil with ◆用挖掘机挖出多余土体 2.2 Transport the soil to other area with truck 用卡车运土体到另外的区域 2.3 Compact the office area paved stone with bulldozer 用压路机压实铺碎石的办公区域 2.4 Septic-tank, oil separator excavation and build temporary toilet, shower excavator vehicle crash 撞车交通风险 ◆Excavators, bulldozers and trucks shall be operated by personnel with relevant operation certificates, and these guys must get safety induction training from SE safety department.由具有相关资质的人员操作货车、挖机、推土机, 并且这些人必须受到SE的安全培训。 ◆All transportation equipments shall be provided with valid production quality certificates and operation introduction, and only after inspected by LMK and marked, shall enter the field. 所有运输设备设备均应具备有效的产品质量证件文书和操作说明书，并经LMK验收贴标后，方可入场作业。 ◆Maintenance and examination for transportation equipments meet requirement of operation introduction or industry/nation code, and hold detailed maintenance and examination record.运输设备的保养和检查满足产品说明书的要求或行业、国家规章，并且有详细的保养检查记录。 ◆Speed limit on site is15km/h.场内限速15Km/h. ◆Set up the caution mark at pedestrian crossing of site road.在现场的行人路口设立警示标志。 化粪池，隔油池开挖，砌筑 ◆Traffic hazard from P1 ◆Overloaded transportation is strictly prohibited.严禁超载运输。 ◆Keep site road in good situation.保持场地道路状况良好 李建军 vehicle overturn 车辆倾覆交通风险 Safe Work Method Statement 安全施工方案
Page 5 of 18 Issue date Serial Number SWMS-JINHUA-002 Revision 1