Title Page

  • Site

  • Date

  • Driver

  • Rego No

  • Trailer Rego No

  • Site Location
  • INSTRUCTIONS

    1. Please answer "Yes," "No," or "N/A" on the questions below.
    2. Add photos and notes by clicking on the paperclip icon.
    3. To add a Corrective Action click on the paperclip icon then "Add Action," provide a description, assign to a member, set priority, and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF, Word, Excel or Web Link.

  • To be completed when receiving and dispatching vehicles with a GVM of 4.5tonnes and over.

    Business Unit:

    Important information for Managers / Delegates and Drivers
    This document is to be completed by a competent employee when receiving or dispatching goods as per the above.
    All reasonable steps must be taken to ensure that the employee is not contributing to any CoR or WHS breach.
    It is to be completed following the unloading or loading of the vehicle and prior to the vehicle leaving Co-op premises

Vehicle

  • 1. The Driver has confirmed the he/she is satisfied that the vehicle's load limit has not been exceeded.

  • 2. The Driver has confirmed that he/she is satisfied that the load is secured and positioned correctly and does not pose a risk to health and or safety.

Driver

  • 1. The Driver has confirmed that he/she is fit for duty.

  • 2. The Driver has confirmed that they are complying with their fatigue management plan.

General Comments and Observations

  • Please add additional comments and observations

Driver's Declaration

  • I acknowledge that by signing this document I am confirming that my vehicle is safely loaded, and I am fit to operate the vehicle and continue with my journey.

  • Driver Name and Signature

  • Hastings Co-op Representative Name and Signature

  • NB: Any concerns regardings this load, vehicle or Driver are to be reported immediately to the Business Unit Manager. Business Unit Manager is then to determine action i.e. report to Driver's Company and / or NHVR. This documentation must be retained ina suitable register and retained for the required time period.

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