Title Page
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Conducted on
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Prepared by
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Location
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Enter driver name
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Enter loader name (if applicable)
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Load Type
- pre-load
- driver self load
- warehouse load
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enter vehicle registration number
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enter number of racks/pallets loaded
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enter the total load weight
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Fit For Work - I am not impaired by Illness, A Medical Condition, Drugs or Alcohol that could impact my safe working performance
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Competency – I have completed all relevant Induction training, Chain of Responsibility training & Safe Operating/Working Procedures for the tasks I will be conducting
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Fatigue – I am comfortable that the job I have been allocated can be done safely within the driving and working hours requirements and am able to take the required breaks
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Speed – I am comfortable that the job I have been allocated can be done safely without speeding and I have had the opportunity to make changes if required
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Vehicle Roadworthiness – I have completed a pre start checklist and the vehicle meets roadworthiness standards to complete the job/s allocated
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Mass - I have taken into account the weight limits of my load and vehicle, and I have had opportunity to make changes if required. If any doubt exists validation by a weighbridge has been completed
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Load Restraint - I have been supplied with a copy of the CCA Load Restraint Guidelines appropriate to the vehicle & load. The load has been restrained in accordance with the load restraint guideline principles.
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As a Loader or Loading Manager you are signing off that, to the best of your knowledge, this Declaration is a true account and that the Vehicle has been Loaded in line with Mass and Load Restraint Requirements as noted in the Declaration
Driver Self-Load/Unload may only be signed by the Driver
A Loading Manager will only inspect and sign off on loads based on risk, as deemed necessary. This is NOT compulsory -
Key Notes
If any doubt exists, by any party, that the load is not compliant or unsafe; please immediately escalate this via the site Escalation process
If Weighbridge Validation is required (ticked) this must be completed prior to Security releasing the vehicle
Security will not release a loaded vehicle unless all fields are completed appropriately and relevant checks have been conducted -
enter total time loading at site
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driver to sign
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loader to sign (driver to sign if self load)
