Delivery Point Risk Assessment

• Document No.

• Audit Title

• Client / Site

• Provide a Photograph of the Delivery Point

  Media

• Conducted on

  Date
• Location
  Address

• Are there any weight restrictions at the delivery point? i.e. is there any signage to indicate the maximum weight allowed at this point, are there any signs indicating NO HGV's at Any Time

  YES

  NO

  N/A

  UNKNOWN

• Are there any vehicle size and or height restrictions at the delivery point? is there any signage to indicate the maximum height allowed at this point, are there any signs indicating NO HGV's at Anytime

  YES

  NO

  N/A

  UNKNOWN

• Are there any specific restriction at the delivery point?

  Select Double Yellow Lines Waiting Restrictions Unloading/Loading Restrictions Narrow Road Close to Junction Close to Bus Stop Close to Taxi Rank Close to Subway Station Close to Bus Station Close to Railway Station

  • Double Yellow Lines
  • Waiting Restrictions
  • Unloading/Loading Restrictions
  • Narrow Road
  • Close to Junction
  • Close to Bus Stop
  • Close to Taxi Rank
  • Close to Subway Station
  • Close to Bus Station
  • Close to Railway Station

• Is the Delivery Point Accessed via a One-Way System?

  YES

  NO

• Additional Premises within Close Proximity to the delivery point?

  Select Schools Restaurants & Bars Rail Station Bus Station Subway Station Shops and or Precincts

  • Schools
  • Restaurants & Bars
  • Rail Station
  • Bus Station
  • Subway Station
  • Shops and or Precincts

• Are there any Pedestrian Crossing Points in the Vicinity of the delivery point?

  YES

  NO

• Are the following Hazards Identifiable at the delivery point?

  Select Camber and or Slope Members of the public at Risk Slip and or Trip Hazards Uneven and or Tactile Surface

  • Camber and or Slope
  • Members of the public at Risk
  • Slip and or Trip Hazards
  • Uneven and or Tactile Surface

• Approximately how far (in meters) is the Unloading/Loading Point to the final Delivery Point?

• Does the driver have to handle carriers across a roadway and or crossing point to gain access to the final delivery point?

  YES

  NO

• Does the driver have to handle carriers Up and Down a Significant Incline?

  YES

  NO

• Does the nature of the delivery require Double Manning?

  YES

  NO

• What type of delivery has been agreed with the customer?

  Roll Off

  HandBall

  Combined

• Photograph of Final Delivery Point i.e. storeroom, basement etc.

  Media

• Provide any additional information relevant to the final delivery point and or additional customer requirements

Dynamic Assessment of Risks for this Delivery Point

• In your Opinion what is the Risk Rating for Manoeuvring at the delivery point (1 being best, 5 being worse)

• In your Opinion what is the Risk Rating for Unloading/Loading at the delivery point (1 being best, 5 being worse)

• Select the OVERALL Risk Rating by multiplying the Manoeuvring result with the Unloading/Loading result (1-6 LOW, 8-12 MEDIUM, 15-25 HIGH)

  LOW

  MEDIUM

  HIGH

• Assessors Name

• Assessors Signature

  Sign

• Date of Assessment

  Date

• Customer Name or Customer Representative Name

• Customer or Customer Representative Signature

  Sign

• Date

  Date