Driving and fatigue risk assessment

• Job Number

• Client / Site Address

• Add media

  Media

• Conducted on

  Date

• Prepared by

Vehicle driving and Fatigue assessment

Vehicle selection

• Vehicle Type

  Select Ford Ranger Ford XR6 Ute Ford Trader Ford BA Sedan Truck VW Caddy Hire car

  • Ford Ranger
  • Ford XR6 Ute
  • Ford Trader
  • Ford BA Sedan
  • Truck
  • VW Caddy
  • Hire car

• Vehicle condition

• Supply a picture of any damage or visible issue with the vehicle

  Media

Determine distance to be travelled

• Travel distance daily or in a single trip

  Select Under 100kms Low risk Over 100kms but under 500kms Medium risk Over 500kms High risk

  • Under 100kms Low risk
  • Over 100kms but under 500kms Medium risk
  • Over 500kms High risk

• Controls identified

  Select Schedule travel times to reduce interaction with wildlife Take regular breaks every two hours Accommodation may be required Consider two drivers were practicable Optimise travel path to job sites

  • Schedule travel times to reduce interaction with wildlife
  • Take regular breaks every two hours
  • Accommodation may be required
  • Consider two drivers were practicable
  • Optimise travel path to job sites

• Controls identified

  Select Schedule travel times to reduce interaction with wildlife Take regular breaks every two hours Accommodation may be required Consider two drivers were practicable Optimise travel path to job sites

  • Schedule travel times to reduce interaction with wildlife
  • Take regular breaks every two hours
  • Accommodation may be required
  • Consider two drivers were practicable
  • Optimise travel path to job sites

• Controls identified

  Select Same Controls as per medium risk Elevated Fatigue issue Accomodation required Segmented journey multiple stops Multiple drivers required Consider alternate means of travel

  • Same Controls as per medium risk
  • Elevated Fatigue issue
  • Accomodation required
  • Segmented journey multiple stops
  • Multiple drivers required
  • Consider alternate means of travel

• Comments

Work time

• Anticipated work periods

  Select Over 12 hours working period Under 12 hours but over 8 hour working period Under 8 hour working period

  • Over 12 hours working period
  • Under 12 hours but over 8 hour working period
  • Under 8 hour working period

• Fatigue level

  Select High fatigue risk

  • High fatigue risk

• Fatigue level

  Select Medium

  • Medium

• Fatigue level

  Low risk

• Comments

Accumulative days travelling

• Accumulative days

  Select 2 consecutive days 3 consecutive days 4 and over consecutive days

  • 2 consecutive days
  • 3 consecutive days
  • 4 and over consecutive days

• Fatigue level

  Select Low risk

  • Low risk

• Fatigue level

  Select Medium

  • Medium

• Fatigue level

  High fatigue risk

• Comments

Sleep

• Determine the level of sleep prior to driving

  Select Less than 4 hours sleep 4 to 6 hours sleep Over 6 hours sleep

  • Less than 4 hours sleep
  • 4 to 6 hours sleep
  • Over 6 hours sleep

• Issues identified

  Select High fatigue risk

  • High fatigue risk

• Issues identified

  Select Medium

  • Medium

• Issues identified

  Select Low risk

  • Low risk

• Comments

General hazards

• Location and route known

  Yes

  No

  N/A

• Hands free mobile and satellite navigation

  Yes

  No

  N/A

• Road conditions

  Safe

  At Risk

  N/A

• Are the weather conditions suitable for driving

  Safe

  At Risk

  N/A

• Issues and actions

  Select Delay travel time Reschedule appointments contact manager

  • Delay travel time
  • Reschedule appointments
  • contact manager

• Comments

Risk assessment completed by

• Additional comments

• Name of person undertaking the site risk assessment

  Sign