HASTINGS CO-OP

• Conducted on

  Date

• Prepared by

HASTINGS CO-OP BUSINESS UNIT CHAIN OF RESPONSIBILITY CHECKLIST

• 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

• REGO No;

• Optional Plate Photo;

  Media

• TRAILER REGO No;

• Optional Plate Photo;

  Media

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Comments;

THE DRIVER

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Comments;

• Drivers 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's Name & Signature

  Sign

• Select date

  Date

• Hastings Co-op Representative Name & Signature;

  Sign

• Select date

  Date
• Site Location;
  Address

• 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.

• Additional Comments;