Journey and Risk Management Plan for Driving

• Purpose for Journey

• Journey Point of Origin?

• Journey Final Destination?

• Name of the appointed Journey Liaison who will not be travelling on the Journey?

• What time will the Journey Commence?

  Date

• What time will the Journey End?

  Date

• List any Designated Mid-Journey Destinations and Rest Break / Driver Swap Locations?

• Total Journey time (driving time plus all break times)?

• Total Driving time (not including breaks)

• How many rest breaks or driver changes required every two hours?

• How many Hours of Driving will occur after Sunset?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Will the Journey Require an Overnight Stay Over?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Will the Overnight Stay Provide at least 10 hours of rest time?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Provide Route Information (map)

  Media

• Total Journey Distance in km?

• Primary Driver Name

• Primary Driver has a valid license to operate the Vehicle?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Can the driver meet their special conditions of their drivers license (if any)

  Yes

  No

  N/A

• Will there be any Supplimentary Drivers?

  Select Yes No N/A

  • Yes
  • No
  • N/A

Supplimentary Drivers

• First Supplementary Driver Name

• First Supplementary Driver has a valid license to operate the Vehicle?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Can the driver meet their special conditions of their drivers license (if any)

  Yes

  No

  N/A

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• Second Supplementary Driver Name

• Second Supplementary Driver has a valid license for the Vehicle?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Can the driver meet their special conditions of their drivers license (if any)

  Yes

  No

  N/A

• How many hours of regular work will the Primary Driver perform on the day of Departure?

• How much rest time will the Primary Driver have prior to Departure?

• Does the total number of hours worked plus the total number of hours to be driven exceed 12 hours in any journey day?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• How many hours prior to departure would the primary driver have been awake for?

• Will the total number of hours awake prior to departure exceed 12 hours?

  Yes

  No

  N/A

• How many hours of regular work will the First Supplementary Driver perform on the day of Departure?.

• How much rest time will the First Supplementary Driver have prior to their first driving shift?

• Does the total number of hours worked plus the total number of hours to be driven exceed 12 hours in any journey day?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• How many hours prior to departure would the First Supplementary Driver have been awake for?

• Will the total number of hours awake prior to departure exceed 12 hours?

  Yes

  No

  N/A

• How many hours of regular work will the Second Supplementary Driver perform on the day of Departure?

• How much rest time will the Second Supplementary Driver have prior to their first driving shift?

• Does the total number of hours worked plus the total number of hours to be driven exceed 12 hours in any journey day?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• How many hours prior to departure would the Second Supplementary Driver have been awake for?

• Will the total number of hours awake prior to departure exceed 12 hours?

  Yes

  No

  N/A

• Number of Additional Passengers (non drivers)

• Names of Passangers

• Total Number of People Embarking on this Journey?

• Total Number of People Disembarking prior to Final Destination?

• Provide details of any Mid-Journey Disembarkations?

• Is anyone travelling under the age of 18?

  Yes

  No

  N/A

• Number of Passengers under the age of 18?

• State any special provisions required by anyone travelling

• Make and Model of Vehicle?

• Registration of Vehicle?

• Owner of the Vehicle?

• Vehicle Registration is Current?

  Yes

  No

  N/A

• Is the Vehicle Adequately Insured?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vehicle Pre Start Inspection Conducted Pre Departure?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Name of the person who conducted the Pre Start Inspection

• Fuel and Refill points have been arranged for the Journey?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Yes

  No

  N/A

• Describe the Cargo to be taken on the Journey.

• Total Weight of the Cargo?

  Yes

  No

  N/A

• Is the Vehicle adequately equipped to carry the cargo?

  Yes

  No

  N/A

• Describe where the cargo will be stored and how it will be secured?

  Yes

  No

  N/A

• Will there be any Dangerous Goods Cargo Carried

  Yes

  No

  N/A

• Have all Guidelines been followed to carry Dangerous Goods

  Yes

  No

  N/A

• Person Approving the Journey

• Is this Journey Approved?

  Yes

  No

  N/A

• Were all appropriate breaks taken as required?

  Yes

  No

  N/A

• Did the Journey go as expected?

  Yes

  No

  N/A

• Provide details of any Incidents during the Journey if any Occured

• Was a shut down inspection conducted on the Vehicle

  Yes

  No

  N/A

• Was the vehicle stored appropriately after the trip?

  Yes

  No

  N/A

• Was the Journey point of contact notified of the conclusion of the Journey?

  Yes

  No

  N/A