Journey Management Plan / Checklist V2

• This form is to be used when travelling over 400kms on a sealed road or 50kms on a dirt road. Rest stops must be approximately every 2 hours.

• Driver Name:

• Conducted on:

  Date

• Vehicle Rego No:

ROADS

• What type of roads will you be travelling on?

  Select Sealed Dirt

  • Sealed
  • Dirt

• Will you be travelling over 400 Kms on sealed roads?

  No

  Yes

• Estimated Klms

Passenger Information

• Will there be any passengers accompaning you?

  No

  Yes

• Enter Passenger Name

Passenger

• Passenger Name:

Destination

• Departing From:
  Address

• Estimated time of departure

  Date
• Destination:
  Address

• Estimated time of arrival

  Date

• NOTE: Rest stops must be approximately every 2 hours.

• Rest Stop Locations:

Rest Stop

• NOTE: Rest Stops must be every 2 hours.

• Enter Rest Stops

• Estimated check in time:

  Date

• Check in method.

  Call

  Text

• To Whom?

• Check in Phone No:

• Will you be travelling over 50 Kms on dirt roads

  No

  Yes

• Estimated Klms.

Passenger Information

• Will there be any passengers accompaning you?

  No

  Yes

• Enter Passenger Name

Passenger

• Passenger Name:

Destination

• Departing From:
  Address

• Estimated time of departure

  Date
• Destination:
  Address

• Estimated time of arrival

  Date

• NOTE: Rest stops must be approximately every 2 hours.

• Rest Stop Locations:

Rest Stop

• NOTE: Rest Stops must be every 2 hours.

• Enter Rest Stops

• Estimated check in time:

  Date

• Check in method.

  Call

  Text

• To Whom?

• Check in Phone No:

DRIVER CHECK LIST

• Note: You must be able to answer ‘yes’ to all the applicable questions prior to commencing your journey. For items marked ‘no’, put controls in place or consult with a Manager / Supervisor prior to departure.

• Do you have a current & valid licence for this vehicle?

  Yes

  No

• Do I have adequate directions to the destination and am I familiar with the route? (Map out your trip to allow adequate time to get to your destination to avoid speeding or skipping rest stops)

  Yes

  No

• Google Maps
  https://www.google.com.au/maps/@-34.8304161,138.5800337,15z

• Do I know the current road conditions? Consider if the road has been closed by floods or fire.

  Yes

  No

• Bureau of Meteorology
  http://www.bom.gov.au/

• Have you had sufficient rest and are you fit for the drive?

  Yes

  No

• NOTIFY YOUR MANAGER BEFORE PROCEEDING.

• Your driving time and non-driving duties will not exceed 10 hours in one day?

  Yes

  No

• Has accommodation been booked?

  Yes

  No

• NOTE: As per the current "Safe Driving of Light Commercial Vehicles" procedure, accommodation must be booked if your total journey time exceeds 10 hours.

• Will I complete my journey during daylight hours? (If possible, plan your journey to avoid times when your concentration levels are at their lowest and your vision may be limited. e.g. late at night and early morning)

  Yes

  No

• Do I have sufficient drinking water and sustenance? (Allow minimum 1 litre/person per hour)

  Yes

  No

• Has your mobile phone been set up as hands-free?

  Yes

  No

• The safest way to use a mobile phone is to pull over and park in a safe place. Note: State road rules do not allow mobile phones to be handled while driving

• Am I aware of the hazards that may be present during this journey and have I got relevant controls in place?

  Yes

  No

VEHICLE CHECKLIST

• Note: You must be able to answer ‘yes’ to all the applicable questions prior to commencing your journey. For items marked ‘no’, put controls in place or consult with a supervisor prior to departure.

• Safety kit present in vehicle and fully stocked?

  Yes

  No

  N/A

• Ensure your safety tool kit is fully stocked before your trip commences.

• Fluid levels acceptable?

  Yes

  No

  N/A

• Vehicle servicing up to date?

  Yes

  No

  N/A

• Tyre pressure and condition okay?

  Yes

  No

  N/A

• Windscreen clear?

  Yes

  No

  N/A

• Mirrors in place?

  Yes

  No

  N/A

• Break lights working?

  Yes

  No

  N/A

• Indicators working?

  Yes

  No

  N/A

• Headlights working?

  Yes

  No

  N/A

• Items on back seat secure (nothing on back seat that can dislodge behind driver)?

  Yes

  No

  N/A

• Any Issues Identified?

  No

  Yes

• Add any issues identified.

Pre-Departure Checklist

• I have completed the Driver & Vehicle Checklist.

• The Driver & Vehicle Checklist MUST be completed prior to commencing your journey.

• I am physically and mentally fit to perform task. (I have had sufficient rest based on past work hours, time of day and not effected by any substance)

• I have suitable communication equipment (e.g. mobile phone ), charged & operational.

Sign Off

• Add signature

  Sign

• e-mail / scan a copy of the completed Journey Management Plan / Checklist to your Manager / check in contact.