Personnel & Vehicle Details
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Primary Driver:
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Reason for Travel:
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Vehicle Type:
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Registration Number:
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Document No.
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Prepared by
Travel Itinerary & Contact Details
Proposed Travel Itinerary:
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Distance of Travel:
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Departing From:
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Time of departure:
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Route:
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Destination:
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Expected arrival time:
Other Drivers and All Passengers (if any)
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Passenger 1 Name:
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Phone:
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Passenger 2 Name:
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Phone:
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Passenger 3 Name:
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Phone:
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Passenger 4 Name:
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Phone:
Check in Details. Must check in at start and end of journey.
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Name of check in person
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Number of check in person
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Method of check in
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Frequency of check in (2 hours maximum)
Journey Management Plan
Journey Risk Assessment and Controls
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Road conditions expected:
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Weather expected:
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List Other Hazards:
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Driving On Your Own?
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How many people sharing the driving?
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Hours awake before commencing the journey?
Controls: Do you acknowledge the following controls?
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Have I completed a Light Vehicle prestart? Mandatory *
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No driver to drive more than 2 hours before having a minimum 15 minute break
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Sufficient rest has been taken prior to the drive for lone drivers
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List all other proposed controls:
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Fuelled up
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Sign off: