Origin ALC - Worker could be harmed when undertaking work related road journeys.

Origin ALC - CRI - Worker could be harmed when undertaking work related Road journeys.

• Origin Operations Area: ( i.e. Combabula)

• Detailed Location:

• Contractor:

• Conducted on

  Date

• Prepared by

• Inspection Team

• Describe Task or Activity being Conducted:

• Journey assessed and deemed necessary.

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Journey planned to reduce risk (e.g. Car pooling, start and finish times, accommodation location).

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Work undertaken has been arranged to include multiple jobs in one journey.

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Journeys are registered when required with NRC.

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Vehicle inspection checklist is completed within the last seven days.

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Fatigue management-how was fatigue assessed and managed on this journey.

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

• Additional Controls added to reduce risk? ( usually documented in Jobstart etc )

  Fully Effective

  Effective in Parts

  Cause 4 Concern

  Absent/ Ineffectual

  N/a

Additional Comments

• Comments

Auditee

• Role:

• Signature

  Sign

Origin Energy Representative

• Role:

• Signature:

  Sign