Title Page
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Conducted on
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Prepared by
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Signature
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Location
Planning
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Placed travel trip and plan into Outlook calendar
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Travel approved by Manager
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Correct vehicle type (if travelling on dirt roads for long distances, take a suitable equipped 4WD vehicle)
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Weather conditions checked and assessed whether safe to travel
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Vehicle pre-start check conducted (vehicle is within service interval, sufficient fuel, check tyres, clean windscreen, fuel cards available)
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First Aid kit available
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Correct PPE worn (long sleeve shirt, long pants, hi-vis vest, lace-up safety boots, wide brim hat, sunscreen, gloves)
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Have you read and signed Safe Work Method Statement - Regional Customer Service Field Work and Driving - West Region
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Tool / Equipment required for the task
- Mobile phone
- Water
- reflector triangles
- measuring wheel
- Wheel brace
- torch
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Has a visual inspection been conducted of tools and equipment?
Situational Awareness
- Worksite
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Activity
- School zone inspection
- Speed zone inspection
- Fatal Crash investigation
- Sign inspection
- High risk crash zone inspection
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Location
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Time onsite
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Description of work
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Do you have phone coverage?
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Are there pedestrians/traffic in close proximity to the task/work area?
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Are there controls in place to protect the public and yourself?
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Have you contacted your Manager if working alone, remote or isolated?
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Parked clear of carriageway, minimum 3 metres if possible, to make/receive phone calls
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Is the vehicle parked in an easily accessible area on flat even ground?
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Is the area free from slips, trips and falls?
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Are there any hazards on site not controlled by the existing Safe Work Method Statement?
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What are the hazards?
Return to Base
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Refuel vehicle and clean windscreen
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Tidy/clean vehicle
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Is there any damage or issues with the vehicle
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Has the damage or issue been reported
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Complete log book and return keys