Road Journey Risk Assessment and Road Journey Management Plan

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date

  Date

• Driver 1 (Name)

• Driver 2 (Name)

• Destination?

• Reason for the Journey

• IVMS installed and working ?

  Yes

  No

  N/A

• Road Journey Manager/Contact

Scoring

• Is this the driver's first time journey on this route? If yes=15 If no=0

• Is the driver a Short Service Employee If No =0 If 7months to 12 months=15 If 6 months or less=40

• How many hours has the driver been on duty before starting the journey? 8 hours to 12 hours= 10 More than 12 hours but less than 16 hours=30 16 hours and greater=75

• How many hours of sleep has the driver had in the last 24hours? *4 hours or less=40 *More than 4 hours but less than 6=5 *6 or greater hours=0

• What is the anticipated driving time (hours) for the journey? Less than 2 hours=0 2 hours to 4 hours=10 Greater than 4 hours to 6 hours=15 Greater than 6 hours=20

• Is there a backup driver for journeys over 10 hours If Journey not over 10 hours=0 If answer is yes=0 If answer is no=5

• Will the journey require driving in darkness? If less than 4 hours=0 If 4 hours to 6 hours=20 Over 6 hours=40

• Will the journey cause the driver to exceed their normal work schedule or drive during a elevated traffic risk periods? If no=0 If yes=5

• What are the weather conditions and visibility for the journey? Good=0 Fair=10 Poor=25

• What is the road surface condition and topography? Good=0 Fair=5 Poor=15

• Are there security issues? No=0 Yes mitigated=40 Yes=75

• Are hazardous materials shipped with appropriate documentation and qualified drivers?<br><br>N/A =0<br>Yes=0<br>No=Stopwork

  Yes

  No

  N/A

Score

• Total score

• Risk Level<br><br>Low=less than 30<br>30 to 49=moderate<br>50 to 75=medium<br>Greater=75

  Low

  Moderate

  Medium

  High

Passenger Information

• Passenger 1

• Passenger 2

• Passenger 3

Route

• Route description

Contact

• Contact Person

• Contact frequency Daily? Every 4 hours? Every 2 hours? Every 1 hour?

Approvals

• Authorizing manager (if required)

• Drivers printed name

• Drivers signature

  Sign