Title Page

  • Site conducted

  • Date & Time

  • Task

  • Work Area

  • Prepared by

VEHICLE COLLISION OR ROLLOVER

Fit for Work and Fatigue Management

  • Are you fit for work and able to stay focused on the task? E.g. physical/mental wellbeing, free from the effects of fatigue and/or medication

Vehicle Preoperational Inspection

  • Is your vehicle appropriate for the task? E.g. load/carrying capacity, size, working conditions<br>

  • Have you completed a vehicle specific pre operational inspection ?

  • Have any critical safety items identified in the pre operational inspection been corrected ? E.g. anti collision detection system, seatbelts, braking systems<br>

  • Are all items in the cab, cargo area and tray secured ?<br>

Operator Competency

  • Are you authorised and competent to operate this vehicle for this task?

  • Is your seatbelt being worn?<br>

Access Control

  • Has permission to enter the controlled area been granted?

Journey Management Plan

  • Have you completed a ‘journey management plan’?

Positive Communication System

  • Is your communication device working and appropriate for the task? E.g. adequate coverage and quantity

  • Do you understand the required positive communication protocols for this task?

Road Conditions

  • Have you confirmed if road and/or work area conditions are safe for operation ? E.g. consider weather, blasting activity<br>

Segregation

  • Have you confirmed that segregation controls are visible, secure and appropriate for the task? E.g. LV and HV separation, windrows, parking locations

  • Have you confirmed that segregation controls don’t create new risks ?<br>

Signage and Demarcation

  • Are signage and/or demarcation controls visible, secure and appropriate for the task? E.g. restricted areas, poor road conditions, reduced speeds, roads closed, river crossings

Downhill Haulage Management

  • Is your payload management system functional ?<br>

  • Do you know the maximum payload for the vehicle you are operating?<br>

  • In the event of overload/brake failure/overspeed/emergency , do you know what to do ?<br>

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.