Information

  • Prepared by

  • Mobile number

  • Date of travel

  • Start point

  • Total Kms

  • Estimated travel time

  • Start date & time

  • Finish date & time

  • Travel after a full shift?

  • Travel during normal sleep time

  • Travel + work hours > 14 hrs

  • You need to take a 15 minute break after every 2 hours of driving. You must take additional breaks if you are showing signs of fatigue.

Break 1 (2 hours after start time)

  • Break time

  • Break Location

Break 2 (2 hours & 15 mins after break 1)

  • Break time

  • Break Location

Break 3 (2 hours & 15 mins after break 2)

  • Break time

  • Break Location

Break 4 (2 hours & 15 mins after break 3)

  • Break time

  • Break Location

Break 5 (2 hours & 15 mins after break 4)

  • Break time

  • Break Location

Break 6 (2 hours & 15 mins after break 5)

  • Break time

  • Break Location

  • Did the driver get 24 hrs notice?

  • Did the driver get 8 hrs in the 24hrs before travel?

  • Call in Person

  • Call in Person's number

  • Have you informed the call in person?

  • If the driver is 15 minutes late communicating, the call in person must call the driver. If there is no answer, the call in person or supervisor will try again every 5 minutes for an additional 15 minutes. After that the supervisor will contact emergency services.

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.