• Document No.

  • Workplace Traffic Management Form

  • Store Location

  • Conducted on

  • Personnel

  • The following checklist should be used to evaluate workplace traffic hazards in order to assess the potential for injury to occur.
    If any of the questions in the checklist result in a NO answer then:
    1. A Risk Assessment must be conducted
    2. Controls must be devised

1A. Hazard Management Details - General

  • Name of Person conducting activity:

  • Date Conducted

  • Work area/ task

1B. Hazard Identification - Analysis of Workplace Records

  • Records of injuries shall be examined to identify where, and in what jobs, workplace traffic related injuries and incidents have occurred or could occur.
    The following factors require consideration. (Tick as appropriate)

  • Any established 'rights of way'

  • Any exclusion zones

  • The maintenance history of the vehicle involved

  • Any vision black spots

  • The training and licencing of the vehicle operator

  • Any traffic management signage

  • Any personal protective equipment worn by vehicle operators

2. Workplace Traffic Hazard Identification (Please tick)

2B. Work Processes

  • Are there work processes?

  • Developed in consultation with operators and employees?

  • Clearly communicated?

  • Reviewed for workplace hazards?

  • Reviewed after implementation?

  • Incorporated into an overall training program?

  • Are systems in place fro?

  • Reporting of equipment damage?

  • Reporting of incidents?

  • Reporting of Stock Damage?

  • Maintenance?

  • Re-fuelling/Recharging?

  • Managing the safety of bystanders?

  • Training operators?<br>

  • Assessment of individual loads?

  • Enforcing of speed limits in the warehouse?

  • Assessing vehicle stablity?

2C. Operator

  • Does the operator?

  • Understand the recharging procedure?

  • Have a licence to operate the equipment?

  • Understand the workplace rules and requirements?

  • Understand the workplace layout?

  • Follow the Traffic Management Plan correctly?

  • Control the vehicle appropriately during its operation?

  • Use safety devices appropriately (Seat belts/horn)

  • Have knowledge of the operator manual?

  • Operate at an appropriate speed?

  • Understand the requirement to report:<br>* Equipment damage<br>* Forklift incidents<br>* Stock damage

2A. Work Environment

  • Public Car Park?

  • Efficient workplace layout/plan?

  • Floor and Surfaces in good condition?

  • Travel and pedestrian paths identified and clearly marked?

  • Pedestrian and vehicle exclusion zones?

  • Designated loading and unloading zones?

  • Clearly identified 'right of way' area?

  • Designated maintenance areas?

  • Identified black spots?

  • Clear and adequate signage?

  • Adequate ventilation for the operation of vehicles with internal combustion engines?

  • Barricades protecting plan and pedestrian walkways?

3. Forklift management

  • Is the Forklift Pre-Operational Checklist currently in use? (Should be recorded on Safety Cloud)

  • Are the Picker and Turret Pre-Operational checklists currently in use. (Should be recorded on Safety Cloud)

Risk Assessment Information

  • If there is a requirement to conduct a Risk Assessment as a result of this evaluation, enter the details here.

  • Items requiring attention

  • Risk Rating (As per risk matrix assessment)

  • If controlled immediately list details here:

  • If longer term controls required list here:

  • Date to be implemented:

  • WHS Officer verifies controls are effective

  • Date signed

  • Manager verifies controls are effective

  • Date signed

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.