HSE Land Transport Risk Assessment Recording Tool

Contents
Session Details Customer, Session Title, Context and Stakeholders
Attendees Session Attendees
Recording Risk Assessment Record and Risk Reduction Plan

Copyright 2019, Worley Rev. 0, 01 December 2019

493032309.xlsx HSE Land Transport Risk Assessment Form
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Project: XX
Customer: Company Name
Contract: Number

Location/Work Area: XX

Assessment Title: HSE Land Transport Risk Assessment Form

Original Assessment: Date
Revsion: Date
Revision: Number

Responsibility: Typically a Department Manager

Key Success Factors:

1 Zero Harm
2 Enter other factors here
3
4

Stakeholders:
1 Enter Here

Copyright 2019, Worley Corporate Base Rev. 0, 01 December 2019

493032309.xlsx HSE Land Transport Risk Assessment Form
Name Company Position

Attendees:

Team Leader:

Facilitator:

Recorded by:

Copyright 2019, Worley Corporate Base Rev. 0, 01 December 2019

493032309.xlsx HSE Land Transport Risk Assessment Form
 HSE Land Transport Risk Assessment Form Number

Back to Contents Page

Risk Assessment Record Risk Reduction Plan Status

Raw Risk Inherent Residual Risk

Percent Complete
Consequence(1)

Consequence(2)

Consequence(3)
Likelihood(1)

Likelihood(2)

Likelihood(3)

Completion
Un-wanted Health or Safety Event

Level(1)

Level(2)

Level(3)
Rank(1)

Rank(2)

Rank(3)
Hazard or Environmental Aspect or Environmental Impact (Change to Recommended Action By Whom

Date
No. Task/Activity (Element of the activity that can Existing Controls (Improve existing controls Target Date Comments
interact with the environment) the environment resulting from the / implement new controls) Person To Action
aspect)

Journey Planning

A-Insignificant

A-Insignificant

A-Insignificant
Risks not identified for the
Short and frequent journeys journey which may lead to

5-Rare

5-Rare

5-Rare
Define journeys and their controls for which a

Low

Low

Low
1 Route assessment which lack adequate controls increased probability of an 25 25 25
Journey Management Plan (JMP) can be exempted.
due to assumed low risk incident and injury severity to
driver.

Vehicle and Driving Standard -

A-Insignificant

A-Insignificant

A-Insignificant
Inappropriate route planned Increase in journey times leading Journey Management 3.5
for journey, increase in to driver fatigue. Route not Journey Risk Assessment 3.5

5-Rare

5-Rare

5-Rare
Low

Low

2 Route planning
journey's undertaken. Road
conditions effecting journey
outcome
Low
matched to vehicle type resulting 25 25 Journey Management Plan 3.5.1 25
in vehicle breakdown, driver
isolation for recovery. Journey Risk Assessment and Management Plan
Form MS-AS-FRM-0036

Vehicle breakdown due to

incorrect operational
A-Insignificant

A-Insignificant

A-Insignificant
requirements. Vehicle safety Vehicle and Driving Standard -
Vehicle type for journey to be inclusions below required Vehicle Management 3.4
5-Rare

5-Rare

5-Rare
Low

Low

3 Allocation of vehicle
Low
undertaken inappropriate to standards for driver protection 25 25 Fit for Purpose 3.4.1 25
conditions Operational Specification 3.4.2, 3.4.4 - 3.4.6
which results in higher severity Prohibited Equipment and Vehicles 3.4.10
injuries in the event of an
incident.
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle and Driving Standard -
Unskilled driver nominated to Inexperienced driver crashes Driver Competency 3.3.2.
5-Rare

5-Rare

5-Rare
Low

Low

Low
4 Allocation of driver undertake journey. vehicle seriously injuring self, 25 25 Licenses Validity 3.3.4 25
Unfamiliarity with vehicle passengers and or 3rd parties. Driver Responsibilities 3.3.7.
General Requirements 3.4.2.

Driver Management
A-Insignificant

A-Insignificant
Inexperienced driver crashes
Vehicle and Driving Standard -

4-Unlikely
Driver maintaining licencing, vehicle seriously injuring self,

B-Minor
5-Rare

5-Rare
Unqualified / inexperience Driver Competency 3.3.2.
Low

Low

Low
5 insurance and competency driver passengers and or 3rd parties. 25 25
Driver Training 3.3.3.
21
standards Penalty for breaches to licensing
Driver Responsibilities 3.3.7
requirements

Fitness to Work Standard

A-Insignificant

A-Insignificant

A-Insignificant
Driver health problems, Low alertness levels of driver Alcohol and Drugs Misuse Standard
4-Unlikely
5-Rare

5-Rare
Drivers presenting self to work fatigue/low alertness, contributes to incident Vehicle and Driving Standard -
Low

Low

Low
6 25 24 25
in fit and alert condition. influence of alcohol and drugs occurrence. Serious injury to Fitness to Drive 3.3.5.
whilst driving driver Driver Responsibilities 3.3.7. (vi)
Driving Restrictions and Duty Hours 3.5.2.
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle and Driving Standard -
Driver distraction increase
5-Rare

5-Rare

5-Rare
Additonal passengers required Unauthorized passengers Driver Responsibilities 3.3.7 (iii)
Low

Low

Low
7 probability of incident. Liability 25 25 25
to undertake journey. during journey General Requirements 3.4.2. (v)
on company.
Definitions 5 (Authorized Passengers)

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493032309.xlsx HSE Land Transport Risk Assessment Form
Risk Assessment Record Risk Reduction Plan Status
Raw Risk Inherent Residual Risk

Percent Complete
Consequence(1)

Consequence(2)

Consequence(3)
Likelihood(1)

Likelihood(2)

Likelihood(3)

Completion
Hazard or Environmental Aspect Un-wanted Health or Safety Event

Level(1)

Level(2)

Level(3)
Rank(1)

Rank(2)

Rank(3)
Recommended Action
(Element of the activity that can or Environmental Impact (Change to By Whom

Date
No. Task/Activity Existing Controls (Improve existing controls Target Date Comments
interact with the environment) the environment resulting from the
aspect) / implement new controls) Person To Action

A-Insignificant

A-Insignificant

A-Insignificant
3rd party road users
hazardous driving activity. Vehicle and Driving Standard -

5-Rare

5-Rare

5-Rare
Other road users traversing Vehicle crash seriously injuring

Low

Low

Low
8 Driving into other lanes, 25 25 Driver Training 3.3.3 25
road network unsafe overtaking passengers and 3rd parties. Vehicle Safety Specifications 3.4.4
manoeuvres

A-Insignificant

A-Insignificant

A-Insignificant
Vehicle incident seriously injuring Vehicle and Driving Standard -
Use of mobile phone and self, passengers and or 3rd Driver Responsibilities 3.3.7 (xi)

5-Rare

5-Rare

5-Rare
Availability of communication

Low

Low

Low
9 other communications whilst parties. Penalty for breaches of 25 25 25
modes during journey
driving mobile phone usage during Journey Risk Assessment and Management Plan
driving Form

A-Insignificant

A-Insignificant

A-Insignificant
Vehicle and Driving Standard -
Prestart checks performed prior Vehicle leaves for journey in Unplanned vehicle breakdown.
Driver Responsibilities 3.3.7. (ix)

5-Rare

5-Rare

5-Rare
Low

Low

Low
10 an unroadworthiness Driver isolation in 25 25 General Requirements 3.4.2. (viii) 25
to journey departure condition. remote/unfamiliar area.
Pre-Use Inspection Checklist

A-Insignificant

A-Insignificant

A-Insignificant
Poor load restraint has free Load can impact with driver and

5-Rare

5-Rare

5-Rare
Load restraint used to tie down movement items in vehicle. other passengers in car resulting Vehicle and Driving Standard -

Low

Low

Low
11 25 25 25
loads carried during journey Unstable vehicle during in injury. Damage to load and Load Restraint/Cargo 3.4.8.
journey. vehicle equipment

Fitness to Work Standard

A-Insignificant

A-Insignificant

A-Insignificant
Failure to comply with Alcohol and Drugs Misuse Standard
Vehicle crash seriously injuring
5-Rare

5-Rare

5-Rare
Driver ensuring compliance established road laws and Vehicle and Driving Standard -
Low

Low

Low
12 passengers and 3rd parties. 25 25 25
with Laws and Road rules. rules. Speeding, unsafe driver Penalties incurred by driver. Fitness to Drive 3.3.5.
behaviour Driver Responsibilities 3.3.7.
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle and Driving Standard -
Vehicles maintain appropriate Lack of appropriate insurance Exposure to liability. Penalties
5-Rare

5-Rare

5-Rare
Vehicle Management Sec 3.4
Low

Low

Low
13 registration and insurance 25 25 25
coverage in event of incident incurred by company Operational Specification Sec 3.4.2. (ii, iii)
requirements
Definitions 5 (Vehicle Insurance)

Vehicle breakdown due to

incorrect operational
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle type for journey to be requirements. Vehicle safety
Vehicle and Driving Standard -
Vehicle selection and types
5-Rare

5-Rare

5-Rare
undertaken inappropriate to inclusions below required Selection 3.4.1.
Low

Low

Low
14 match journey to be 25 25 25
standards for driver protection Prohibited Equipment and Vehicles 3.4.10.
undertaken conditions
which results in higher
consequence injuries in the event
of an incident.
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle safety inclusions
Vehicle safety and operational insufficient to protect driver Increased severity of Vehicle and Driving Standard -
5-Rare

5-Rare

5-Rare
Low

Low

Low
15 specifications applied to in the event of an incident. driver/passenger injuries in event 25 25 General Requirements 3.4.2 25
vehicles undertaking journey's Unstable loads leading to of incident. Vehicle Safety Specifications 3.4.4.
rollover.
A-Insignificant

A-Insignificant

A-Insignificant
Vehicle breakdown during
Vehicle and Driving Standard
Vehicles maintaining operating journey. Vehicle in Longer vehicle recovery time.
5-Rare

5-Rare

5-Rare
General Requirements 3.4.2 (viii)
Low

Low

Low
16 integrity through service and unroadworthy state. Driver isolated in unfamilair 25 25 25
repairs Continued use in unsafe location.
Pre-Use Inspection Checklist
condition.

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493032309.xlsx HSE Land Transport Risk Assessment Form
Risk Assessment Record Risk Reduction Plan Status
Raw Risk Inherent Residual Risk

Percent Complete
Consequence(1)

Consequence(2)

Consequence(3)
Likelihood(1)

Likelihood(2)

Likelihood(3)

Completion
Hazard or Environmental Aspect Un-wanted Health or Safety Event

Level(1)

Level(2)

Level(3)
Rank(1)

Rank(2)

Rank(3)
Recommended Action
(Element of the activity that can or Environmental Impact (Change to By Whom

Date
No. Task/Activity Existing Controls (Improve existing controls Target Date Comments
interact with the environment) the environment resulting from the
aspect) / implement new controls) Person To Action

Vehicle and Driving Standard -

A-Insignificant

A-Insignificant

A-Insignificant
Failure or extended time to Increased severity of Vehicle and Driving Standard -

5-Rare

5-Rare

5-Rare
Use of supplementary Supplementary Requirements 3.4.9

Low

Low

Low
17 recover from unplanned driver/passenger injuries in event 25 25 25
equipment on vehicles
event or incident of incident. Journey Risk Assessment and Management Plan
Form

A-Insignificant

A-Insignificant

A-Insignificant
Increased risk of injury to driver
Unsafe vehicles and Vehicle and Driving Standard -

5-Rare

5-Rare

5-Rare
Prohibited Vehicles and in event of incident. Vehicle

Low

Low

Low
18 equipment used during a 25 25 Selection 3.4.1. 25
Equipment journey unable to protect drive in event Prohibited Equipment and Vehicles 3.4.10.
of incident.

Journey Management

Vehicle and Driving Standard -

Failure to identify high risk
Land Transport Risk Assessment 3.2

A-Insignificant

A-Insignificant

A-Insignificant
journeys and implement In Vehicle Monitoring System 3.6
appropriate risk control Increase risk of incident and

5-Rare

5-Rare

5-Rare
High Risk Journeys for

Low

Low

Low
19
operational activities measures. Off road and night injury to driver. Vehicle 25 25
HSE Land Transport Risk Assessment Tool
25
driving, adverse weather breakdown in unfamiliar location
conditions, animals on road, Journey Risk Assessment and Management Plan
security concerns,
Form

Driver is not aware of Increase in journey times leading

A-Insignificant

A-Insignificant

A-Insignificant
Journey Risk Assessment and Management Plan
appropriate risk for planned to driver fatigue and increased
Form
5-Rare

5-Rare

5-Rare
Implementation of Journey journey to be undertaken. risk of incident. Route not
Low

Low

20
Management Plans (JMP's) Poor road conditions, adverse
weather, on road vs off road
conditions, night driving.
Low
25 25 25
matched to vehicle type resulting
in vehicle breakdown, driver Vehicle and Driving Standard -
Journey Management Planning 3.5.1
isolation for recovery.

Vehicle and Driving Standard -

A-Insignificant

A-Insignificant

A-Insignificant
Fitness to Drive 3.3.5.
5-Rare

5-Rare

5-Rare
Increased driver fatigue and Increase risk of incident and Driver Responsibilities 3.3.7. (vi)
Low

Low

Low
21 Duty, Driving and Rest Hours 25 25 25
low alertness levels injury severity to driver. Driving Restrictions and Duty Hours 3.5.2.

Fitness to Work Standard

A-Insignificant

A-Insignificant

A-Insignificant
Continued non compliance by
drivers with duty/driving Driver behaviour not corrected
5-Rare

5-Rare

5-Rare
Vehicle and Driving Standard -
Low

Low

Low
22 Driver and Vehicle Monitoring hours, non authorized route increasing probability of incident. 25 25 25
travelled and local laws and Penalty to driver. In Vehicle Monitoring System (IVMS) 3.6
road rules.
A-Insignificant

A-Insignificant

A-Insignificant
Failure to provide sufficient Journey Risk Assessment and Management Plan
communications during Increased probability of incident Form
5-Rare

5-Rare

5-Rare
Communications throughout
Low

Low

Low
23 journey. Driver using and injury to driver. Penalty to 25 25 25
the journey
communications while driving driver. Vehicle and Driving Standard
and vehicle in motion. Driver Responsibilities 3.3.7 (xi)

Risk Item/Step

0
A-Insignificant

A-Insignificant

A-Insignificant
5-Rare

5-Rare

5-Rare
Low

Low

Low
25 25 25

Risk Item/Step

0
Copyright 2019, Worley Corporate Base Rev. 0, 01 December 2019
493032309.xlsx HSE Land Transport Risk Assessment Form
 Rev. 0, 01 December 2019
Comments
Status

Completion
Date
Percent Complete
25

25

25

25

25

25

25

25

Rank(3)
Residual Risk

Level(3) Low 0 Low 0 Low 0 Low 0 Low Low 0 Low 0 Low

Likelihood(3) 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare
Consequence(3) A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant
Target Date
Person To Action
By Whom
Risk Reduction Plan

/ implement new controls)

(Improve existing controls
Recommended Action

25

25

25

25

25

25

25

25
Rank(2)

Corporate Base
Inherent

Level(2) Low Low Low Low Low Low Low Low

Likelihood(2) 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare
Consequence(2) A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant
Existing Controls

25

25

25

25

25

25

25

25
Rank(1)
Raw Risk

Level(1) Low Low Low Low Low Low Low Low

Likelihood(1) 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare 5-Rare
Consequence(1) A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant A-Insignificant
(Element of the activity that can or Environmental Impact (Change to
resulting from the
Hazard or Environmental Aspect Un-wanted Health or Safety Event
interact with the environment) the environmentaspect)

493032309.xlsx HSE Land Transport Risk Assessment Form

Risk Assessment Record

Task/Activity

Copyright 2019, Worley

Risk Item/Step

Risk Item/Step

Risk Item/Step

Risk Item/Step

Risk Item/Step

Risk Item/Step
No.