REV: 1

JOURNEY MANAGEMENT PLAN

STATUS: ISSUED FOR USE

Review Date: 05/10/2015 DOC OWNER: HSE SYSTEMS MANAGER

Trip Description:
Names of Passengers Alternate driver?
(for light vehicles / pickups only)

Is the trip necessary? Why?

Can it be combined with

another trip? Why not?
Is there a need for night
driving? Why?
Name of nominated contact
person
Name of Driver (and Company if not Bush
Telegraf) Is the driving license
Departure Departure Vehicle ID Is the vehicle or other mode of valid for the vehicle Has the driver completed the required training
date time transport fit for the trip? for this vehicle?
and country?

Arrive Depart Date of Date of

Route Destination and Rest time Time Depart Arrival Rest Contact Known hazards to destination / rest areas and mitigation measures, specific
Areas Break? required? instructions.

FEEDBACK TO PERSON'S SUPERVISOR: Did the trip go

Driving Life Saving Rules Driver signature
as expected? If not, Why?
No alcohol or drugs while Wear you seat belt
working or driving.
Follow prescribed Journey Management Plans.
Manager signature
Do not use your phone or
exceed speed limits while
driving

STATUS: Issued for Use REV: 1 Doc Owner: HSE Systems Manager 1 of 2
This document is UNCONTROLLED when printed
 Journey Management Plan 99-H-FM-0065

Use this page to detail any overall trip risks and associated mitigation measures
Emergency Response: (e.g. contact details, remote areas without PHONE coverage etc)

Security: (e.g. hijack, robbery, cases of load or vehicle theft etc)

Location and Timing: (e.g. driving times, impact of driving at night with poorly lit roads)

Local Environment and Circumstances: (e.g. weather, route conditions, vehicle roll over risks etc)

Deviation from the Journey Management Plan: (e.g accidents, unsafe road, call from office etc. the deviation must be communicated and recorded)

Any other comments

Signature

STATUS: Issued for Use REV: 1 Doc Owner: HSE Systems Manager 2 of 2
This document is UNCONTROLLED when printed