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�`.`� _ r--; � —* 11777 r-71. , a` "?'I 71 r— r7 r, 1 177 ADMIN-602 ADMIN-603 L Page 5 of 13.1 JOURNEY HAZARD DAILY VEHICLE CHECKLIST g Page 5 of 131 ASSESSMENT CARD " Rev. 1 April 2006Stanw _ec Rev. 1 April 2006 Employee Name: Region/Business Unit: STOP! THINKI GOI Date: Time: Vehicle Color: Vehicle MakelModel: Vehicle License Plate Number: Name Date Job: Job M #of Miles Driven STOP Job: Job M #of Miles Driven Job: Job M #of Miles Driven bo I need to make this journey? ❑ Yes ❑ No Vehicle Mileage Stop ❑Stantec Vehicle Vehicle Mileage Stop ❑ Rental Vehicle STOP Total Miles Driven E] Personal Vehicle Perimeter Walk Around: OK NOT OK Where am I traveling? How long will I be driving? Check for signs of vandalism, negligence, damage or ❑ ❑ And do I have an ETA with a contact person? unusual conditions Have I communicated area hazards and safest mode of transport? Check all tires for excessive and unusual wear and proper ❑ El —include the spare tire if it is easilyaccessible THINK Check under vehicle for signs of leakingfluids ❑ El Check wiper blades(Do they work?) Do they need replacement? El ElHow can I ensure that I have a safe journey? Check all light systems — brake, head, back-up, running, El El THINK turn signals,emergency flashers Check to make sure doors, truck/toolbox lids, tailgates all open and close properly (Make sure you have keys to any Am I well rested an alert for the journey? ❑ Yes ❑ No toolboxes that you may need to access) ❑ ❑ THINK Check Gauges on Dashboard: OK NOT OK Fuel Level ❑ I ❑ Have I done a vehicle walk around and ensured that the vehicle ;OiHight_i.i es No Engine Coolant Temperature Gauge ❑ ❑ Service Indicator Lights ❑ ❑ ELEMENTS OF THE DRIVING STANDARD Batte -Charge-fhdicator--- =_ ._. -_... r..-.._❑._ :: ❑ • Has vehicle been inspected? ❑ Yes ❑ No Inside Vehicle: OK NOT OK Will passengers be transported? ❑ Yes ❑ No Make sure seatbelts are present for all who will be riding in ❑ ❑ Has cargo been secured? L3, Yes ❑ No Secure all cargo in the vehicle so that items will not become the vehicle Driver's License is current? ❑ Yes L3 No El ElAppropriately rested and alert? L3 Yes El No projectiles in the event of sudden stops or collisions . Journey risks have been identified? ❑ Yes ❑ No Adjust the seat position,rearview and side mirrors ❑ ❑ Seatbelts are in working order? ❑ Yes ❑ No Adjust temperature controls,vents, radio,etc. ❑ ❑ • Medically fit for driving? 13 Yes E3 No Notify the vehicle manager or rental company if you feel that any deficiencies are unsafe and DO NOT drive the vehicle? Signature: HAVE A SAFE TRIPI DRIVING IS RISKY BUSINESSI STANTEC Consulting Corporation Attachment 6