Road Safety Assessment
Assessment Information and Scope"
Chapter Question
0.1. Assessment Information
0.1.1. Assessed Company
Name
Location (=Town/City)
Country
Postal Address
Phone
Fax
Website
1. Contact Person
Email
2. Contact Person
Email
Headquarter's Name + Address
0.1.2. Assessor
Lead Assessor
Name
Company
Country
Phone
Mobile Phone
Fax
Email
Other Assessors
1. Name
2. Name
0.1.3. Assessment
Site(s) inspected (within the 5km rule)
First Assessment
Re-assessment
Date (DD-MM-YYYY) Duration (number of days)
* Road Safety assessment
Previous Road Safety assessment
0.2. Assessed company profile
0.2.1. Key Contacts
Name Contact numbers
General Manager
Operations Manager
Quality Assurance Manager
Safety & Health Manager
Environmental Manager
Dangerous Goods Safety Adviser
Security Adviser
0.2.2. Quality Management and Environmental Management System Certification
Type Certification Body Scope Registration Number Expiry Date
ISO 9001:2000
ISO 14001
0.2.3. Type of "Transport Service" operator :
What is your main activity?
Road transport service
Transfer Terminal (truck/rail/barge/…)
Others
Do you provide the following service?
Forwarding Agency (Land)
Intermodal/Multimodal Services
Airfreight service
Others
0.2.4. Geographical coverage
National transport
International transport
0.2.5. Type of drivers and subcontracting
Own company drivers
Fully integrated subcontractors (incl. 1 driver company)
Non-integrated subcontractors
Spot subcontracting
0.2.6. Type of equipment and subcontracting
Own company equipment
Equipment operated by subcontractors
0.2.7. Percentage of chemical road haulage, performed by own drivers and subcontractors, at the site being assessed ?
Own company drivers :
Fully integrated owners/drivers :
Not fully integrated subcontractors :
Spot subcontractors :
100%
0.2.8. Percentage (of total tonnage) of chemical traffic transported by subcontractors?
Liquid Solid Gas
Bulk
Packed
0.2.9. Type of product/packaging
Liquid Solid Gas
Bulk
Packed
0.2.10. Products transported
Total tonnage of chemicals transported per year?
What percentage of this total tonnage is classified as dangerous products ?
What classes of dangerous goods are regularly transported?
Class Yes
Class 1 Explosive substances & articles
Class 2 Gases
Class 3 Flammable liquids
Class 4.1 Flammable solids
Class 4.2 Substances liable to spontaneous combustion
Class 4.3 Substances which, in contact with water emit flammable gases
Class 5.1 Oxidising substances
Class 5.2 Organic peroxides
Class 6.1 Toxic substances
Class 6.2 Infectious substances
Class 7 Radioactive material
Class 8 Corrosive substances
Class 9 Miscellaneous dangerous goods
0.2.11. Are following infrastructure and activities present at the assessed site ?
Office buildings
Parking of empty vehicles/tanks/containers
Parking of loaded vehicles/tanks/containers
Maintenance workshops
Temporary storage of packaged products
Fuel storage and refuelling
Waste storage / treatment
Cleaning Station (subject to separate assessment)
Packaged Warehouse (subject to separate assessment)
Other