Lancer Fleet Safety Evaluation

Transcription

1 Lancer Fleet Safety Evaluation Account Name: Address:, Contact Type: Telephone Visit Client Number: Link # Contact & Title: Surveyed By: Survey Date: Report Completion Date Phone: Work: Cell: Address: Fax#: SAFETY SURVEY SUMMARY GENERAL FINDINGS Management Procedures Management Interest Driver Selection Procedures Drivers Ability / Qualification Training Program Adequacy Supervision Program Adequacy Accident Procedures Efficiency Facilities Equipment Condition Maintenance Program Safety Program Acceptable Acceptable with Recommendations Acceptable RECOMMENDATIONS Letter Type: LI Grade# 1 Address to: Value Added Material Left: No Yes FOLLOW UP Why was visit made? Audit Follow-up Claims Growth Prospect Other: Follow up visit requested? Yes No Time Frame? 30 Days 60 Days Other Fleet Transportation Survey Page 1 of 7 06/08/2006

2 OPERATION & AUTHORITY President: US DOT #: Operating Mngr: Carrier Type: Safety Director: Y N Operates only under this authority? If No, whose? In Operation Since: Y N Authorized to Transport HazMat? Average Haul (#miles): If Yes, see HM table below) Longest Haul (ST./ST.) Y N Ever had a DOT Compliance Review? Total miles last year If Yes, Date: Drivers usually out for: Result = N/A Nature of Operation: Y N Operates in Canada? Driver Type: Y N Operates in Mexico? Y N Are Passengers Allowed? If Yes, is written authority given? N/A OPERATIONAL INFORMATION Total number of non-driver employees: Dispatch Mechanics Clerical Describe: (A) Any significant changes in your operations during the past two (2) years: (B) Anticipated changes in your operations during the policy period: Operation Type: Dump Reefers Livestock Car Hauler Flatbed Vans Other: Y N Brokerage? If Yes, is the brokerage a separate corporation? Y N If No, percentage of insured s revenue from brokerage: Y N Warehousing? If Yes, give details: Other Terminal Locations: Major Cities: EAST SOUTHEAST SOUTH MIDWEST WEST # Trips/Mo. # Trips/Mo. # Trips/Mo. # Trips/Mo. # Trips/Mo. Baltimore/DC Miami Houston Kansas City Los Angeles Boston Atlanta Dallas/Ft. Worth St. Louis San Francisco Philadelphia Tampa/St.Pete Oklahoma City Chicago Portland Hartford & CT Orlando Tulsa Milwaukee Phoenix NY City Charlotte Gulf-AL, LA, MS Detroit Seattle East-DE, MD, NY Jacksonville Cincinnati Denver NJ, PA Louisville Cleveland New England-ME, Memphis CT, MA, VT, NH, Nashville and RI Regular traveled lanes: Percentage of trips within a radius of: % miles % miles % >500 miles TYPE OF FREIGHT & COMMODITIES HAULED Any Oversized Loads? Y N If Yes, Type: Over width Over height Over length ALL Commodities Hauled Fleet Transportation Survey Page 1 of 7 06/08/2006

3 HAZARDOUS MATERIAL if applicable Explosive material Oxidizing/organic peroxide materials Gas materials Radioactive materials Flammable liquid materials Corrosive materials Flammable solid materials Miscellaneous materials Poisons Other regulated materials EQUIPMENT 1. Is Bobtail Coverage required for Owner-Operators? Y N N/A If Yes, are Certificates of Insurance on file? Y N 2. Are there extra trailers? Y N If Yes, how many? Location: 3. Are trailers spotted? Y N If Yes, where? Equipment Breakdown: TRUCKS & Straight Trucks Tractors Other Comments TRACTORS Company Owner-Operator TRAILERS Vans Reefers Flatbeds Tanks Dumps Other Comments Company Owner-Operator DRIVER SELECTION & QUALIFICATIONS How are drivers paid: Percentage of Revenue If other, specify: DRIVER BREAKDOWN Company Owner-Operator # Longhaul Drivers # Local Drivers # Part-time Drivers Comments DRIVER INFORMATION Average number of drivers for last 12 months: Number of drivers replaced in last 12 months: ANNUALIZED DRIVER TURNOVER: Number of drivers employed less than 1 year: Number of drivers employed between 1 and 2 years: Number of drivers employed between 2 and 3 years: Number of drivers employed 3 years or more: DRIVER SELECTION DRIVER SELECTION 1. Minimum Age Requirement 2. Minimum Experience Requirement 3. # of allowable tickets in prior 3 years 4. # of allowable accidents in prior 3 years 5. Are these requirements Written? 6. Are these requirements being followed? 7. What is Driver Age Range Fleet Transportation Survey Page 2 of 7 06/08/2006

4 Applicable DRIVER QUALIFICATION Comments & Description 1. Applications Complete? 2. Physicals Current? 3. If med. cert. accepted, are they verified 4. Physicals conducted by Comp. doctor 5. Driver Safety History (3 years) 6. Driver Drug/Alcohol inquiries (2 years 40.25) Pre-Hire MVR s Obtained & Kept 8. Annual MVR s 9. Certificate of violations 10. Annual reviews 11. Road test adequate and documented 12. Pre-hire drug test before dispatch 13. System in place to track expiration/due dates DRUG AND ALCOHOL TESTING 1. Pre-employment testing 2. Random testing 3. Consortium 4. Written drug and alcohol policy 5. Driver awareness training 6. Percentage of random test STUDENT DRIVER PROGRAM, IF APPLICABLE Are students Used? Y N Comments & Description: TRAINING HOURS OF SERVICE 1. Hazardous materials & test 2. Company rules/policies? 3 Equipment familiarization 4. Regulatory compliance 5. Accident procedures 6. Handling freight 7. Is safety training documented 1. Logs/time records filed systematically 2. Logs turned in within 13 days 3. Logs kept on file for six months 4. If used, are exemption rules followed 5. Total hours recapped? 6. Checking for false logs 7. HOS Audits 8. Is there a disciplinary policy for logs FATIGUE QUESTIONS What % of your drivers total on-duty hours are logged between: Midnight-6 am noon-6 pm 6 am-noon 6 pm-midnight What % of your driver start times occur in the following time periods: Midnight-6 am noon-6 pm Fleet Transportation Survey Page 3 of 7 06/08/2006

5 6 am-noon 6 pm-midnight What are the drivers typical weekly work schedules: Days on Days off (Weekly) What is the usual notice a driver receives for up-coming trips/assignments: Less than 12 hrs 2-3 days 7+ days 24 hours 4-6 days What % of your part-time drivers have other jobs? % Do you have trips or schedules that REQUIRE continuous driving between 11pm-7am? Y N Do you have schedules that require a driver to sleep one night and drive the next? Y N Do any of your drivers start trips or legs between 10pm-2am? Y N Does the fleet have cruise control on the vehicles? Y N Any cruise control restrictions? Are drivers evaluated for sleep disorders during their physicals? Y N ACCIDENT PROCEDURES & RECORDS 1. Separate files kept for each accident 2. Accident register in compliance 3. Accident reporting kits on all units 4. Do your drivers carry cameras? 5. Preventability determined 1. Claims Review conducted: Y N Comments: 2. Are claims reported timely: Y N Comments: INCENTIVE 1. Awards/Recognition Program Y N Comments: MAINTENANCE Does the company service their own vehicles? Y N If No who does: If Yes, does this include: Preventative Light Repairs Major Repairs Body Work COMPANY EQUIPMENT Applicable 1. Written maintenance schedule 2. Means to ensure regular PM s 3. Regular inspection intervals 4. Written inspection checklist 5. Work orders or documented maintenance 6. Separate files for each unit 7. Annual inspections on-file/up-to-date 8. Driver Vehicle Inspection Reports 9. Certifications for Annual Inspectors 10. Certifications for brake repairmen OWNER-OPERATOR EQUIPMENT 1. Pre-Lease (written) inspections 2. Are there (written) periodic inspections? 3. Annual inspections on-file/up-to-date 4. Copies of maintenance records on file 5. Separate files for each unit (FHWA ROADSIDE INSPECTIONS) 6. Copies kept for 12 months 7. Is FHWA OOS percentage monitored? 8a. Vehicle OOS Rate Fleet Transportation Survey Page 4 of 7 06/08/2006

6 8b. Driver OOS Rate 8c. Accident OOS Rate VISUAL INSPECTION OF EQUIPMENT Good Average Poor Item Comments & Description 1. General appearance 2. Brakes 3. Tires 4. Trailers EQUIPMENT INFORMATION 1. Are all vehicles registered in the same EXACT name: Y N If No, please provide a copy of at least one registration for as many names as vehicles have been registered under. 2. Are all units registered in the same state? Y N If No, please list ALL states where vehicles are registered: 3. Are units relocated anytime during the year? Y N If Yes, please explain: GENERAL SAFETY PROGRAM 1. Written safety policy 2. Drivers manual 3. Safety meetings held (frequency) 4. Record of attendance 1. Do you have How s my driving program? Y N Audited? Y N 2. Are electronic recording devices used? Y N Which products? 3. Are accident cameras in vehicles? Y N If Yes, are they used? Y N 4. Is Reflective Tape used on all vehicles: Y N If No, explain: DRIVER SUPERVISION 1. Call in procedure or satellite comm 2. Documented driver performance 3. Reviews after accidents & violations 4. Written disciplinary policy 5. Evidence disciplinary policy is followed 1. Is there a cell phone policy? Yes No Comment: 2. Are hands-free devices used? Yes No Comment: SECURITY AND OTHER HAZARDS Summary: 1. Security for units stored on premises 2. Lot lighted 3. Vandalism potential 4. Units locked (keys removed) 5. Security for fuel stored on premises Fleet Transportation Survey Page 5 of 7 06/08/2006