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Health & Safety.Form.Journey Management Plan 




NOTE: This JMP is required for workers who travel to site from a residential address that is greater than 80km or 1hour+ travel time to site.

Site address: 1100 Wybong Rd, Muswellbrook, NSW 2333

Estimate Boundaries

South from site – Branxton 2335, Milbrodale 2330, Glendon Brook 2330

North from site – Murrurundi 2338, Merriwa 2329, Murrumbo 2849


Must be on Thiess Journey Management Form.

Part A: Worker to complete

  • Worker Details
  • Name and DOB on form must match the person registered
  • If medications are listed in Section 1, they must match Order 43 declaration and be sent for Site Approval (MPO Health)

2 Roster Details

  • Must be completed


3a Travel to Begin Roster

  • Complete if required (e.g. if you live outside the area and travel to work from a closer residence i.e. staying with family or rented room that is different to your residential address on licence)

3b Travel to Site During Roster

  • To be completed

3c Travel to Home at the End of Roster

  • Complete steps 1 – 4 if required (e.g. if you live outside the area and travel home from work at the end of the roster)
  • All to complete Total Travel Duration with signature and date

Part B: Worker and Supervisor to Complete

4 Fatigue Risk Evaluation

  • All to complete
  • If “High Risk” is ticked – must be referred to site for Approval (MPO Health)

5 Discussion and comments

  • Complete if required

6 Control

  • All to provided at least 3 Controls (can circle relevant control from those provided).

Part C: Review and Approval

7 Acknowledgement

  • Must be signed by person registered
  • Supervisor / Manager must acknowledge and sign

8 Health, Safety and Environment Review

  • To be left blank for Thiess Rep to complete.
  • Issue Date = as listed
  • Expiry Date = 12 Months from issue date


Page Version: 7

Note: This Document is not version controlled when printed.

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