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GPS CHEMOIL LLC FZC Doc. No.

GPSCO-HSE-F23

TANKER DRIVER Revision : 0

EVALUATION FORM Date: 20.11.2017

Driver Evaluation

Instructions for using the Driver Evaluation Form


This form is a suggested method of recording a driver evaluation within the GPSCO. It may not
meet regulatory requirements in all jurisdictions and must be reviewed for suitability before use.

The evaluation form is designed to record both good and poor behaviours and skills. The evaluator
should check off each item as it is demonstrated, scoring a pass, needs improvement, or fail. If a
poor behaviour is demonstrated make a note of what it was and where it occurred.

The final evaluation is based on the overall demonstrated skills, behaviours, and attitudes.

The debriefing after the road test should discuss errors noted and ask if the driver was aware of
making these errors. Often small errors are made through habit or poorly taught skills and this is a
good time to make minor corrections or suggest alternate methods.

TANKER DRIVER EVALUATION FORM (GPSCO-HSE-F23) Rev. 00 PAGE 1 OF 4


GPS CHEMOIL LLC FZC Doc. No. GPSCO-HSE-F23

TANKER DRIVER Revision : 0

EVALUATION FORM Date: 20.11.2017

Driver Evaluation Form


DRIVER INFORMATION
Name: Date of Evaluation:

Emirates ID No. & Validity :

Location : Teminal-1 / Terminal-2 Place : Fujairah

UAE DL No. : Issuing Authority : Issue Date: Expiry Date:

REASON FOR EVALUATION


INITIAL EVALUATION
RETRAINING
POST-ACCIDENT
OTHER REASON
(SPECIFY)

DEMONSTRATED COMPETENCIES/BEHAVIOURS
PART 1 – NEEDS
PASS FAIL
PRE-TRIP INSPECTION AND EMERGENCY EQUIPMENT IMPROVEMENT

Carries out checks on Engine for level of Engine Oil, Brake Fluid, Gear Oil, Coolant and their
leakages, if any.

Checks – Oil tank levels, seat belts and overall condition of the cabin.

Checks – Tires (condition and air pressure), head lights, signals/indicator lights, trailer hookup, body,
doors, horn, and windshield wipers.

Knows use of emergency warning devices and fire extinguisher

Checks instrument panel for warning indicators and

Sets rear/side-view mirrors for optimum visibility.

PART 2 – NEEDS
PASS FAIL
PLACING VEHICLE IN MOTION AND USE OF CONTROLS IMPROVEMENT
ENGINE
Starts engine without difficulty
A
Allows appropriate time for warm-up
Understands gauges on instrument panel
CLUTCH AND TRANSMISSION
Starts loaded unit smoothly
B
Uses clutch properly
Uses proper gear sequence

TANKER DRIVER EVALUATION FORM (GPSCO-HSE-F23) Rev. 00 PAGE 2 OF 4


GPS CHEMOIL LLC FZC Doc. No. GPSCO-HSE-F23

TANKER DRIVER Revision : 0

EVALUATION FORM Date: 20.11.2017

BRAKES
C Knows operating principals of air brakes
Tests brakes before starting trip
LIGHTS
D Knows lighting regulations
Uses appropriate headlight beam

PART 3 – NEEDS
PASS FAIL
BACKING AND PARKING IMPROVEMENT
REVERSING
Gets out of the cabin and checks before reversing
Looks back as well as checks mirrors
A
Avoids reversing from blind side
Sounds horn when reversing – before moving
Controls speed and direction when reversing
PARKING
Parks off pavement
C Avoids parking on soft shoulder
Uses emergency signals when needed
Secures unit properly upon parking

NEEDS
PART 4 – SLOWING AND STOPPING PASS FAIL
IMPROVEMENT
Uses gears properly (ascending)
Gears down properly (descending)
Stops and re-starts without rolling backwards (no rollbacks)
Uses mirrors to monitor traffic at rear
Hazard lights/Signals following traffic congestion
Avoids sudden stops
Stops clear of pedestrian crosswalks

PART 5– NEEDS
PASS FAIL
TRAFFIC OPERATIONS IMPROVEMENT
A TURNING
Selects correct lane well in advance
Signals well in advance
Monitors traffic conditions and turns only when safe to proceed
Does not swing wide or cut short
Completes turn in correct lane
B SPEED
Adjusts speed according to road, weather, traffic conditions and legal limits
Slows down for rough roads or crossings

TANKER DRIVER EVALUATION FORM (GPSCO-HSE-F23) Rev. 00 PAGE 3 OF 4


GPS CHEMOIL LLC FZC Doc. No. GPSCO-HSE-F23

TANKER DRIVER Revision : 0

EVALUATION FORM Date: 20.11.2017

Maintains consistent speed


C COURTESY AND SAFETY
Fails to allow faster traffic to pass
Fails to keep right and in own lane
Unnecessary use of horn
Other discourtesy or improper conduct

PART 6 – NEEDS
PASS FAIL
MISCELLANEOUS IMPROVEMENT
A GENERAL DRIVING HABITS AND ABILITY
Uses seatbelt
Consistently alert and attentive
Performs routine functions without taking eyes off road
Checks instruments regularly
Distracted by phone, radio, GPS
Willing to take instructions and suggestions
Adequate self-confidence in driving
Nervous, apprehensive
Easily angered
Complains too much
Professional personal appearance, manner
Good physical stamina
B RULES AND REGULATIONS
Knowledge of Terminal rules
Knowledge of regulations: Federal and local
Knowledge of special truck routes / timing restrictions
REMARKS:

GENERAL PERFORMANCE:
Satisfactory Unsatisfactory
QUALIFIED FOR:
Road Tanker Truck
Other (specify)
EXAMINERS SIGNATURE: DATE:

PLEASE ATTACH ADDITIONAL PAGES IF REQUIRED

TANKER DRIVER EVALUATION FORM (GPSCO-HSE-F23) Rev. 00 PAGE 4 OF 4