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OSM 3.13 Transfer of Bulk Liquids Exhibit 2 (Inbound Bulk Unloading Checklist)

This checklist is a step by step guide on how to properly and safely unload your truck .
UNVR - 0913 - Chicago 68th St.
04/28/2023

OSM 3.13 Transfer of Bulk Liquids Exhibit 2 (Inbound Bulk Unloading Checklist)

This checklist is a step by step guide on how to properly and safely unload your truck .

    Date

    Arrival Time

    Carrier Name (If Applicable)

    Inbound Trailer/Railcar Number

    Compartment 1

    Product Name

    Compartment 1

    Product Code

    Compartment 1

    UN Number

    Compartment 1

    Receiving Tank Number or Packaging Line

    Compartment 1

    Inbound Quantity

    Enter Quantity in GAL or LBS

    Compartment 1

    Receiving Tank Capacity

    Enter Quantity in GAL or LBS

    Compartment 1

    Drum Off?

    • Yes
    • No
    • N / A

    Purchase Order Number

    Compartment 1

    Trailer Dome Seal #(s)

    Compartment 1

    Trailer Bottom Outlet Seal #(s)

    Compartment 1

    Verify Compartment is Large Enough For Quantity Ordered & All Information is Correct

    Employee Signature:

    Click here to sign

    Compartment 1

    Second Party Verification

    Employee Signature:

    Click here to sign

    Compartment 2

    Product Name

    Compartment 2

    Product Code

    Compartment 2

    UN Number

    Compartment 2

    Receiving Tank Number or Packaging Line

    Compartment 2

    Inbound Quantity

    Enter Quantity in GAL or LBS

    Compartment 2

    Receiving Tank Capacity

    Enter Quantity in GAL or LBS

    Compartment 2

    Drum Off?

    • Yes
    • No
    • N / A

    Purchase Order Number

    Compartment 2

    Trailer Dome Seal #(s)

    Compartment 2

    Trailer Bottom Outlet Seal #(s)

    Compartment 2

    Verify Compartment is Large Enough For Quantity Ordered & All Information is Correct

    Employee Signature:

    Click here to sign

    Compartment 2

    Second Party Verification

    Employee Signature:

    Compartment 3

    Product Name

    Compartment 3

    Product Code

    Compartment 3

    UN Number

    Compartment 3

    Receiving Tank Number or Packaging Line

    Compartment 3

    Inbound Quantity

    Enter Quantity in GAL or LBS

    Compartment 3

    Receiving Tank Capacity

    Enter Quantity in GAL or LBS

    Compartment 3

    Drum Off?

    • Yes
    • No
    • N / A

    Purchase Order Number

    Compartment 3

    Trailer Dome Seal #(s)

    Compartment 3

    Trailer Bottom Outlet Seal #(s)

    Compartment 3

    Verify Compartment is Large Enough For Quantity Ordered & All Information is Correct

    Employee Signature:

    Click here to sign

    Compartment 3

    Second Party Verification

    Employee Signature:

    Compartment 4

    Product Name

    Product Code

    UN Number

    Receiving Tank Number or Packaging Line

    Inbound Quantity

    Receiving Tank Capacity

    Drum Off?

    • Yes
    • No
    • N / A

    Purchase Order Number

    Trailer Dome Seal #(s)

    Trailer Bottom Outlet Seal #(s)

    Verify Receiving Tank is Large Enough For Quantity For Being Received & All Other Information is Correct

    Employee Name:

    Employee Signature:

    Click here to sign

    STOP WORK AUTHORITY: Both loader and carrier should implement process for work stoppage should an unsafe condition exist before, during or after loading. A Supervisor must be notified and the unsafe condition corrected before starting the product transfer.

    Unloader Pre-Unloading Inspection Checklist

    Time Unloading Inspection Completed

    Employee Name:

    Employee Signature:

    Click here to sign

    LAB SAMPLE: Pull lab sample in accordance with Quality Assurance Laboratory Test Procedures and obtain lab approval prior to off-loading.

    Unloader Name:

    DURING UNLOADING: Monitor transfer for leaks and ensure no one comes within 25 feet without proper PPE. Exercise STOP WORK AUTHORIT as necessary and notify Supervisor of any issues.

    Unloader Post-Unloading Inspection Checklist

    Time Unloading Inspection Completed:

    Employee Name:

    Employee Signature:

    Click here to sign

    Comments/Note Any Issues:

    • Pass
    • Flag
    • Fail
Source: UNVR - 0913 - Chicago 68th St. (Community Member)

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