Title Page

General Information

  • Name of Operator

  • Name of Dangerous Goods Coordinator

  • Telephone Number

  • E-mail

  • Site conducted

  • Conducted on

  • Prepared by

  • Airport Name

  • Location
  • Type of Operation

Dangerous Goods Handled (Based on historical data)

  • Commercial Dangerous Goods Cargo Accepted at Station

  • If yes > Average quantity of package per year

  • Cargo Aircraft Only Quantities of Dangerous Goods Accepted at Station

  • If yes > Average quantity of package per year

  • Non-Dangerous Goods Commercial Cargo Accepted at Station

  • If yes > Average quantity of package per year

  • Dangerous Goods COMAT Shipped

  • If yes > Average quantity of package per year

  • Mail / Post Loaded

  • If yes > Average quantity of package per year

HIDDEN DANGEROUS GOODS WARNING

  • Where documents are accepted

  • Where the cargo is accepted

REFERENCE DOCUMENTS

  • DGM/OPS Manual

  • Company - Emergency procedures

  • ICAO Technical Instructions

  • ICAO - Emergency response guide

  • IATA Dangerous Goods Regulations

DANGEROUS GOODS CONSIGNMENT INSPECTION

1. Package/Overpacks - Markings

  • 1.1 - Proper Shipping Name including technical name (if app.) and UN No

  • 1.2 - Name and address of shipper and consignee

1.3 - Package specification markings:

  • Correct code for type

  • Correct packing group for contents (X, Y or Z)

  • Correct gross mass (combination packs)

  • Legitimacy of markings, if can be checked

  • 1.4 - Explosives - net quantity and gross mass

1.5 - Refrigerated liquefied gases - indication of:

  • Upright position

  • “Keep upright”

  • “Do not drop - handle with care”

  • 1.6 - Dry Ice / Carbon Dioxide Solid - net mass

  • 1.7 - “Limited quantity “

  • 1.8 - “Diagnostic Specimen” if Instruction 650 used

1.9 - Radioactive materials Markings:

  • Industrial type: TYPE IP-1, TYPE IP-2, or TYPE IP-3

  • Industrial package Type 2, Type 3 or Type A: (VRI CODE) of the country

  • Type A, Type B(U), Type B(M), or Type C

  • Type B(U), Type B(M) and Type C packages - design identifier / trefoil symbol

  • Packages > 50 kg gross mass

1.10 - Overpack

  • Markings of packages clearly visible or reproduces on outside

  • For UN specification markings or Type A, B or C, statement: “overpack”

2. Labelling

  • 2.1 - Hazard Label (s) - Appropriate to contents

  • Hazard Label (s) - Correct specification

  • 2.2 - Number for primary / subsidiary risk

  • 2.3 - “Cargo Aircraft Only” label, if required

  • 2.4 - Package orientation labels x 2, if required

  • 2.5 - ‘Cryogenic Liquid” labels if required

  • 2.6 - For magnetised Material, handling label if required

  • 2.7 - Keep away from heat

2.8 - Radioactive materials labelling:

  • Transport Index for (Cat II & III only)

  • Contents and activity

  • Two labels on opposite side

  • Fissile material label (CSI) for other than excepted

  • 2.9 - Radioactive material, excepted package

3. Condition

  • 3.1 - Package appears to be in good condition

DOCUMENTS

4. Dangerous Goods Transport Document

  • 4.1 - Numbered if more then one page

  • 4.2 - Name and address of shipper

  • 4.3 - Name and address of consignee

  • 4.4 - Statement of “Passenger & CAO” or “CAO”

4.5 - Correct order for:

  • UN /ID no

  • Proper shipping name

  • Class / division

  • Packing group

  • 4.6 - Sequence of description of Dangerous Goods

4.7 - Additional information

  • Subsidiary risks

  • Number of packages

  • Net quantity / gross mass for each package

  • Packing instruction number

  • Special provision reference

  • "overpack used"

  • ‘Limited quantity”

  • ‘Salvage package’

  • 4.8 - Infectious substances - contact name & tel no

4.9 - Packages of mixed dangerous goods:

  • “Q” value shown and does not exceed 1.0

  • Segregation requirements met

  • Self reactive subs. Division 4.1 and 5.2, indication that the package must be protected from direct sunlight and heat

  • 4.10 - Declaration that the goods are properly packaged, marked and labelled and in accordance with the applicable regulations

  • 4.11 - Declaration must be signed and dated by the shipper

4.12 - Radioactive materials:

  • “Radioactive materials” if not part of name

  • Name or symbol of radionuclide(s)

  • Description of physical or chemical form or special form if not part of name

  • Total activity for LSA-II, LSA-III, SCO-I and SCO-II

  • Category of package(s) or over pack(s)

  • Transport index (es) (Cat II & III only)

  • Package dimensions (Cat II & III only)

  • Certificates (i.e.: special form, Type B package design)

  • Supplementary requirements for loading, stowage, carriage, or a statement that no such requirements are necessary

4.13 - Air Waybill (if used)

  • Statement concerning the attached document “shipper’s declaration”

  • “Cargo Aircraft Only”

  • Statement for “Excepted packages of radioactive materials”

4.14 - Exemptions / Special Approvals

  • Copy of document attached (exemptions or approval)

  • Conditions complied with

ACCEPTANCE CHECKLIST

  • 5. Use of checklist and accurate completion

NOTIFICATION TO CAPTIAN/NOTOC

  • 6. Use of a NOTOC

6.1 - Information for each item:

  • AWB no.

  • Proper shipping name and UN/ID no

  • Class / division, subsidiary risks and Compatibility group for Class 1

  • Packing group and number of packages

  • Net quantity / gross mass

  • Loading location on aircraft

  • Indication “Cargo Aircraft Only”

  • Point of unloading

  • Category & transport index – radioactive materials

  • indication of a State exemption

  • 6.2 - Confirmation that no damaged/leaking packages, from the person responsible for loading

TRAINING

  • Adequate number of trained staff on duty

  • Acceptance staff received in depth training

  • Recent training within 24 months

Employees Names

    Employee Name
  • Name

  • Position

  • Date of Last Training

OBSERVATION

  • Observation

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