• Shipper/Carrier Name

  • Loading Dock Sanitation Condition

  • Evidence of Cross Contamination

  • Trailer Condition

  • Record Temperature of Delivery Vehicle

  • Are pallets used?

  • Pallet Control Policy being followed

  • Pallets are Properly Labelled and Dated

  • No damaged or stained pallets used with food products

  • Customer and Product Information
  • Customer Name

  • Invoice / Bill of Landing / Skid #

  • Quantity Shipped (cases)

  • Food & Exterior Packaging Condition

  • Surface Temperature of Product (Celcius)

  • Incident
  • Scan Bill of Lading/Invoice with Rejection

  • Rejection Incident (list products rejected & invoice #)

  • Give the Reason for rejection


  • Verified By

  • Verified On

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