Title Page

  • Gatehouse pass and non compliance discrepancy

  • Conducted on

  • Customer

  • Outloading

  • Inloading

Outgoing Load Quality Check

  • Is the pallet and stock in good condition?

  • Is the product stacked securely on load?

  • Does the Load manifest and seals match the inbound/Outbound paperwork?

  • Is the information on the pallet docket correct and does the count match what's on the load?

  • CHEP Transfer #

  • LOSCAM Transfer #

Drivers section

  • Drivers section

  • Drivers name

  • Drivers license

  • Photo of license

  • Vehicle rego

  • Transport company

  • Trailer /Container Number

  • Number of pallets:

  • Chilled

  • Freezer

  • Ambient

  • Copy of weight estimate/ pre load provided

  • Yes

  • No

  • The below declaration must be completed prior to any Loading/unloading activity taking place

  • Driver- how many hours do you have left on your current (not including rest breaks)

  • Do you have enough work hours to complete your onsite task plus the next section of your scheduled trip

  • Are you fit and well to undertake this trip

  • Have you had your required rest breaks throughout your current shift

  • Are you free of alcohol and non prescription drugs that may affect your capacity to work

  • Are you suffering from any medical condition that may affect your capacity to work

  • Are there any obvious road worthiness issues with the vehicle you are operating

  • Is your drivers license current and valid

  • I ( the driver) acknowledge it is my responsibility to count and check the pallets as they are unloaded from my vehicle, to ensure the pallets I deliver match the corresponding transfer docket

  • The law requires that:

    - Loads be restrained to prevent unacceptable movement during all expected conditions of operation
    - Loads not be placed in a way that makes vehicles unsafe or unstable
    - Loads must be secured so they are unlikely to fall or be dislodged from the vehicle.
    As a driver I am aware of the requirements of load restraint and will restrain my load accordingly.

  • Driver induction number

  • Induction card expiry date

  • Signature

Operation/Clerical Section

  • Clerical Name

  • Booked Time

  • Delay Time

  • Appointment Number

  • Rons

  • Attached to truck (688)

  • Checker name

  • Product type

  • Dock

  • Arrival time

  • Start time

  • Finish time

  • Departure time

  • Pallets exchanged

  • Yes

  • No

  • Trailer hygienic

  • Yes

  • No

Record any discrepancies found on POD

  • Record any discrepancies found on POD

  • Chain of responsibility non compliance issues (Woolworths only)

  • Line item non compliance issues

  • Sscc label

  • Pallet issues

  • Pallet configuration

  • Carton barcode

  • Carton issues

  • Inbound stock

  • Please take photos below for any issues listed above

  • Photo

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.