Loading Check Form (v.1.0.3)

Form to be completed, post-loading, prior to shipping structural loads (to project / customer site). Bill of lading to be issued by shipper following completion of this form.

• Project #:

• Division #:

• Load #:

• Trailer #:

• Date of loading check:

  Date

• Performed by:

• Shipment origination:
  Address

LOAD REVIEW

• Take four (4) pictures of the load (FRONT, PASSENGER, REAR, and DRIVER-side)

  Media

LOAD QUALITY

• Left to ship items indicated on loading summary sheet or bill of lading (BOL):

  Yes

  No

  N/A

• Assembly tags visible:
Noted discrepancy:

• Take a photo:

  Media

• Noted discrepancy:

• Assemblies on Load (i.e. type):

• Bolted:

• -bolts are marked (indicating 'impact-tight'):

  OK

  DEFICIENT

  Not applicable

• Inspector shall check a sample number of bolts to ensure that they are "hand-tight".

• Palletized hardware:

• -wrapped:

  OK

  DEFICIENT

  Not applicable

• -strapped:

  OK

  DEFICIENT

  Not applicable

LOAD QUALITY

• Load Building:

• Dunnage OK:

  Yes

  No

  N/A

• -hardwood used:

  OK

  DEFICIENT

  Not applicable

• -nailed / strapped:

  OK

  DEFICIENT

  Not applicable

• -inline blocking:

  OK

  DEFICIENT

  Not applicable

• -blocking between flanges:

  OK

  DEFICIENT

  Not applicable

LOAD SAFETY:

• Is there a possibility for the load to shift while in transit?

  Safe

  At Risk

  N/A
Noted hazard:

• Take a photo:

  Media

• Noted hazard:

• Were loading deficiencies identified at any time during your inspection?

  Safe

  At Risk

  N/A

• Identified deficiencies may require load to be held and required corrections taken.

• Do the identified deficiencies require correction.

  YES

  NO

  Not applicable

• LOAD MUST BE HELD.
  Noted deficiencies are to be corrected, and the load re-checked, prior to shipping.

• Are there any other concerns with the load, quality and or safety?

  Safe

  At Risk

  N/A

• Consider holding the load, and addressing your concerns with driver, loaders, and/or Supervisor.

• Concern addressed:

• Bill of lading (BOL) to be issued to driver.

• Driver is to visually inspect the load for safety and apply 'load securement' measures.

• I have inspected this load and find it to be safe for transport, to the best of my ability.

  Sign

• Bill of lading (BOL) to be issued to driver.

• Driver is to visually inspect the load for safety and apply 'load securement' measures.

• I have inspected this load and find it to be safe for transport, to the best of my ability.

  Sign

• Bill of lading (BOL) to be issued to driver.

• Driver is to visually inspect the load for safety and apply 'load securement' measures.

• I have inspected this load and find it to be safe for transport, to the best of my ability.

  Sign