PIC-Trip information

• Conducted on

  Date
• Location
  Address

• Destination

• Washout Facility

• Driver Information (Last, First, MI)

• Trip ID

• Tractor number

• Trailer number

• Is this a farm or a truck wash facility inspection?

  Farm

  Wash Facility

• Instructions:
  Inspect each area of the vehicle for cleanliness and whether or not it is dry.
  Please provide a yes/no answer to all questions (clean=yes).
  

Tractor

• Exterior

  Yes

  No

• Add media

  Media

• Tire Wells

  Yes

  No

• Storage Boxes

  Yes

  No

• Electric Prods

  Yes

  No

• Cab Floors

  Yes

  No

• Seats<br>

  Yes

  No

• Steering Wheel<br><br>

  Yes

  No

• Dash

  Yes

  No

• TADD

  Yes

  No

  N/A

• Is the truck dry?

  Yes

  No

  N/A

Trailer

• Exterior

  Yes

  No

  N/A

• Winter Panels

  Yes

  No

  N/A

• Tire Wells

  Yes

  No

  N/A

• Undercarriage

  Yes

  No

  N/A

• Storage Boxes

  Yes

  No

  N/A

• Rubber Bumpers

  Yes

  No

  N/A

• External Chute

  Yes

  No

  N/A

Cargo Area

• Ramps

  Yes

  No

  N/A

• Ceilings

  Yes

  No

  N/A

• Floors

  Yes

  No

  N/A

• Walls

  Yes

  No

  N/A

• Gates

  Yes

  No

  N/A

Equipment

• Sort Boards

  Yes

  No

  N/A

• Paddles/Shakers

  Yes

  No

  N/A

• Shovels

  Yes

  No

  N/A

• Brooms

  Yes

  No

  N/A

• Inspector Print Name and Date

  Sign

• Inspector signature

  Drawing

Information

• Farm Name

• Barn

• TADD Sticker

  Yes

  No

  N/A

• Instructions:
  Inspect the tractor and trailer from outside. DO NOT enter the tractor or trailer.
  If you, the inspector, is re-entering the farm, it is REQUIRED to shower into the farm
  Inspect each area of the vehicle for cleanliness and whether or not it is dry. Please provide a yes/no answer to all questions (clean=yes).

Driver Protocol

• Driver protocol pdf
  

• Did the driver put on disposable boots when exiting the tractor cab

  Yes

  No

  N/A

• Did the driver put on clean disposables boots and coveralls before entering the trailer

  Yes

  No

  N/A

• Did the driver stay on his side of the clean/dirty area during loading/unloading?

  Yes

  No

  N/A

• Please note any concerns in the comment section below. You have the right to reject a dirty trailer.

Tractor

• Exterior

  Yes

  No

  N/A

• Cab Floor

  Yes

  No

  N/A

Trailer

• Exterior

  Yes

  No

  N/A

• Winter Panels

  Yes

  No

  N/A

• Rubber Bumpers

  Yes

  No

  N/A

Cargo Area

• Floors

  Yes

  No

  N/A

• Select from range

• Walls

  Yes

  No

  N/A

• Gates

  Yes

  No

  N/A

• Ramp

  Yes

  No

  N/A

• Ceilings

  Yes

  No

  N/A

Equipment

• Sort Boards

  Yes

  No

  N/A

• Paddles/Shakers

  Yes

  No

  N/A

• Inspector Print Name and Date

  Sign

• Inspector Signature

  Drawing