Trailer Entry Form - Dyersburg, TN

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location

• Delivery Number/PO #

CHECKLIST FOR LOADING AND UNLOADING TRAILERS AND TRUCKS

A box not checked will be investigated to determine why an unsafe act was performed. TEAM LEADERS review daily!

• Dock Number:

• Carrier:

• Trailer Number:

Mark Yes, No, or N/A

• Tractor/Truck engine is off

  Yes

  No

  N/A

• Verify brakes are set (Ask driver)

  Yes

  No

  N/A

• Driver is out of Tractor/Truck

  Yes

  No

  N/A

• Verify dolly legs for proper placement

  Yes

  No

  N/A

• Safety sign in front of Tractor/Trailer/Truck

  Yes

  No

  N/A

• If Tractor is disconnected, a stabilizing jack is placed under nose of Trailer

  Yes

  No

  N/A

• If Truck or Trailer is parked in yard, 2 chocks will be placed. One is placed in front of the front most wheel; the other is placed in the rear of the front most wheel

  Yes

  No

  N/A

• If Truck or Trailer is backed up to dock, 2 chocks will be placed. Both are to be placed in the front of the rear most wheels. (one chock on each side of the vehicle)

  Yes

  No

  N/A

• If Tractor is disconnected, and centerline of rear-most set of wheels is greater than 5' from rear of Trailer, then stabilizing jacks are placed under rear of Trailer

  Yes

  No

  N/A

• Proper placement of dock lock (ICC bar)

  Yes

  No

  N/A

• Trailer sides and floor visually inspected for safe entry

  Yes

  No

  N/A

• Overhead clearance OK for safe enter/exit. Floor capacity is adequate

  Yes

  No

  N/A

• Trailer sides are in place and stakeposts and stakepost brackets are safe

  Yes

  No

  N/A

• Are trailer walls, floor, and ceiling in good condition?

  Yes

  No

  N/A

• Is the trailer clean?

  Yes

  No

  N/A

• OK for entry/OK for Load/Unload

  Yes

  No

  N/A

• Remember: Never load/unload a flatbed or softside from the dock

Hexpol Quality Policy

• Hexpol, the leader in custom compounding, is committed to be a world class supplier to every customer we serve, by providing impeccable service, quality, delivery, and technical excellence.

• We accomplish this by:

• • Being customer focused in every area of the business

• • Continually improving our products and processes

• • Conforming to relevant standards and requirements