WRW Un-Announced Lube Oil Delivery Observation

• Document No.

• Un-Announced Lube Oil Delivery Observation

• Terminal

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Driver Name

• Customer Name

• Subfleet

• Truck, Trailer

• Terminal

• Products

Accident Prevention

• Was the site inspected for hazards before entering and correct delivery address confirmed?

  Yes

  No

  N/A

• Did the driver enter delivery area slowly and carefully?

  Yes

  No

  N/A

• Driver avoided backing the truck if possible

  Yes

  No

  N/A

• Driver got out and looked/inspected the area before backing

  Yes

  No

  N/A

• Equipment secured and driver did a walk around of truck before leaving

  Yes

  No

  N/A

• Driver left delivery location carefully and used the safest exit route

  Yes

  No

  N/A

• Cell phone is not on dashboard area, no cell phone mounts in truck

  Yes

  No

  N/A

Injury Prevention

• Driver was wearing seatbelt

  Yes

  No

  N/A

• Driver used 3 point stance to enter and exit the truck

  Yes

  No

  N/A

• Driver walked slowly and carefully while carrying equipment or stepping over hoses

  Yes

  No

  N/A

Spill Prevention

• Driver stuck tank with stick and confirmed delivery will not exceed 90% of the tank's capacity

  Yes

  No

  N/A

• Driver stuck tank after filling to verify amount pumped into tank

  Yes

  No

  N/A

• Driver recorded before and after tank sticking on handheld or paper ticket

  Yes

  No

  N/A

• Driver ensured he was pumping from the correct tote/compartment/drums before engaging pump

  Yes

  No

  N/A

• No product leaks during delivery

  Yes

  No

  N/A

• Driver was in attendance during ENTIRE delivery

  Yes

  No

  N/A

• Hoses drained properly, no spillage while securing equipment

  Yes

  No

  N/A

• Truck has spill kit available

  Yes

  No

  N/A

Mix Prevention

• Tank labels are checking against BOL to ensure products are same

  Yes

  No

  N/A

• Driver ensured all hose connections were hooked to correct tote/compartment/drum

  Yes

  No

  N/A

• Driver can explain his double check procedure for preventing mixes

  Yes

  No

  N/A

Misc

• Appearance and uniform acceptable

  Yes

  No

  N/A

• Correct PPE was used

  Yes

  No

  N/A

• Paperwork filled out neatly

  Yes

  No

  N/A

• Shipping papers and guide books are available and in correct location

  Yes

  No

  N/A

• Did not damage hoses or nozzles by dropping or dragging

  Yes

  No

  N/A

• Did not throw, drop, or slam fittings or nozzles

  Yes

  No

  N/A

• Observed Safe Behaviors

• Observed Unsafe Behaviors