CONTAINER RECEIVING REPORT

DATE TIME

CARRIER LICENSE PLATE DRIVER & LICENSE #

LOADING ZONE CHECKED BY:

Are the compartment door seals intact? Check One

Yes Broken Missing

If the seals are missing was the container an LTL shipment? Yes No
Seal Number(s)

Is the trailer free of pests including pets? Check One

Yes No

Does the trailer show any evidence of unusual material or off odors? If so, describe.

Does the trailer show any evidence that it was used to transport any harmful nonfood items or water
product? Check One
Yes No

Is the integrity of the load intact? Check One

Yes No

If the trailer was delivering refrigerated or frozen items, was the refrigeration unit turned on and was the
trailer cold? Check One
Yes No

Quantity Accepted Quantity Rejection

Reason for rejection: