Appendix A: Fuel Transfer Safety Checklist

Appendix A - Oil Transfer Checklist

Oil Transfer Location:
Truck Company Name:
Vessel Name:

Response Personnel Information:

Vessel (Name, Phone):
Truck (Name, Phone):

Instructions for Completion:

The safety of operations requires that all questions be answered affirmatively. In the case of a negative answer, the operation shall not be carried out. No vessel is to load or discharge oil until this form is completed in its entirety.

Date/Time

Product

Quantity to be loaded

Description of Receiving Tank

Capacity of Receiving Tank

Rate

Pumping Pressure (psi)


Declaration:

We have checked all the items on this checklist and have satisfied ourselves that the entries we have made are correct to the best of our knowledge.

Vessel Representative

Truck Representative

Name:
Name:
Signature:
Signature: