This form must be completed by receiving staff upon every supplier delivery before signing the delivery manifest.
Date of Delivery
Time of Arrival
Supplier Name
Driver Name
Purchase Order No.
Delivery Manifest / Invoice No.
Checkpoint | Yes/No | Action Required/Notes | ||
|---|---|---|---|---|
A | B | C | ||
1 | A. Delivery vehicle appears clean and free of obvious contamination? | |||
2 | B. Temperature-controlled areas (e.g., chiller/freezer units) are operational? | |||
3 | C. Driver uses appropriate PPE (e.g., gloves, hair net, clean clothing)? | |||
4 | D. Delivery vehicle is secured during offloading? |
Instructions: Use a calibrated thermometer. Check the core temperature of a representative item for each temperature category.
Category | Required Temp Range | Actual Temp (Item 1) | Actual Temp (Item 2) | Pass | Fail | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | Frozen Goods | Below -18°C | |||||
2 | Chilled Goods | Between 0°C and 4°C | |||||
3 | Hot Holding | Above 60°C |
Check every item listed on the manifest for the following criteria:
Checkpoint | Yes | No | N/A | Action Required/Notes (e.g., item rejected, quantity short) | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | A. All quantities match the P.O. and Manifest? | |||||
2 | B. Packaging is intact (no dents, tears, leaks, or signs of tampering)? | |||||
3 | C. All items are clearly labelled with product name and quantity? | |||||
4 | D. All items have an adequate 'Use By' or 'Best Before' date remaining? | |||||
5 | E. Goods appear fresh, free of odor, discoloration, or pests? | |||||
6 | F. Specific for Dry Goods: Packaging is dry and not water-damaged? | |||||
7 | G. Specific for Produce: Checked for signs of wilting, mold, or bruising? |
Item Name | Qty Rejected | Reason for Rejection | Action Taken | Returned or Disposed | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | ||||||
2 | ||||||
3 | ||||||
4 | ||||||
5 |
Total Value of Rejected Goods:
Declaration: By signing below, the receiving staff member confirms that the inspection was carried out in accordance with receiving procedures, and all rejected items have been noted on this form and the supplier's manifest/invoice.
Receiving Staff Signature
Supplier Driver Signature
To configure an element, select it on the form.