Attachment 10_ DLA Form 1367_Shipment Release.pdf

PDF 846 KB Posted

Attached to
Turkey Electronic Hazardous Waste Federal contract opportunity
Solicitation number
SP4500-26-R-0006
Issued by
Defense Logistics Agency

About this file

The document is a DLA Form 1367 Shipment Receipt/Delivery Pass from August 2018, prescribed by DLAI 4160.01 and sponsored by Disposition Services. This blank form is used to document the transfer and tracking of property or materials, with sections for recording shipment details such as vehicle information, weight measurements, weather conditions, and release information. The form includes fields for capturing specifics like customer account, invitation and contract numbers, material description, shipment type (partial or final), loading time, and requires signatures from authorized representatives and security personnel.

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Text version

PDF (DLA)DLA FORM 1367, AUG 2018

SHIPMENT RECEIPT/DELIVERY PASS Prescribed by: DLAI 4160.01 Sponsor: Disposition Services

DIGITAL WEIGHT INDICATOR & PRINTER TICKET

DRIVER

PASSENGER

WEATHER:

9A. "X" TYPE OF SHIPMENT

TO BE COMPLETED BY SECURITY PERSONNEL ONLY

5. CLIN 6. DESCRIPTION OF MATERIAL 7. UNIT 8. RELEASED

QUANTITY

lbs. GROSS lbs. TARE lbs. NET

CUSTOMER ACCT:

CUSTOMER NAME:

VEHICLE TYPE LICENSE PLATE NO STATE

WEIGHMASTERS INITIALS/DATE ON OFF

CUSTOMER/AGENT/DATE ON OFF

SNOW

REMARKS

RAIN N/A

2. FROM: (Name and location of Activity and Installation from which property is being removed)

3. INVITATION NUMBER 4. CONTRACT NUMBER

9. SHIPMENT NUMBER

PARTIAL FINAL

10. TIME LOADED 11. VEHICLE LICENSE NO.

12. RELEASED BY (Printed Name and Signature of Authorized Representative)

13. TITLE OF AUTHORIZED DISPOSAL

REPRESENTATIVE RELEASING PROPERTY

15. DATE PROPERTY IS RELEASED14. SIGNATURE OF PURCHASER OR AGENT

16. TIME SHIPMENT LEAVES INSTALLATION 17. SENTRY'S INITIALS

1. TO: PURCHASER OR AGENT (Name of Carrier, if Applicable)

DATE

PDF (DLA)

DLA FORM 1367, AUG 2018

SHIPMENT RECEIPT/DELIVERY PASS

Prescribed by: DLAI 4160.01 Sponsor: Disposition Services R:\DRMS\DRMS1367.FRP Printing lsc1872

DIGITAL WEIGHT INDICATOR & PRINTER TICKET

DRIVER

PASSENGER

WEATHER:

9A. "X" TYPE OF SHIPMENT

TO BE COMPLETED BY SECURITY PERSONNEL ONLY

5. CLIN

6. DESCRIPTION OF MATERIAL

7. UNIT

8. RELEASED

QUANTITY

lbs. GROSS lbs. TARE lbs. NET

CUSTOMER:
IFB:
VEHICLE:
LICENSE NO:
STATE:
GROSS:
TARE:
NET:
INITIALS:
DRIVER ON: Off
DRIVER OFF: Off
CUSTOMER:
PASSENGER ON: Off
DRIVER OFF: Off
SNOW: Off
REMARKS:
RAIN: Off
RAIN: Off
TO:
INV NO:
CONTRACT NO:
ITEM:
QTY:
DESCRIPTION:
UNIT:
SHIMENT NO:
PARTIAL: Off
FINAL: Off
TIME LOADED:
VEHICLE LIC:
RELEASED BY:
TITLE:
DATE REL:
SIGN:
TIME LEAVES:
SENTRY:
PrintButton1:
TextField1:
ResetButton1:
DateTimeField1:

File details come from the government source that posted it. Updated .