Offloading_Form.doc

This is a Receiving/Off-Loading Authorization Form used by the City of Palo Alto's Regional Water Quality Control Plant (RWQCP) to document the safe receipt and unloading of bulk 12.5% sodium hypochlorite deliveries. The form requires completion by both a qualified City employee and the delivery driver prior to unloading and establishes mandatory safety protocols and documentation requirements. The form mandates completion of 15 checkpoint items across three phases: pre-offloading preparations including barricade placement, driver familiarization with emergency equipment and safety shower/eyewash station locations, verification of product specifications and documentation (Bill of Lading, Certificate of Analysis, Weight Certificate), and confirmation that personal protective equipment is properly donned by both driver and RWQCP personnel; during-offloading monitoring requiring leak inspections, continuous attendance within 25 feet of the unloading process per Department of Transportation regulations, and adherence to tank fill limits maintaining a 10% safety margin with maximum 5,000-gallon tank volumes; and post-offloading procedures including spill assessment, secure lockout/tagout of receiving ports, and equipment return to storage. The form specifies delivery sequencing for split deliveries, requiring Tank 3 first followed by Tanks 1 and 2, with tractor-trailer turnaround optimized at the DMF location using empty tanks.

The form serves as a critical safety and compliance document for the RWQCP's ongoing sodium hypochlorite procurement contract, with copies distributed to Accounts Payable, Operations, and retained as originals. Non-compliance with prescribed precautions may result in disciplinary action up to termination of employment or suspension of the supplier's business relationship with the City. The form explicitly prohibits proceeding with offloading if Material Safety Data Sheets are unavailable or if any checkpoint is answered negatively, unless the supervising official provides written documentation that alternative safeguards have been implemented. Completion of this authorization form is a contractual requirement for all sodium hypochlorite deliveries to the RWQCP's two separate facility locations.