DD 250-1.pdf
DoD Form PDF 535 KB Posted
- Solicitation number
- SP0600-10-R-0228-0001
- Issued by
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Defense Logistics Agency Energy
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Tanker/Barge Material Inpsection and Receiving Report (DD250-1)
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Other versions and copies of DD Form 250-1
| File | Revision | Posted | Attached to |
|---|---|---|---|
| ATT 3 - DD250-1.pdf | Revision not stated | TSURUMI BARGE TRANSPORTATION SERVICES | |
| ATT 3 DD250-1.pdf | Revision not stated | TSURUMI BARGE TRANSPORTATION SERVICES | |
| ATT_3_DD250-1_BARGE_MATERIAL_INSPECTION_AND_RECEIVING_REPORT.pdf | Revision not stated | TSURUMI BARGE TRANSPORTATION | |
| ATT_3_DD250-1_BARGE_MATERIAL_INSPECTION_AND_RECEIVING_REPORT.pdf | Revision not stated | TSURUMI BARGE TRANSPORTATION SERVICES |
Who attaches DD Form 250-1
| Agency | Files |
|---|---|
| Defense Logistics Agency Energy | 5 |
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Text version
TANKER/BARGE MATERIAL INSPECTION
AND RECEIVING REPORT
Form Approved OMB No. 0704-0248
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
SEND THIS FORM IN ACCORDANCE WITH THE INSTRUCTIONS CONTAINED IN THE DFARS, APPENDIX F-401.
1. TANKER/BARGE 2. INSPECTION OFFICE 3. REPORT NUMBER
LOADING REPORT DISCHARGE REPORT
4. AGENCY PLACING ORDER ON SHIPPER, CITY, STATE AND/OR LOCAL ADDRESS (Loading) 5. DEPARTMENT 6. PRIME CONTRACT OR P.O. NUMBER
7. NAME OF PRIME CONTRACTOR, CITY, STATE AND/OR LOCAL ADDRESS (Loading) 8. STORAGE CONTRACT
9. TERMINAL OR REFINERY SHIPPED FROM, CITY, STATE AND/OR LOCAL ADDRESS (Loading) 10. ORDER NUMBER ON SUPPLIER
11. SHIPPED TO (Receiving Activity, City, State and/or Local Address) 12. B/L NUMBER
13. REQN. OR REQUEST NO. 14. CARGO NUMBER
16. DRAFT ARRIVAL15. VESSEL
FORE AFT
17. DRAFT SAILING
FORE AFT
18. PREVIOUS TWO CARGOES
FIRST LAST
19. PRIOR INSPECTION
20. CONDITION OF SHORE PIPELINE 21. APPROPRIATION (Loading) 22. CONTRACT ITEM NO.
23. PRODUCT 24. SPECIFICATIONS
25. STATEMENT OF QUANTITY LOADED DISCHARGED LOSS/GAIN PER CENT
BARRELS (42 Gals) (Net)
GALLONS (Net)
TONS (Long)
26. STATEMENT OF QUALITY
TESTS SPECIFICATION LIMITS TEST RESULTS
27. TIME STATEMENT DATE TIME
NOTICE OF READINESS TO LOAD DISCHARGE
VESSEL ARRIVED IN ROADS
MOORED ALONGSIDE
STARTED BALLAST DISCHARGE
FINISHED BALLAST DISCHARGE
INSPECTED AND READY TO LOAD DISCHARGE
CARGO HOSES CONNECTED
COMMENCED LOADING DISCHARGE
STOPPED LOADING DISCHARGING
RESUMED LOADING DISCHARGING
FINISHED LOADING DISCHARGING
CARGO HOSES REMOVED
VESSEL RELEASED BY INSPECTOR
COMMENCED BUNKERING
FINISHED BUNKERING
VESSEL LEFT BERTH (Actual/Estimated)
28. REMARKS (Note in detail cause of delays such as repairs, breakdown, slow operation, stoppages, etc.)
29. COMPANY OR RECEIVING TERMINAL
(Signature)
30. I CERTIFY THAT THE CARGO WAS INSPECTED, ACCEPTED AND
LOADED/DISCHARGED AS INDICATED HEREON.
(Date) (Signature of Authorized Government Representative)
31. I HEREBY CERTIFY THAT THIS TIME STATEMENT IS
CORRECT.
(Master or Agent)
DD Form 250-1, NOV 92 Previous edition may be used.
The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0248). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
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| appl: Adobe Professional 7.0 |
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