Product Received Field Ticket

Please complete the following form for all products received into the plant facilities.  Please not that all fields (*) must be completed.  If there are any questions, please contact your supervisor.  Thank you very much.

Emergency Notifications

In an emergency ‘hit’ the Emergency Notification Red Button to the left.  This will ‘Pop Up’ a list of key numbers to dial. 

In the event of a life-threatening emergency dial 911 first.

Basic Information

In-Out
Product Type
Date / Time

Supplier/Customer Information

Address

Product Information

Grind Out Results
For hydrometer calibration: cg = mg + (tr - tc) * correction factor, where: cg = corrected gravity mg = measured gravity tr = temperature at the time of reading tc = calibration temperature of the hydrometer. correction factor = 0.00045

Provide Images

Use your camera to take a picture and it will be directly uploaded without additional actions on your part.  You can also use the Alternative method as appropriate.

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.
If you have other images you wish to upload or camera is not available, you can upload up to 5 files here.

Volume of Product Delivered

Measure of Product Received
Convert from gallons using the conversion tool below as necessary. If other, convert using standard metrics.
To the best of my ability and by my signature affixed below, I concur that on this date, the data submitted in this form is accurate and correct.
Checkboxes

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Gallons to Barrels Converter Calculator

(If Necessary)

Barrels converted from gallons. Copy to Barrels field above.
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