Fill in all boxes below:
Please ask the customer to read, fill in and sign the below declaration before delivery.
Customer Declaration
I, the customer, confirm that the tank ullage has been checked, and there is sufficient room for the quantity and grade ordered. In the event of any spillages or incidents during delivery, I, the customer, will be fully liable and responsible. If I, the customer, am not present to sign the declaration, I authorise the driver/carrier/supplier to continue the delivery on my behalf, I, the customer, accept full liability and responsibility.
Warning - Gas Oil or Kerosene is not to be used as road fuel.
Tank 1
Before Delivery
After Delivery
Tank 2
If you have no further deliveries please press here:
Before Delivery
After Delivery
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Tank 3
Before Delivery
After Delivery
If you have no further deliveries please press here:
TOTAL QUANTITY DELIVERED
To be completed after delivery has been made