DD Form 250-1 Tanker/Barge Material Inspection and Receiving Report

What Is DD Form 250-1?

DD Form 250-1, Tanker/Barge Material Inspection and Receiving Report is a form released by the Department of Defense (DoD) and used for documenting movements of petroleum products by tanker or barge to cover origin or destination acceptance of cargo. This form is also used to record the shipment or receipt of Government-owned products.

The November 1992 edition of the DD Form 250-1 is available for digital filing and download below or can be found through the Executive Services Directorate website.

The DD 250 Form may also be used for sending quality data to the point of acceptance in the case of origin inspection on FOB destination deliveries or a pre-inspection at the product source. In these cases, the form should be annotated with the words "INSPECTED FOR QUALITY ONLY."

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TANKER/BARGE MATERIAL INSPECTION
Form Approved
AND RECEIVING REPORT
OMB No. 0704-0248
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.
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
15. VESSEL
16. DRAFT ARRIVAL
17. DRAFT SAILING
FORE
AFT
FORE
AFT
18. PREVIOUS TWO CARGOES
19. PRIOR INSPECTION
FIRST
LAST
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
28. REMARKS (Note in detail cause of delays such as repairs, breakdown, slow
27.
TIME STATEMENT
DATE
TIME
operation, stoppages, etc.)
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
29. COMPANY OR RECEIVING TERMINAL
COMMENCED BUNKERING
FINISHED BUNKERING
(Signature)
VESSEL LEFT BERTH (Actual/Estimated)
30. I CERTIFY THAT THE CARGO WAS INSPECTED, ACCEPTED AND
31. I HEREBY CERTIFY THAT THIS TIME STATEMENT IS
LOADED/DISCHARGED AS INDICATED HEREON.
CORRECT.
(Date)
(Signature of Authorized Government Representative)
(Master or Agent)
DD Form 250-1, NOV 92
Previous edition may be used.
Adobe Professional 7.0
Reset
TANKER/BARGE MATERIAL INSPECTION
Form Approved
AND RECEIVING REPORT
OMB No. 0704-0248
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.
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
15. VESSEL
16. DRAFT ARRIVAL
17. DRAFT SAILING
FORE
AFT
FORE
AFT
18. PREVIOUS TWO CARGOES
19. PRIOR INSPECTION
FIRST
LAST
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
28. REMARKS (Note in detail cause of delays such as repairs, breakdown, slow
27.
TIME STATEMENT
DATE
TIME
operation, stoppages, etc.)
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
29. COMPANY OR RECEIVING TERMINAL
COMMENCED BUNKERING
FINISHED BUNKERING
(Signature)
VESSEL LEFT BERTH (Actual/Estimated)
30. I CERTIFY THAT THE CARGO WAS INSPECTED, ACCEPTED AND
31. I HEREBY CERTIFY THAT THIS TIME STATEMENT IS
LOADED/DISCHARGED AS INDICATED HEREON.
CORRECT.
(Date)
(Signature of Authorized Government Representative)
(Master or Agent)
DD Form 250-1, NOV 92
Previous edition may be used.
Adobe Professional 7.0
Reset

Download DD Form 250-1 Tanker/Barge Material Inspection and Receiving Report

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How to Fill out DD Form 250-1?

The form is made up of a single page with filing guidelines provided separately. DD Form 250-1 instructions are as follows:

  1. Block 1 of the DD 250-1 requires the individual filing the report to specify whether the form is used as a discharge or loading report.
  2. Block 2 of the form is for the name and location of the inspection office. Block 3 is for the report number. Each form should be numbered consequently to correspond with the number of shipments made against a contract.
  3. Blocks 4 and 5 are for identifying governmental activity placing the order. Block 5 is for the military department shipping the product. Block 6 requires the phone number of the prime contract.The name and address of the contractor must be provided in Block 7. Storage contact phone number - if any - goes to Block 8.
  4. Block 9 is for entering the name and the location of contractor's facility from which shipment is made.
  5. The delivery order number, purchase order number, subcontract or suborder number placed on the supplier is specified in Block 10.
  6. Block 11 is for the name and address of the consignee. Block 12 requires the initials and number of the bill of lading.
  7. Block 13 is for providing the number and date as stated in the shipping instructions. Block 13 is left blank if the DD 250-1 is used as a discharge report. The cargo number must be entered in Block 14.
  8. The name of the tanker or barge is specified in Block 15. The vessel's draft on arrival must be entered in Block. Block 17 is for the vessel's draft on completion of loading.
  9. The type of product constituting previous two cargoes should be entered in Block 18. Block 18 is left blank if the form is used as a discharge report. Block 19 - Prior Inspection - must be left blank unless used as a discharge report.
  10. Block 20 requires the condition of the line before and after loading. Block 21 is for entering the appropriation number shown on the contract, purchase order or distribution plan. Block 21 is left blank if the DD 250-1 is used as a discharge report. Contract item number should be in Block 22.
  11. Block 23 is for the product nomenclature and grade as shown in the contract or specification, the stock or class number, and the NATO symbol. Block 24 is intended for specifications and amendment number.
  12. Block 25 - Statement of Quantity - is a blank chart. Loaded figures should be taken from the loaded report. If a part of products is discharged at multiple points, all losses and gains should be calculated and entered in percent.
  13. Block 26 - Statement of Quality - is a chart with three columns. The first column - Tests - requires all inspection acceptance tests of the specification and any other quality requirements of the contract. The second column - Specification Limits - is for the limits or requirements as stated in the specification or contract. These must be listed directly opposite each entry in the first column. The third column - Tests Results - is for the test results applicable to the storage tank or tanks from which the cargo was lifted.
  14. Block 27 contains a list of actions. All applicable entries of the time statement must be completed using local time. Any additional details may be specified in Block 28.
  15. The company or a representative of a receiving terminal representative should sign the DD 250-1 in Block 29. Block 30 is dated and signed by a Government representative. The signature of the master of the vessel or his agent is provided in Block 31. All names should be typed in or hand-written.

DD 250-1 Related Forms

  1. The DD Form 250, Material Inspection and Receiving Report is a form used for documenting the delivery and receipt of a product.
  2. The DD Form 250C, Material Inspection and Receiving Report (Continuation Sheet) is a continuation sheet for the previous report.