Damaged Displaced Vehicle Report
To: Damage Prevention & Freight Claims
Railcar/Truck Number:*
Railcar/Truck Number
Date:*
Waybill Date:*
Date that the railcar is loaded at Origin
Damages Noted:*
Date damages were observed
Inspector:*
The Inspector that viewed the vehicles on-rail
Telephone:*
The inspection groups local phone number
Vehicles A Deck:*
Vehicles B Deck:*
Vehicles C Deck:*
Manufacturer:*
Vehicle Manufacturer
Origin:*
City and State or Province the railcar was loaded
Destination:*
City and State or Province the railcar was unloaded
Damaged:*
Number of vehicles that were affected in the
incident and that will be included in this report.
Damaged Vehicles only
Displaced:*
Number of vehicles that were affected in
the incident and that will be included in this report.
Vehicles that are not damaged but moved from original
chock settings
Total Estimated Cost:*
0
This is an estimate of all vehicles damaged in
an overall dollar amount. Mitchell Manual should be
used in determining estimates.
Seal A End:
Enter seal # from A end
This should be provided by the off-loading facility.
This is needed to determine if the railcar has been opened
anywhere prior to arriving at destination. Very important
in theft related occurrences.
Seal B End:
Enter seal # from B end
This should be provided by the off-loading facility.
This is needed to determine if the railcar has been opened
anywhere prior to arriving at destination. Very important in
theft related occurrences.
Remarks/Explanation
Provide a brief explanation of condition of all vehicles on railcar, and chock applications
Distance between doors/vehicles
VEHICLES
A DECK
B DECK
C DECK
Vehicle Reports
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