For All's Grocery Surplus Data Record (not Amazon) 
Hi Service Members, please fill out a separate form for pickup. For reference-  1 full banana box is average 30 lbs
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Date *
MM
/
DD
/
YYYY
Driver Name *
Store/Pickup Location *
TOTAL # pounds food Picked Up at Store/Location (count boxes, multiply x30) *
TOTAL # of Pounds Composted at Store (count boxes, multiply x30 lbs.) - All Stores *
1st or Only Delivery Location: What location was the food delivered to? (Location address + info) For multiple drop offs on same route, fill out sections below for additional deliveries.  *
1st Delivery: Approx. # pounds food delivered. Count boxes, multiply by 30 lbs. *
2nd  Delivery on same route (if applicable): What location was the food delivered to? (Location address + info)
2nd Delivery (if applicable):  Approx. # pounds food delivered. Count boxes, multiply by 30 lbs.
3rd  Delivery on same route (if applicable): What location was the food delivered to? (Location address + info) 
3rd delivery (if applicable): Approx # pounds food delivered? Count boxes, multiply by 30 lbs.
Were refrigerated items received at or under 41 degrees F? Answer Yes or No below. If no, please explain the circumstance. For example, the donated item was at room temperature, there was an issue with the store's refrigeration, etc. 
 *
Required
Were frozen items received at or under 0 degrees F? Answer Yes or No below. If no, please explain the circumstance. For example, the donated item was at room temperature, there was an issue with the store's refrigeration, etc. 
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Required
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