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I <br />General Petroleum FOR CHEMICAL EMERGENCY <br />REMIT T0: P.O. Box 31001-1235 <br />Corporation Pasadena, CA 91110-1235 Spill, Leak, Fre Exposure or Accident <br />19501 S. Santa Fe Avenue Customer Service: (800) 659-5823 • Fax: (310) 356-2624 CALL CHEMTREC-DAY OR NIGHT <br />Rancho Dominguez, CA 90221 Credit Inquiries: (310) 356-2400 800-424-9300 <br />BILLING ADDRESS. SHIPPED,TO: <br />ILRMS. <br />I <br />CH22?8090055 <br />CH232328BOOl <br />rif.() HUAk LOW Ti 4 4.74 <br />COUNTRY CODE: <br />6.CAO 55 GAI_ D R M <br />6ei BULK GALS <br />FOR COMPANY USE ONLY <br />RT❑ TF❑ <br />OP❑ <br />ARRIVED LOAD POINT <br />AM DATE <br />COMPLETED LOADING AM DATE <br />TIME SPENT LOADING <br />TRUCK # <br />B/L # <br />NM <br />PM <br />ARRIVED DESTINATION <br />AM DATE <br />COMPLEJED UNLOADING AM DATE <br />TIME SPFNT UNLOADING <br />EXCESS TIME <br />A-7(.� <br />PM <br />PM <br />END <br />c�vs <br />DIESEL <br />OTHER <br />WATER DETECTED? <br />TEMPERATURE <br />GRAVITY <br />RO.T HAZARDOUS MATERIALS PLACARDS PROVIDED <br />SHIPPER i CAMER <br />TANKBr <br />L1YES <br />DRUM DEPOSIT <br />THS1ST0GMT -FKT1fEADM IWADMATEXUAPEPRMAY <br />CfASSM DEK%a),,PAOVOED,MAMMMDLMUDAN7ARE <br />H PROPEA COWTIOP FOR TFI MSPORTATM A00"NO TO THE <br />BEGINNING <br />DRUM CREDIT <br />OUR PUMP <br />TANK <br />El YES El NO <br />' "�TMOFT*OUWMMOF' "TATIM <br />N0E5WOEAF1AZV IBMATffW <br />RECEIVED BY <br />DATF IAADED/DELN6RED RY -.� <br />` _ �� <br />rIMMML 8119KOCYROE IAM -0443M <br />(`1 ICTAkiGO r+n <br />� <br />