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STRAIGHT BILI, OF LADING - SHORT FORM - ORIGINAL - Not Negotiable SHIPPERSNUMBER 5-179476 DATE: 12/05/2013 Shipper(fromA Consignee(to) i LAWRENCE LIVERMORE NATL LAB FOR NNSA CLEAN HARBORS ENVIRONMENTAL SERVICES CORRAL HOLLOW ROAD GT+ TRACY CA 95376- •1021 BERRYESSA ROAD TECHNICAL CONTACT: SAN JOSE CA 95133- JOBlWORK ORDER: Project 32149 Task 5325-10 !CONTACT NAME: ROUTE: PREFERENCE#:No. Description of Articles,Special Marks.and Exceptions Weight Shipping Type of Package HM (Subject to Correction) NMFC Item No. Class Rate Units CCReeLt 1 PALLET Non-regulated waste, solid (fluorescent tubes) SDOP0165-1) i 182 lb 1 F/B DRUM Non-regulated waste, solid (fluorescent tubes) (DOP0165-11 93 lb r 2 METAL DRUM Nan-regulated waste, solid (broken CRTs) (DOP0174-1) 9316 R 1 EC IVED r i i DEC 0 4 2015 ENVIR NMENTAL E HEALTH DEPARTMENT 4tNTHE EVENT OFEMERGENCY.TELEPHONE 1-(925)423-4205 - 24 HRS !npaaaaaalonn,,, 6e�.�ete�.e�i�m•allloiri+.ai�..hu.anen. 368 lbi <<<TotalPieces Contact or Registrant Name.or Contract Number 1.LNL Emergency Dispatch afthrearder,DwurteragnmatonolNrfM 169 kg, •hipper7cpnalgre,within pm hawo, fREIGHT CHARGES - Remarks: --- ARE: If chis shipment is to be Derivered To the This shipment is for the U.S. Department of Ener4gy and the actual SXIN14-02 shipping If S - 179476 X Prepaid total transportation char es paid to the carriers} by the consignor P.aferenEe release number LSJOtl42 on invoice. Consignee without recourse on the consignor. Collect or consignee are assignable to, and shall be reimbursed by, the U.S. 'See attached packing list for containers numbers. 3rd Dam, the consignor shall sign thr. fol low,ng : Government and is subject to the terms and conditi Dns set forth in i the standard form of the D.S. Govermhent uill of Lading and to any staunent: The carrier shall not ,aha delivery: available special rates or charges (see Remarks) of this shipment without payment of freight ! (41 [FR 109-40.50 and 41 CFR 109-40.3} .and all other lawful charges. Yes No SECTION 13712110721 RATES APPLY-TENDER NO, Received,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,if applicable,otherwise to the rates,classifications and rules that have been established by the carrier and are available to the shipper,on request The property described above,In apparent good order,except as noted(contents and conditions of contents of packages unknown)marked, I consigned and destined as shown herein,which said carrier{the word carrier being understood throughout this contract as meaning any person or corporation In possession of the property under the contract)agrees to carry to Its usual place of delivery at sold destination,If on Its route,otherwise to deliver to another carrier on the route to said destination.It is mutually agreed,unless otherwise specifically staled in Individually I determined rates and contracts that have been agreed upon In writing between the carrier and shipper,as to each carrier of all or any of said property over all or any portion of said route to desUnation,and as to each party at anytime interested in all or any of said property,that every service to be performed hereunder shall be subject to all the terms and conditions of the Uniform Domestic Straight BILI of Lading set forth(1)in Uniform Freight Classification In effect on the date hereof,If this Is a call or rail-water shipment,or(2)In the applicable motor carrier classificatlon or tariff if this is a motor carrier shipment Shipper hereby certifies they are familiar with all terms and conditions of the said bill of lading,set forth in the classification or tariff which governs the transportation of this shipment,and the said terms and conditions are hereby agreed to by the shipper and accepted for him/herself and their assigns. This is to certify that the above named materials are properly classified.described,packaged, - W Placards Required Label(s)applied marked,labeled,and are in proper condition for transportation according to the applicable Trailer Loaded by: _i Shipper 0 Driver regulations of the Department of Transportation(Applicable for Hazardous Materials Only) Freight Coupled by: Shipper Shipper,Acting under contract _._ -_____- with the [':Driver,Loose pieces U.S. Department of Energy: []Driver,pallet said to contain ['Driver,pallets canlaining Carrier GT+ J GOVERNMENT TRUCK ON BEHALF OF' NNJA Vehicle/Car No: ?e Date r Per K�LY Nlt4ifr Date 12/05/2013 Seaf: TRANSPORTATION DEPARTMENT - PERMANENT POST OFFICE ADDRESS OF SHIPPER Page 1 of 2