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o:11 ,.t a ...Jt.... _ cl..-.a C _ n.:..;. 1 - Nnt Nanntiahla chinnPr'c Nttmher, 10192017 date: 10/19/2017 TRANSPORTATION DEPARTMENT -PERMANENT POST OFFICE ADDRESS OF SHIPPER rnut x yr 1 z �ryy--- a V N Ul Ci\ 4P Shipper (from) Consignee (to) * /'ern,} * LAWRENCE LIVERMORE HATL LLB Site 300 FOR NNSA Altamont Landfill L Resource Recovery Corral Hollow Road Altamont Pass Road VV 11 Tracy, G 95376 Livermore, G 94550 Technical Contact: Shari Brigdon; (925) 423-7665 Contact Name: 1ob/Wark Order: Route: Reference 4: 621270G No. Weight Shipping Type of Package NM Description of Articles, Special Marks, and Exception NMFC Item No. class Rate (Subject to Units (Subject to Correction) Correction) 1 DUMP TRUCK Uncontaminated Construction debris and weathered wood products. 5000 The ( Utility poloo cut into small sections ) 4 IN THE EVENT OF AN EMERGENCY, TELEPHONE (925) 423-4205 -24 HRS hhk9Rt.rheai.ovaari.e+w•••d•�.rw-,.-"h. 5000 lbs 1 «Total Piecescvri.r.en.•hv Contact or Registrant Name, or Contract Number LLNL .e+uy ur avoew/ronlgror.frN. rr.o hv�.. 2268 kqa FREIGHT CHARGES It this shipment is to be delivered to the This shipment is on behaff of the U.S. Department of Energy and the actual total Remarks: - FT -1 ARE: consignee without recourse on the transportation charges paid to the camer(s) by the consignor or consignee are Altamont Profile# 621270CA rn consignor, the consignor shall sign the asshgnabie to, and shall be reimbursed by, the U S. Government and is subject to Z Prepaid following statement: The carrier shall not the terms and coridibons set forth in the standard form of the U.S. Government ❑ Collect make delivery of this shipment without Bill of Lading and to any available spec ai rates or charges tV m � ❑ I'a Party payment of freight and all other lawful charges. (41 CFR 109110.50 and 41 CFR 109-40,1 O Z NNSA Yes ❑ No M (see Remarks) V.S. SECTION 13712/10721 RATES APPLY -TENDER NO RecelweL subject to indivieluatty determined rates or contexts that have Leen agreed upon in writing between the carrier and shipper, if applicable, otherwise to the rates, classifications and rules that have been established by the tamer and ere evaltabfe to the shipper, on request. The Property described above, In apparent good order, except as noted (contents and conrfafons of contents of packages unknown) marked, cosigned 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 said destination, If on hs route, otherwise to deliver to another carrier on the route to said destination. it is mutually agreed, unless otherwise specifically stated in individually determined rates and contracts that hive been agreed upon In writing between the carrier and shipper, as to each carrier of all m any of Laid property over all o, any portion of said route to destination, and as to each party at anytime interested in all or any of said property, that carry service to be performed hereunder shall be zub)ect to aft the terms and condition of the Uniform Domestic Straight 94 of Lading set forth (1) in Uniform Freight Classification in effect on the date hereof, if this h a rail or rall-water shipment. a (2) in the applicable motor tamer classification or tarts if this is a motor carrier shipment. Shipper hereby « rtlfws they are familiar with all temp 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 certifythat the above named materials are properly classde 1, described, packaged. „ Trader loaded by ❑ Shipper ❑ Dnver Placards Required: Label(s) applied: marked, labeled, and are in proper condrtion for transportation according to the applicable regulations of the Department of Transportation (Applicable for Hazardous Matefials Only) Freight Counted by ❑ Scupper ❑ Draer Loose pieces Shipper, acting under contract DE-AC52-07NA27344 J with the U.S. Department of Energy: ❑ Diver pallet said to contain LA1eRENCE LIVERMOR.E HATL L.AB ❑ Driver, pallets containing Carrier GT+ / Goverrubont Truck Vehicle/Car No Per Date �(C/ 7 Frank xotte, coordinator Per Date 10/19/2017 Seal l/GGGGJJ//// TRANSPORTATION DEPARTMENT -PERMANENT POST OFFICE ADDRESS OF SHIPPER rnut x yr 1 z �ryy--- a V N Ul Ci\ 4P