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0 0 <br /> ***24 HOUR EMERGENCY RESPONSE, CALL (877) 577-2669 + * <br /> .1 <br /> 11855 White Rock Road BILL OF LADING <br /> ENVIRONMENTAL SERVICES Rancho Cordova, CA 95742 <br /> GROUT (916)351-0980 Tel Lading Manifest: 105444 <br /> Wene.Region (916)351-1707 Fax -14 <br /> it <br /> 3 DEUVERYDATE JOS 7 7 <br /> SHIPPER/CUSTOMER RECEIVED RE .1 <br /> SIERRA CHEMICAL POINTOFCONTACT <br /> ADDRESS Darlene Hardy <br /> 1010 INDUSTRIAL DRIVE PHONE# <br /> CITY,STATE,ZIP (209)507-7156 <br /> STOCKTON CA 95206 <br /> CARRIER/TRANSPORTER <br /> 21st Century Environmental PHONE# <br /> CONSIGNEE/FACILITY (400)580-1791 <br /> GENERAL ENVIRONMENTAL MGT LLC POINTOFCONTACT <br /> ADDRESS <br /> 11855 WHITE ROCK ROAD PHONE# — <br /> CITY,STATE,ZIP (916)351-0980 <br /> RANCHO CORDOVA , CA 95742_ <br /> HM USDOTOescnp}ion (Ixluding Propwshrpplrtg Na o thasard Cws spd)DNu ber) Containers <br /> otal <br /> A X UN1951 --—.1 2.1 DNIYERS(R YgSTE RQ UIIYERSf� VFSTE No Type Quawny UOM <br /> ERb(12f) <br /> DM p <br /> ISS <br /> e u'^► 6V5; 2, ( �t�� �A a �;rnusa/lu <br /> EVP(1 Zy <br /> C <br /> GEM has the appropriate <br /> D permits tor, and will accept <br /> the wa <br /> shipping. <br /> Special Handling Instruction and Additional Information: <br /> a) 512991-01 - fR:R(ISDL CWR4 ((ROYEM RASTE) - fill DIC11 (1) C$� <br /> Aftk 3JAC_01 (1) <br /> Placard-Provided YES NO <br /> .SHIPPER'S CERTIFICATION:This ism certify that the above named materials are properly classified,described,packaged,marked and labeled,and er4in p aper condition for 669 <br /> transportation according to the applicable regulations of the Department of Transporatlon. <br /> (SHIPPER)PRINT OR TYPE NAME <br /> - /) SIGNATU E <br /> X (,�,hr Q, X –•�� ^+° r^x ^ vaan <br /> (CARRIE <br /> PORT )PRINT P /SME SIGN TURE spa <br /> K ' /, ��' L L/. ` Mo ) 1 f <br /> CONSIGNEE/FACILITY) X !1 _7 <br /> PRINT OR PE NAME SIGN UR ////�_ MY I U <br /> ( ML • I <br /> orm#PSF209-REV.D1/12 <br /> CONSIGNEE COPY <br />