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I STRAIGHT BILL OF LADING—ORIGINAL—NOT NEGOTIABLE Shipper's No. Carrier9ftos erl!/rX�w�ri9E�T i OE4 T CAC Carrier's No. RECEIVED,mubbd IONdwIduary determined Was or comoons fhet have bean agreed upon b wdbg bowmen the artier end shipper,If applicable,etberwism to the mems,tlassfrimdoru and rules mal-ems estabkhed by the carder and em mallahle b No tapper,an request and all appis elo elate and leaved mgulabbnm: at date ci Na Progeny desaWed below.In appenea Bond ander,Concept an-sled(o.mmila end condition Of content of Packages wilmomm),mtrload,corillignied,and destined as Ildu®fed 1»We,whlM said (Ne word dompany bang Underabiad Nmrgllma Nla mntmd at mel inq aoy parson or copoodon in possessbn of the property under the ventrad)agrees to May b dolly"at soot destneton,g an las We,adherwbut to cleaver In aridlnr canter an the route W said tlestlnaLbn.B is mot,*agreed as an each aMd d ell or try al Bald Property over 0 or wry portion d aNd rade to d000na each perry"arty dose Inaamstetl is ee or odic d sae Prapary mat m¢ry::coke W be Waned hareurider shell be subject to as me conditmm mrd radted low,whoi ton.n, er W molal.¢,coq Ne mnddtmse on Na beck lmred,which efl b the and ed ld hiloseYeM bus P by prktbd or written,herein TO: VaCxc eri 7LFt ,le4G So(�a `ay.IS FROM: / - f✓+ bf�S'C �(Jt7i Iw-b��% QC Consignee ShipRer Street &L5 / Street Destination O.0 Z- Ori in Zi VA 9S.r2yr2._ Route Delivering CarrierVehicle Number U.S.DOT Hazmat Reg. No. 2�vSGitC. t.d,�rf �- cam/ Cao P � A es.4C. w�+s o o� 56 2 Remit COD to: ft=- 0"a in. 'k COD FEE: YpmutlNbben War n.b Na roNgn o COD AMT: tlhoN eatoum en tea gndpnel, lea Address: �� Prepaid ❑ City: State: Zip: new ymmt c1 b.yaI and all $ Collect El$ NOTE;Whew me one Is dependent an value,Shippers are remdmtl to date epetlflcally In wilting TOTAL CHARGES: FREIGHT CHARGES: the egraod or dedered value o1 NO property,The sg,ead or declared value of the propmty Is hereby specifically dated by ben Mippor to be not succeeding Per IBpuwvew Pre Itl C011W NOfE:LIawmy Lbntletbo nor lose or deouge In b• pment may be eppllmbic Smut 49 ll.B,C. •e td CMAJ and I]BYSHIPPER BYCARRIFA TNa Is to unity Nil Ne abovcruniN meudsh aro Menly caaastbd,dawtee,padmye,merkaa e and ki and em N poster cwElibn for eereponstion wowing to to applicable mgu4eme d k DRIVER'S Ne DepeM�maelTmnoponeake,Per SIGNATURE SHIPPER• � S CARRIER: 1 lYl PER: DATE: PER: Fnoo YJDATE: 26 EMERGENCY RESPONSE ��6 NAME OR CONTRACT NUMBER TELEPHONE ,�•r r—,S �f•� OR OTHER UNIQUE IDENTIFIER: 29-BLS-C3 969(Rev.9110) �'i