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I 111, 01 11JJIJI119 VI um Carbon,and r®tained by the agent Shipper No. ` Carrier No. Eveween Envtonmental ServicesDate be of Of (Name of carrier) (SCAC) On Coiled on Delivery shipments,the leaers'COD'must appear before consignee's name w as otherwise provided In Item 430,Sec.1.. FROM- : TO: -v Shipper Gevake Toyota Consignee AERC RecydkV Street 4 Rao St a atif Rd Street 3057Z u I,CA 95 . State Zip Code City«. Hayward State, CA Zip Cod 209-367-6500 24 hr.Emergency Contact Tel.No. Route € Vehicle Number No.of Units[ BASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES &Container Type Proper Shipping Name,Hazard Class or UN or NA Number,Proper Shipping Name, (Weight, Volume, (Subject to RATE (For Carrier UN or NA Number,Packing Group Hazard Class,Packing Group Gallons,etc.) Correction) Use Only) iversal waste ) - 1 PLACARDS TENDERED: YES p NO =I REMIT C.O.D.TO: Note—.(1)Where the rate is dependent on value,dippers are required to state I hereby declare that the contents of this ,ADDRESS - - saciticamk Inwritingthe agreed or declared value of the property,as kfk"e:'The consignment are fully.and acouretety . agreed or declared value of the property b hereby specifically stated by the shaper to described above.by-the proper shipping - - C.O.D.FEE: be riot exceeding per name and are classified, packaged, Cj®® Amt: $ PREPAID ❑ .(2)Where the applicable tariff proviso specify a limitation of the carrler's liabilit,absent market and lebeiled/placerded,and are - - COLLECT❑ $ a release or a value declaration by the shipper and the shipper does not release in all respects In proper condition for - the carrier's tiabfitiy or declare a value,the carrier's fiabOW shall be limited to the extent transport according to applicable Subject to Section 7 d the conditions.If this stdPrnent Is to be dhhMered to me TOTAL provided by such provisions.See NMFC Rem 172 International sed national conal9gnee withom recourse.hm the consignor,the amsignw shall sign the CHARGES $ (3)Commodities requiring special or additional care or attention in handling or stowing governmental biMn ebtemem: must be so marked and packaged as ro ensure safe .See Section 2(e)of �ubtiare' The terrier;hall not make delivery of gds shipment without.payment of FREIGHT CHARGES Rem 360,Bilis of Lading,Freight Bilis and Statements of Charges and Section 1(a)of `. freight and all other lawful charges. FFREEIIGt AI Check box charges the Contract Terms end Conditions fora Rat of such articles.- - Signature tgl� ®d mal dcihtle when bon at ❑ .01W r - RECEIVED,subject to she classificallons and tariffs in effect on the deb of the leave of this Big of Lading, tinatlon andasto each the properly above m apparent good order,except as noted(contents and condition of corn {tel efs any time Interested m aH otens and.property,that every cervico to tams of - unlast m),marked,consigned,and destined as Indicated above which said carrier a performed on he date r shall be subject ro efi the bit of lacing arms and conditbns In the governing chat, word corder being understood throughout ft contract as meankg any person or corporation in - aifioatbn on the date of shipment possesslon of the property under the contract)agrees to carry to its h�1al place of delivery at sell desti- -Shipper hereby na and t that he Is familiar with all the hereby agterreed a and y the in the nation.If on its route,otherwise ro deliver to another ceder on the route to Said destination.h is mutu- accepted or hi classification and tib send terms and conditions are hereby agreed b by the shipper ally agreed as each center of all or any of,said property over all or any portion of saki rot"to des- accepted for hkrhaeti and his assigns. SHIPPED Geweke Toyota CARRIER EVERGREEN ENVIRONMENTAL Ei TAL r PER 7ZL�Z; 2 PE DATE Permanent post-office address of shipper, STYLE F365-3 0 2003 LABELMASfER® (800)621-5808 www.labelmaster.com .. PPMrEDON RECYCLED PAPER PRIarED WIN -