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,11'r.1,GHT BILL OF LADING —SF f FORM-Original-Not Negotiable S -r's No. <br /> (Carrier) SCAC. Carrier's No. <br /> Received,subject to the classifications and tariffs in effect on the date of this Bill of Lading: <br /> at /y/ E•C•4:va/tYl. .S�octr6til G•� 96ZUS date ��-/ ems-- from <br /> the property described below.in apparent good order,except es noletl(contents and condition of contents of packages unknown),marked,consigned,and destined as indicated below,which said company(the word company being understood throughout this <br /> contract as meaning any person or corporallon in possession of the property under the contract)agrees to carry to its usual place of delivery at mid desdnaUon,If on its own road or its own water line.otherwise to deliver to another carder on the mute to said <br /> tlesllnelion.It is mutually agreed,as or each canner ct all or any of said property over all or any gonion of said route to destination,and as to each party at any time Interested in all or any of said property,that every service 10 be performed hereunder shall be <br /> subject to ell the conditions not prohibited b law,whether primed or written,herein contained(as specified in Appendix B to Pan 1035)which are hereby agreed to by the shipper and axepted for himsell and his assgns. <br /> (Mail or street address of consignee for purposes of notification only.) FROM: <br /> TO: 7-9'CAI /40.J <br /> Shipper <br /> Consignee <br /> Street /L X80 �lj CGd4A/ AV-r-- Street <br /> Destination �l�c�//Jn,/TO C4 Zip 9280/ Origin cTYpG,rCT3,J C'�- ZIP <br /> Route: <br /> Trailer InitlaV U.S.DOT Hazmat <br /> Delivering Carrier Number Reg.Number <br /> DescriptionNo.of <br /> HM <br /> pacII <br /> -'w OA1/"AhIT.�//�f j �O <br /> �Z.e/L�OGa-S cSG./3sTAn/G6� 'O�r� /vD <br /> 8© <br /> 22a 1,4s J /r --- - � O <br /> Subject to Section 7 of conditions,g this C. O. D. FEE: <br /> Remit C.O.D. to: ro D ��� shipment is to tis delivered to the consiccinsignor, <br /> the <br /> `/ without recourse on the consignor,the <br /> consignor shall sign the foltowing statement: Prepaid ❑ <br /> Address: The caner shall not make delivery of this <br /> City: State: Zip: $ shipment without payment of freight and all Collect ❑ <br /> other lawful charges. <br /> 'If Ute shipment proves benreen two pons bye carrier by water.the law requires that the bill of lading shall slate whether it is'carnees or shippers weighr. Charges Advanced FREIGHT CHARGES <br /> Nae.-where the rate a dependent on value,suppers are required to stale specifically in writing the agreed or declaretl value d the property. <br /> The agreed or declared value of the property is hereby $ (Signature of consignor) ❑Prepaid ❑Collect <br /> specifically staled by the shipper to be not exceeding per <br /> This is 10 cedity that the above-named materials are property classified,dewribed.packaged.marked and YES NO-FURNISHED BY CARRIER <br /> tabeled and are in proper condiuon for traneponation according to the applloable regulations of the Deperbnenl , <br /> of Transponauon. DRIVER'S SIGNATURE: <br /> Per <br /> SHIPPER: c�uA7 vUG CARRIER: <br /> PER: BATE: �' Z 6� PER: DATE: <br /> EMERGENCY RESPONSE -'I S35-Sa s <br /> TELEPHONE NUMBER: —�--�– <br /> Permanent post office address of shipper Q G Monitored at all times the Hazardous Material is in transportation including storage Incidental to transportation(§172.604 <br /> 9-BLS-A3(Rev.7/95) <br /> Stockton, CA <br /> $ 202.50 <br /> ACCOUNTING -t <br /> PAY LAST AMOUNT <br /> IN THIS COLUMN <br />