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j;m <br /> BILL 4F LADING <br /> 3909 Park Road, Suite D <br /> SER�cI:s Benlcla, CA 94510 <br /> t=,;a (877} 74&3040 _� _ -i r 1�a7.I r <br /> WesE-era Region <br /> DELIVERY DATE JOB#,r 1 yyc <br /> SHIPPER I CUSTOMER POINT OF CONTACT <br /> !:'M-J7j, OIL FRODwiln. ids <br /> 00RESS PHONE# <br /> 'ITY STATE ZIP <br /> '.ARRIER/TRANSPORTER PHONE# <br /> 'ONSIGNEE/FACIUTY POINT OF CONTACT <br /> tiCRWA,RP,, D-KC <br /> ADDRESS +i PHONE# <br /> Sta ms's s i'f •L'Cla 5 -"'y {�i3i �1 .3�� <br /> 'ITY STATE ZIP <br /> y l 3 y <br /> WAS" 01,Q) 1T'U 41 AFI C"IP KI F", <br /> 3 <br /> >pecial Handling Instruction and Additional Information <br /> al - WA tMAROUS WAS12 5001 (,olf kyr) mjr-'PWS4't q-W ��O? '320TUTI fl. N PTRM� u'#ER&7IWY IMM4 <br /> Y'10?0 Oati 643-5,)31 111SI i1ri-2.171 <br /> placards Provided YES No Emergency Phone#(877) 748-304© <br /> SHIPPER S CERTIFICATION i hereby declared That the contents of this consignment are fully and accurately described above by proper shipping name and arech sided packed, <br /> narked,and labeled and are in all respects in proper condition for transport by highway.vessel and rad according to applicable mtemandmal and national govenwient regulabom <br /> SHIPPER)PRINT OR TYPE NAME = r SIGNATURE __ . Nonni DAY YEAR <br /> K r! - X ��- <br /> Cw 11,R/TRANSPORiERk PRINT OR TYPE NAME SIGNATURE Jnr DAY YEAR <br /> X x �, ,. <br /> CON5IGNEE/FACILrrY)PRINT PR TY�ENA�VIE SIM 7�TURE CA YEAR,, <br /> =orm#PSC 201-RV 6104 r l <br /> r <br /> SHIPPER <br />