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S rRA GHT BILL OF LADING Shipper's No. <br /> ORIGINAL-NOT NEGOTIABLE <br /> n , Carrier's No. <br /> .9V5 SCAC <br /> CARRIER: �L /��' Date 2 <br /> TO: n r� �7 FROM: <br /> Consignee �560 S r��P-0P F,0 Shipper -7-0:5&0 /(l�i/G£"r/de- <br /> Street 3 b6 GZ Street / SUo avulse, Ave, <br /> Destination zdzo ZiP 7 T���67 <br /> Orlgln �a r Kvv � Zp <br /> Vehicle Number U-S. 007 Hazmat Reg.NO. <br /> Route: <br /> �-� 1157- r�AhK ,air <br /> Remit C.O.D. to: COD <br /> C. O. D. FEE: TOTAL CHARGES: <br /> Address: V Collect $ $ <br /> City: State: Zip: AMT: $ C1 <br /> •If the shipment move°between two ports by a wrier by water,the law requires shat the' sulrjed to sadiort 7 of mrbbaree this ahipmera is a h°deNv°red 1a ne ams{pea+dmarl FREIGHT CHARGES <br /> bill of lading shall state whether it is'Carriers or shipper's weight'. rewraee on tle ,tM aoadrpar ahei sIg°tl1°fu w'ng stalenrenG FRETWer PREPAID <br /> Nota.-where the rale is dependent on valve.shippers are mquired to stale spec*-SllY In The®tiler shag rd make delwy of tlds shlpmerd witlawl paymaM d frelgM and all ether lawful Exceo when CHECK BOX <br /> writlng khe agreed or declared value of the proPartY• dergnt box a1 right ❑it larges are <br /> The agreed or declared value of the Property is hereby <br /> specifically stated by the sldPPer (%Mdse of cW WWO ` � 1v m� <br /> L.be-1 axce Per <br /> RECEIVED,subject to the ctavifleaUare erd raters m efleet on the data of 1hb N of LadLng.the PQM deso'�above In aQyamM good order.aacepl ea noted(n or corporation <br /> and i on in possession <br /> of a sionnof of pa rOMA+armur d . <br /> 6eug understood Ihn>trghoirl IM1b molted y meaning any person car oarparatbn'n P of the PrePedY oder 1M <br /> marked,consigned and destined as Indicated above.which said wmparN Iths word mnpanY u to ee[3r®raise d <br /> contract)agrees to carry to!is usual plass at deMry al said desWueon.if on ire awn road car ib awn water%ne,oiherwlse to delbw to another order on the foute to said destination.It Is mutually agreed, <br /> al or arty of saM property veer all car ern/PO of Said raN m desilnatlon aM as to each parry at any time Interseled in al or erry said ptopeny,that every service to be performed hereunder shall be subject Is all the <br /> conditions not prohNted by law,whether prinlrrd orwrrllan,hereto aontalned(a epeaflad In Appandbr a to Pert 1035)which am hereby agreed to by IM shipper and ecnQted for himself and hh aaslgna. <br /> This is to certify that the above-named materials are properly classified,described,packaged,marked and labeled and <br /> are In proper condition for transiDortafion according to the applicable re ulations of the De artrnent of Tlans ortation. PER: <br /> CARRIE <br /> SHIPPER: DATE: <br /> ] _ PER: DATE: -L <br /> MOWORED AT ALL-nmes THEEMERGENCY RESPONSE INCLUDING STORAGE NE <br /> C NTAN O TTR IN <br /> O j(1 2.644)NSPOflTA710N. <br /> TELEPHONE NUMBER: f ) 3Q QLS-C3 <br />