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This Shipping Order must be legibly filled in,in Ink,in Indelible Pencil,or in Carbon,and retained by the Agent. Shipper NO.J 19 2 7 4 Carrier No. Pop—L— of 1— I I 1,17 6 6"', Name of carrier Dale ( 1 {SCAC) �^ On Ceesq on DYwry■npnMle.fy leer 007 rrult WPM bane wralp inane ores Dater l7MitlW h hem 4W Seat. ` Shipper HILL BROTHERS CHEMICAL CO. ;It TO: t �D n Street 0I0 ('kor,i AVQ Ut Street 11i IN. (1J4_71 City So r T x Stateff e1 zip Code`i Cry -� state/ ZIPCoda' ')-O�p 24 hr.Emergency Contact Tel.No. CHEMTREC 1-800-424-9300 Route Vehicle Number No.of Unffe BASIC DESCRIPTION TOTAL GUANTITY VMGHT CHARGES - , &Confetti Type H M Proper shipping Name.Hazard Class, (Weight,Volume, (Subjed to RATE (For Carrier ,y •'. IdefLtlllratlon Number(UN or NA),Packing(croup,per 772.101,T 72.2p2,172203 etc.) Currectlon) Use Only) UN1003.Ammotile,Ash 7 S ,2,InMtfllllloft H�ardrMhydfnw Ammonia s a 'w ` ].Q i� ,r e tR PLACARDS TENDERED: YES O NO❑ REMIT wee—(t l HTrre r III r■ CepredeTt on vura,111110 a era MWred In State I hereby declare that Ma contenq o7'hisC.O.D.ADDRESS teL aoedVxly h wrflNg the agfeed or declared value N the poperty.Y MrW7:The epwiprmerd am ketY am■xuatay Oeadibed { apnea or clattered race N fib pnopep h MreGy ep.akyer tlmW t tf A show abo+e by Te wow sh4Ptrq reuse and are /� PREPAID F ?¢ ba not�i dlaaalflad. paeka(fad. marked And COD 4heleWPrca riled.W ns h a1 rasps t in V Amt:$ COLLECT❑ S rtl VYrtera fM apNkable reran proWkne Ipedly a enVullm a Te rxnra'e Iphllly WOMr mrdh1on for bsnpod eawrding to Ali a rein"or a v"W Wraeen by Ta ehpper And the ehWo apes i epplk■co �ntern■non■I and nasional SubJen to secwn 7 of the ehgalere b to be name the candies or dedue a v kw,Ina IynlerY cordifor e,d hi flabley Ilbary tleall be smiled toOwermwm deemed Id the t»rnlgnee wnt+ctd recmeee on the conelgrrgr,fM TOTAL e�.. cite enan mavided by sLtdt proy+Idrra 5w NMFC Iran tT2. mnrlpnor shall e91 the IoIW.p*LMWn tt: CHARGES $ 4r'Fj (3)C,ommgddlw requiringcare or-pow or amm" or anmaon In nanding or The[only VAN rot nuke df iv9ry of tha e7yprryra wldgta,A; tlbwiy ri be w masked and peaaved as to mars We franepdrtawn.8ae payee or"Vint ena all newhtal A,harg.a. FREIGHT CHARGES Section 2(e)N Irrn MC.IIiIY N Lading.Freignt bee and Stiffer"of C7rryee b.FREIOHTTPPREP tlp Cheak�D. and Section 7(a)of the Curbed Terms end Cdnaeme fora list of suds articles. rya h ceded c re,p,ewa a Canegrcd daltbtapM RECEIVED.mtad to din olaW reden ue t,f In~on the dada of bva of In of Lading.the pop" and a b each Arty Al any ems h,l ai in■#a a^Y eaN GrnPartK Ina[w+ry whoa C d perbme0 dPW"Ped aeon M.PoW errL good uder,woept w noted lo.ernr Ma mtddm of wntwtee ar paatew rrrtdwknl. n«wne.r Neil be"a,ro aI me by or 1ai erne and pp,dnpna n IM Wry^e'te CIeW W■M P.M bin or marked.oorrgrwd,end dMned w Indicated abort ehkn field terrier".ord terrrr baaW erCfiallod Ii anprnanl. yy, gee Duped w mteNg Any deism a wpuaedn n powawrn y ea downy under Ina teraeoi)arm In terry m ehgpw h.In..am ea......amlwr wio�aI pa Ipne unne and mrratlme n oa MerrYng eeaeeleaaeee end b urrl plate an deYrrr a ace dwararn,e te tin rMa,olt a .n dallrer b enWw rarer on 1.aside r ml YN aak rfirme aM o 111lona w twe W a inioa n by the NbPar eM r«epttl Ill nenwr ar,e nr raap+e desauvin.u r muarry egraad w n..&—,w a u or any at,sae ydb.7y fir tl u shy poops d wd rase m SHIPPER (� v ! ✓ fj S CARRIER /� `jvD� ^� PER /7 �4 HT " PERDATE /' 1 _ -� _ !I.r; 4�:r..ram.,a�i�'�e1•.��ie�:r� .r_ :Lin ..w_ _ -. .. , .r1�-�!!a.:lv,�51 ..i, N::..,-° ��i� _:�ylr�•�4~+�k"evr:a'��+ �1�X}