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This Memorandum is an acknowledgment that a lilt!at Lading has been Issued and is not Lingmal
<br /> &II of Lading,nor a copy or duplicate,covering the property named herein.and is Shipper No.
<br /> intended solely for filing or record.
<br /> Carrier No.
<br /> ADVANCED CHEMICAL TRANSPORT, INC.
<br /> Pae ° of Date 1112112017
<br /> 9 (Name of carver) (SLAC) f1 �
<br /> Or C Delivery ettfpmerrs :'C.the 10119 D must ear appbefore consignee's nano•as w drervdae prontled in ham 43C,Sac.• FROM: �f*eW,�f'hod Dishid(Sleffa High)
<br /> TO: :fit•_::�"? i.`Faw. aF»ata8- « L'i i Shipper
<br /> Consignee I1 OO ThOlIMS ,St
<br /> a Street
<br /> tom.'-_e'i `'��,:►:trw�rti dei
<br /> Street est
<br /> City State CK Zip Code
<br /> City Slate Zib Code
<br /> hr.Emergency Contact Tel.No.
<br /> Route Vehicle
<br /> Number
<br /> No.of Units BASIC DESCRIPTION TOTAL QUAWM WEIGHT CHARGES
<br /> &Container Type UN or NA Number,?roper Shipping Name,Hazard Class,Packing Group (Weight, ,sic.)Volume, (Subject n) RATE For Canner
<br /> Gallons,etc.) ConacKltxt} Use Only)
<br /> 7 �
<br /> RQ►Uhu63,Peeteek wmrkerI 3,Pfili,(DWI)
<br /> �f-,
<br /> PLACARDS TENDERED: YES o NO 4 -REMIT
<br /> c:O.D.TO:
<br /> Note ce If)where Ina rate dependern ori value,shippers aro regwred to state I hereby salon,m�Ire contents of this ADDRESS
<br /> spedsicaly'vs writing the agreed or dedered value of the prop",as folk":'rhe
<br /> agreed or declared value of the property h hasty apsoifraly Stated by the shipper w consgnmenf are }oily am eccurnmly J
<br /> be not ex eWrrg Per described above by We proPe+shipping / C.O.D.FEE:
<br /> {2}VJrrare the eppiirahte tvtR proNalorus speay a limitation of the camera liebilrty abeam "time dna are classified, packaged, COD �, /Amt_ PREPAID D
<br /> a release or a value declaration the shit marked antl labaliedlpkecian)A,end are . COLLECT 0 S
<br /> by ppar and the shipper tldes rm!release in all respects in proper condition for
<br /> HIS
<br /> Lamers liabllly or declare a value,the earners llabllhy shall be lurked to the extam trartspon according to applicable $ublux'11 Se wr-711 Iha contlniarw,tl rr�ia ahpmaitf a m be delvered to ate TOTAL
<br /> Provfdee by such emviworts-See NMFC item 172 irttamtadorts and national govemmen b', com.gn 'wundu ioxase an the cnnefpndr, 1 r1 s'o—be anaff Vier the CHARGES $
<br /> (3)Cemmoddies requiring special Or aceitona care a-anenlan in handling Or stowing regulations. � ��y shall rat make o}eat shwegnf.rnhwt peyrtrenl dr
<br /> must be so marred and packaged as to ensure sale transportaoon-Sea Section 2(e)o1 fm-Th and air othm l not charge PREIGHT CHARGES
<br /> hem 360.BIIs d Lading,Freghl BIAS and Statemerns 01 Charges we Sechon t(a)d qflr� rREIG+U PREPAID Crooke—i=v:
<br /> the Contract Terms and Coneidons for a list of such art ides. axaaat�Atan 11x1, ❑ eeamlk�r„
<br /> Signature IB,P,µ,n acorelpnr) right m oiwrLed
<br /> RECEIVED,subject to the daeafi®mrs arc muds 0 shed or,me care d fie is"of this aW of Lading, final on and as to each party at oily tints imereasd in a1 o any sad property.ma'everya wv to
<br /> the propdescribedydescribedave ed agin apparent good orderes-IIII noted(merges and condition of con- be padormed hmre dsr 1,.4:be suoled to all the bill of faring lents and condloons in no goverrmg ce,
<br /> terrm of packages rmlvrowrii.-?ked mnsgne4 and destined as Ind sated above rr"ch said cwmw sihcaDm on the date of stitom rtt.
<br /> (the word tamer being undertcnndhro
<br /> throughout this corrom:t as mmr,nerson g any pof corporation m Stripper hereby certe-es mat he is tamlliar whh all tete 10I rerma and conditions In the
<br /> possessior M the property unoortite coni agrees to carry to is usual piece of aehvy at said dean- governing claV1,fication an the and torts and conditions ars hereby agreed m by the shipper and
<br /> nation,it On its route,otherwise to deliver m SItamer on the route to sad oasmarwn.It is mato- accepted for hfmsalf and his assigns.
<br /> ally agreed as to each Cartier of all or any of,said property over all or any portion of mid mute to des-
<br /> • 'ER h4anteM LkkT*dS i Distrkt;Siern iliSko, CARRIER AdvaR 4d, Chemical Transport, inn,
<br /> t ) 1 :
<br /> PER _ i` 'f' ice( J { + _ PEIR �. t. r ;
<br /> DATE
<br /> Permanent post-office address of shipper, STYLE F375-3 02012 LABELMASMO (1,00)821-5808 www.labelmaster.com
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