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This Memorandum Is an acKnowleagment mat a bill or Lai nas peen issues ane Is not urlginal <br /> Bill 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 /> A0Vk SEE) CHENCAL TRAPO (, MC. Date <br /> Page of <br /> {Name of carrier)aOv11 (SLAC) <br /> .� t on Dery shipments,the letters'COD'must appear before consignae's name or as otherwise provided In hem 430,Sac.t. FROM: &� V�Se bol Dk Pe L(Shit NO) <br /> Tv: � U Gel"� Shipper <br /> Consignee 17"TYOWAS St <br /> 2274 Louise Ave Street <br /> Rufacca CA 96331 <br /> Street City state Zip Code <br /> CA $533$ W225 rA-tea TI <br /> City menteca State Tip Code 95336 <br /> � <br /> 24 hr.Emergency Contact Tel.No. <br /> Route Vehicle <br /> Number <br /> No.of Units BASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES <br /> &ContainGallons,,etc.}er Type UN or NA Number,Proper Shipping Name,Hazard Class,Packing Group {weight, it {Subject Correctionn)) RATE 1,or Carrier <br /> Use Only) <br /> i,r j" UX3291, RAV"e M ft&CAt WaSte, K.01 S, <br /> j`- ate' Wase ,6-2,PW ✓ f <br /> PLACARDS TENDERED: YES NO 0 REMIT <br /> Nota—(t Where the rete Is dependent on value,shippers are required to state C.O.D.TO: <br /> J �° I hereby dant a that the and <br /> acs n vas ApD SS <br /> speaficalN in writing me agreed or declared value oI the property,as fellows'fie consignment are fully end socumtefy �- _ F <br /> agreed or declared value of rw property is hereby specifically slated by the shipper to described all by the proper shipPn9 ^ - '- C.O.D.FEE: <br /> he nm esceedirg per name and are classified, packaged DOD __ Amt. r"� PREPAID ❑ <br /> (2)Where the applicable tadrf provislorvs specify a limitation of the carriers rrahgity ahem,, marked and labelledlplacardad,and are - � COLLECT ❑ $ <br /> a release or a value declaretion by the shipper and the shipper does not release in all respects in proper condition for �`- <br /> the tamers liability or declare s value,the tamers liability snail be limited to the extort trenspnd according to applicable Subtest to Section 7 d the tonsil rret-iL this sriPmerrt a n be deemed to the TOTAL <br /> provided by such provisions.See NMFC Item 172. international and national govemmertml co"s'gnee without recourse on Ire r�onsoy <br /> lfin _the consignor shall sign rhe CHARGES $ <br /> (a)Commodities requimtg special or addidond care or attention in handling or stowing regulations <br /> ldlownp s am w c f' ti <br /> must he sn marked and Taw corner shall nct mass ddrve7 of trio ah' wtlhoul paymem d <br /> packagatl as to ensure sale transportation.See Section 2(e)ofFREIGHT CHARGES <br /> lrerght and all ottteylawail chargee. <br /> item 360,Hills o1 L.etling,Freight Slls and Statements of Charges end 5eotlon 1(aJ of _- FRE1Cfir PPEPAfD CYrerM bd,raarerges <br /> the Contract Terms;and Conditions for a list of such articles, Signature "' �� —lo ca <br /> (agrenna wdvegmr} '�,.� nghtwrlwGatO cored <br /> RECEIVED,subject to the dassifirabons and fermis in efiad on the date d the issued this&II of Lading, tinabon anti as to each pai at any time interested in all a any said property,that every saI to <br /> the property described above in apperare goad order,ee W as noted(Contents and condition of con- be performed hereunder shall be subject to all the bill of lading terns and conditions In the govemng dos. <br /> tents of packages unknown;,marked consigned,and deednad as indicated above which said carrier clncaom,on the dl of shipmem. <br /> (the ward carder being understood throughout the contract as meaning any person or oerporetfon In Shipper hereby codifies that he is tarNOar with all the lading tears and nonditions in the <br /> possession o(ma properly tndarths contract)agrees Io carrytads usual place of deliveryal said deep governing nlassificalion and the said terms and conditions are hereby agreed to by the shipper and <br /> nation,K on its route.otherwise to deliver to another tamer onthe route to said dostination.It is ml accepted for himsec and his assigns. <br /> I agreed as to each canter of all or any of,said property over all or any portion of said MOW to des. <br /> PER Mi11 I.`et i�"I Sem »� tri l� t CARRIER QdVanC. xr. !wl I <br /> PER ! � _r PER <br /> t R <br /> DATE ,.{— <br /> Permanent post-office address of shipper. ,.d� STYLE F375-3 02612 LAsEPIASfER® (804)621-5808 ..labelmeater.com <br /> ,�L{,p�t�PPMiH]ON REGYR£a PAPER <br /> ��J usrr¢soreEu+Trac I SOY IN1C <br />