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This Shipping Order must be legibly filled in,in Ink,in Indelible Pencil,or in <br /> Carbon,and retained by the Agent, <br /> Shipper No. 19 2 7 4 <br /> Carrier No. <br /> Pap I of IDate 1,1566"", <br /> (Name of carrier) (—SCAC) <br /> hr on calima on ce"i"ry*0110a.f*bbwOOD'MM Wpm babragwWWw'I mmoraw—mw pivy"In hvn4W Seal. <br /> FWW: <br /> Shipper HILL BROTHERS CHEMICAL CO. <br /> TO: <br /> A <br /> Corsa Iw" Street LJID Avz <br /> Stir" C4 s0 T K c <br /> Stat,i p4 Zip Code` <br /> cRye, Su"K r\ ZlpCodo2-� 24 hr.Emergency Contact Tel.No. CHEMTREC 1-800-424-9300 <br /> Vehicle <br /> Roulle Number <br /> No.of uniteASIC DESCRIPTION TOTAL QUANTITY WEIGHT CHARGES <br /> AL <br /> 4;r. COftnerTy" HM Proper Name.Hazard Claw, (Weight,Volurnii, (Subject to RATE (For Carrier <br /> 9kWMk&on Number(UN or NA),Packing(croup,per 172.101,172.202,172-103 aqj&.�aw.) Correction) Use Only) <br /> —1 <br /> PL, <br /> UN 1003.AmmoMill,AphydWS, S <br /> Ammmin <br /> JI <br /> 7- <br /> z. <br /> 51" <br /> PLACARDS TENDERED: YES IM NO Q REMIT <br /> NM—(1)WhM TO nFIS h 60PWW <br /> Kt On VWu*,1010POare M <br /> W "r8d In state I h0ribbY d"re dUt t"contents of this C.O.D.TO:ADDPIESS <br /> ffL iamidftally In-&Q ft mWafed or decared 4WY tie property..fali'Ria coirmip—M am"and—alaty dawbW <br /> 1Iw1dt1tNh0W OW"by W*WOW WVPPkV nUm aW are C.O.D.FEE: <br /> 094.1"ifid, patkagad. marked and PREPAID 0 <br /> tote not ftowwo-Per'` spread or CeLlered wkreNme COD ":$ COLLECT 0 $ <br /> M V00 Ire w0two w"nivions WWN a iriftow aam smartWdmy IWW-NPL-Csrciod."eri,e&I—P-M in A <br /> applicable International end national SW�W to Secftn 7 of Ine conormorg,K ma, m,W t. <br /> =4 nalem w a vskm 6161MOM by Me 099 and ft GhWW 6M not wow oondhion Im vsrApDr, Powiding <br /> to <br /> ft Dandies wb"or declare■@,faw,me 06-4"Way W*be Inmaid 11 owwrewital daii—ed 10 the 00nallI100,wd*A riico—Ii on tre ow"nor.re TOTAL <br /> negmaw <br /> 1*4-M MAW bY 89h PVM404.Sft NWC U.172, —Vrw 8hall&9n the following oaii,,rani: <br /> (3)Cornmodidea niquidna BpKW or am*wW ere or mwrw in nanding or The Carrie'Pah ncx nuke(Wimy al Inia�iprrrq ftrW CHARGES $ <br /> paytrant in"4nt ard am new wmnar,.. <br /> SWA FREIGHT CHARGES <br /> Seca.2(.1 o; FREIOHT PREPAJD Ch.Ck 1). <br /> man,No.8-fil or L14q.Freight eft 6w swisin"oi chno ~b.1d <br /> &4 Sai 1(1)of to Owdrid Teirns and Condidone for a Ito of WM V&**. ddeeG <br /> =d'ifoad <br /> m`*"ch""'Al"y 6"."f—tfid In U=Y=�WXItLthd <br /> RECEIVED,.0ni&W ftfa"Acisii—.4 ,ft n ft dina&bv�fi of this 91161 Lading,sot aensnr dtlrNaptn arta <br /> dP",4*,fibm =�—i—i cenditen of—twhi.or pidmom-�ei --I b. Wft'..1 a to or Jd'le`nn,and g <br /> .k d, —V Mid acinar"wd—rio b"rndirftfid d—vw 09-1. <br /> PtYaMlm w-PV.M labr tna o,r,i ' ——~.n—0.11.1.w d-Wrfd <br /> — <br /> tinal1w,M on rm",cown'I"wM sal <br /> —iW""am Na" h~ <br /> M. ddl—1.—1--n- 1.ran.b w Na1h.= In. WOW ler 1h.1 ane ee Iia <br /> SHIPPER 0 v 117S CARRIER <br /> PER PER <br /> 42 <br /> 7-4;1 15;1 DATE <br /> -1 , r k; ' Z 'kFT -AT <br />