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Straight Bill of Lading-Short Form-Original-Not Negotiable Shipper's Number. S-263120 Date: 12/17/2020
<br /> Shier(from) Consignee (to)
<br /> Lawrence Livermore NATL ON BEHALF OF THE US NNSA Clean Harbors Environmental Services, Inc.
<br /> Corral Hollow Rd 1020 Berryessa Rd. *CLHA*
<br /> Tracy, CA 95376 San Jose, CA 95133
<br /> Technical Contact: Contact Name• Customer Service
<br /> Job/Work order. Project 32150 Task OPS.RHWM.DISP (925) 423-6541
<br /> Route: Reference 9: LXE0641
<br /> No, Weight
<br /> Shipping Type of Package HM Description of Articles,Special Marks,and Exceptions NMFC Item No. Class Rate (Subject to
<br /> Units (Subject to Correction) Correction)
<br /> 1 TRUCK, Non-regulated waste, liquid (condensate water) (DOP0099-BB) Z?75 r
<br /> TANKER 'i
<br /> 925 423-4205 In tho event of d—go o.lim of the material dncdbed In
<br /> 1 «Total Pieces 1N THE EVENT OF AN EMERGENCY,TELEPHONE ( } 24 HRS chi.Bill of lading while In thep.—ion of the wrd.r,the z� J
<br /> Contact or Registrant Name,or Contract Number LLNL Emergency Dispatch .arderagreeet.n.11fy th..hipper/. Jgn.rwifhh,two
<br /> h.um
<br /> FREIGHT CHARGES If this shipment is to be delivered to the This shipment is on behalf of the U.S.Department of f nergy and the actua,total Remarks.
<br /> ARE: consignee without recourse on the transportation charges paid to the carner(s)by the consignor or consignee are
<br /> consignor.the consignor shall sign the assignable to,and shall be reimbursed by,the U.S.Government and is subject to SJNH21-03 r shipping document S-263120: Reference
<br /> IM Prepaid following statement-The carrier shall not the terms and conditions set forth n the standard form of the U S Government release number LXF-0641 on invoice. Q00301101,
<br /> ❑ Collect make delivery of this shipment wltho.t Bill of Lading and to any available special rates or charges Q00324130, Q00300519, Q00300518, 000324131,(200301118
<br /> ❑ 3rd Party payment of freight anti all rather I,twfid 141 CFR 109-40 SO and 41 CFR 109-40 3) sQ Zo 06�3IS7S
<br /> charges
<br /> x❑ Yes ❑ No
<br /> (see Remarks) U-S, NNSA
<br /> SECTION 13712/10721 RATES APPLY-TENDER NO
<br /> Received,subject to individually determined rates or contracts that have been agreed upon In writing between the carrier and shipper.If applicable,otherwise to the rates,classifications and rules that have been established by the carrier and
<br /> are available to the shipper,on request. The property described above,in apparent good order,except as noted(contents and conditions of contents of packages unknown)marked,consigned and destined as shown herein,which said
<br /> carrier(the word Carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to its usual place of delivery at said destination,if an Its route,
<br /> otherwise to deliver to another carrier on the route to said destination. It Is mutually agreed,unless otherwise specifically stated In Individually determined rates and contracts that have been agreed upon in writing between the carrier and
<br /> shipper,as to each carrier of all or any of said property over all or any portion of said route to destination,and as to each party at anytime interested in all or any of said property,that every service to be performed hereunder shall be subject
<br /> to all the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth(1)in Uniform Freight Classification in effect on the date hereof,If this is a rail or rail water shipment,or(2)in the applicable motor carrier classification
<br /> or tariff if this Is a motor carrier shipment. Shipper hereby certifies they are familiar with all terms and conditions of the said bill of lading,set forth in the classification or tariff which governs the transportation of this shipment,and the said
<br /> terms and conditions are hereby agreed to by the shipper and accepted for him/herself and their assigns.
<br /> This Is to certify that the above named materials are properly classified,described,packaged, Trailer Leaded by: ❑x Shipper ❑ Driver Placards Required:
<br /> marked,labeled,and are in proper r ondit'nn for trampottation acro(d'ng to the applicab'e
<br /> regulations of the Department of Transportation(Applicable for Hazardous Materials Only) Freight Counted by-
<br /> 17 Shipper
<br /> Shipper,acting under contract DE-AC52-07NA27344 with the ❑ Driver,Loose pieces
<br /> U.S.Department of Energy: ❑ Driver.pallet said to contain22Uao
<br /> 1
<br /> LAWRENCE LIVERMORE NATL LAB ON BEHALF OF THE U.S. NNSA ❑ Driver,pallets containing Carr er
<br /> CLHA / Clean Harba EnvlrOtlntental Services, In
<br /> Scott A. Gra , Sh' C dinator Vehicle/Car No:
<br /> Pu- Date
<br /> Per Date 12/21/2020 Seal.
<br /> TRANSPORTATION DEPARTMENT-PERMANENT ST OFFICE ADI)RESS OF SHIPPER PAGE 1 OF 1
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