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4 <br />• • • StericCle SHIPPING PAPER <br /> • • y <br /> 0 Environmental Solutions <br /> DELIVERY DATE JO&# <br /> SHIPPER/CUSTOMER POINT OF CONTACT <br /> ADDRESS PHONE# <br /> CITY,STATE,ZIP <br /> Tj nily (;t; .37 7 <br /> CARRIER/TRANSPORTER PHONE# <br /> CONSIGNEE/FACILITY POINT OF CONTACT <br /> ADDRESS PHONE# <br /> CITY,STATE,ZIP <br /> Containers Total <br /> HM US DOT Description(Including Proper Shipping Name,Hazard Class:and!D Number) No T e Quantity UOM <br /> YP <br /> A U911IR-AL WST :ilio N? <br /> C <br /> D <br /> Special Handling Instruction and Additional Information: <br /> t -71 ej 3y 3d <br /> ()V <br /> Placards Provided YES NO <br /> SHIPPER'S CERTIFICATION:"I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, <br /> Dackaged,marked and labelled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations." <br /> I also certify that all times listed above are true and correct. <br />;SHIPPER)PRINT OR TYPf NAME SIGNATURE MONTH DAY YEAR <br /> x �r x 9 T 1. <br />;CARRIER/TRANSPORTER) RI OR TYPE NAME SIGNATURE MONTH DAY YEAR <br /> K x (:1 �"7 <br />;CONSIGNEE/FACILITY)PRINT OR TYPE NAME SIG URE MONTH DAY YEAVI <br /> K x <br /> CONSIGNEE <br />