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�n . STRAIGHT BILL OF LADING P Z J t Shippers No. ORIGINAL-NOT NEGOTIABLE $. L. Carrier's Na CARRIER: SCAC Date s t � G �s f TO: t:'I'�' t� TC. FROM: i �ltf � C )t t' �i c{ C -^ t Consignee - t !� Shipper f '� i, L Street € t r 1�r Street E 1 .. E e, p^14C LL Destination L �_�e (C' %' �t E,� C Zip ��` 0 Origin c% Zip a Route: j V ` uJYlber J.S.DOT Hazmat Reg.No. 3 F 1 . )i..' �7 �` G.l.,_, y��1t��.vy�' t'.- vL'-Cori"�''•� �' l ^W PSY_ s FF [ c to Z z =� Remit C.O.D.to: C.O.D. Amt: C. 0. D. FEE: 3 Prepaid Address: IIIA ' v Cit State: Zip: $ Collect $ ' o ® y. N NOTE-Where the rate is dependent on value,shippers are required to state specifically in writing sebiealas«ran7amr rl u:narem ala beael ar dtolnero:gnee,mature aneanme FREIGHT CHARGES tonsgrar.Na m^sgna hyl g m I ng Statemc�l a f the agreed or declared value of the property. The agreed or declared value of the property is me a�•.ms olmetad may_Imas ipmemwbrasp ymemonmgntema avarlawuwgs' PREPAID COLLECT hereby specifically stated by the shipper to be not exceeding $ Per (sig—reefo sig'.1 � ns specify a f<,a.,,r s 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 Where the applicable tariff prows o p ty -J - rules that have been established by the carrier and are available to the shipper,on request;and all applicable state and federal regulations;the Property described below,in apparent good order, limitation of the carriers liability NMFC Item y I i y .'-- except t as noted contents and condition of contents of acka es unknown,marked,const ned,and destined as indicated below which said company(the word company being understood if there is no release or value declaration by the p ( p g ) 9 shipper,and the shipper does not declare a value throughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to delivery at said destination,if on its route,or otherwise to or release the carriers liability,thaty liabilityNMFC shall -. deliver to another carrier on the route to said destination.It is mutually agreed 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 be limited to the extern provided bItem a y party at any time interested in all or any of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law,whether printed or written,herein 172.California intrastate shipments must comply o `^ contained,including the conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. with NMFC Item 173. NOTE Llablllty Limitation for loss or damage In this ahlp—at may be appilcablo.Sea 49 U.S.C.14706f.X'A'and(e). o, This s to cert�ty that the abovenamed materials are p operty classified,descried,packaged marked and labolad and are , YES NO-FURNISHED BY CARRIER .T In proper oentl Non for transportation according t the appl caUe regulations of the Department of Transportation. I .� � CEMW DRIVERS SIGNATURE: + Far t r.. d O Ot SHIPPER: CARRIER: bQ o PER: DATE: 3 PER: /1 DATE: EMERGENCY RESPONSEMonitored at all tinnet the Hazardous Material is in transportation including storage incidental to transportation(172.604). TELEPHONE NUMBER: