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STRAIGHT BILL OF LADING
<br /> �1 0 -2 -X70
<br /> ORIGINAL- NOT NEGOTIABLE Shipper's No.
<br /> Carrier's No.
<br /> CARRIER: SCAC Date
<br /> T®: ;#1, , ; C_
<br /> A/v FROM: C:?irot!1tL !LL'
<br /> Consignee Shipper iq Z_ ,'-C_
<br /> Street Street
<br /> Destination zip Origin zip
<br /> Route: Vehicle Number U.S.DOT Hazmat Reg.No.
<br /> tip W
<br /> Kind of Packages,Description of Articles HAzARD
<br /> (IF HAZARDOUS MATERIALS-PROPER SHIPPING NAME) CLASS
<br /> I-/V
<br /> a
<br /> dale
<br /> V Fo I
<br /> i Z
<br /> Remit C.O.D.to: C.O.D. Amt: C. 0. D. FEE
<br /> Address: Prepaid
<br /> City: State: Zip: Collect
<br /> $
<br /> NOTE Where the rate is dependent on value,shippers are required to state specifically in vvilf�n, t110S.1-7oftf, c.ndfl..Jf1h'srhprmrt 1h. FREIGHT CHARGES
<br /> =rs no_sgror
<br /> ,
<br /> property
<br /> is
<br /> IS
<br /> n lbs fo"ox:;ng slatemsnl:
<br /> the agreed or declared value of the property. The agreed or declared value of the The IM 1.1-,,a&Mshat,"y of tNs Wiprt,1.hout pa)—nI of f.!ghl d 0.1h.,I.Mul chags'.
<br /> hereby specifically stated by the shipper to be not exceeding $ Perof C—g—) F]PREPAID[]COLLECT
<br /> RECEIVED,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,it applicable,otherwise to the rates,classifications and Wher,?the applicable tariff provision, 00
<br /> 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 ad order, limitation at the or, (lability NMFC Item 172),
<br /> except 'a 11"t,"t--is no release or value declaration by the
<br /> ers
<br /> except gadnoted(contents and condition of contents of packages unknown),marked,consigned,and destined as indicated below which said company(the word company being understood h %
<br /> through 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 sr ,'Prep sand t.1e rhrlp does not declare a value
<br /> throughout
<br /> I .the a R the lialblh�shall
<br /> ,:r,,d
<br /> (lability,t, be 1 "., Item
<br /> deliver 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 0 provided b,
<br /> to172.rr" he 'domi.pe
<br /> party at any if..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 California" I D 1%1 a shipments must comply
<br /> contained,including the conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. WithNMFC Item 173.
<br /> NOTE:LI.blI:ty 1.1.1tot! for I...-damage In this shipment may be applicable.See 49 U.S.C.14706(c)(1)(A)and(B)'
<br /> This is to c ify that the above-named materials are property classified,described,packaged,marked and labeled and or-19. 9-T,Me
<br /> in proper condition for transportation according to the applicable regulations of the Department of Transportation. it YES NO-FURNISHED BY CARRIER
<br /> Per J I DRIVERS SIGNATURE:
<br /> SHIPPER: LVK£( -�n__:1 Cle, Clvl ,�L;hl"r rr L CARRIER: tG
<br /> P DAT PER: DATE:
<br /> EMERGENCY RESPONSE 3 Monitored at all times the Hazardous Material is in transportation
<br /> TELEPHONE NUMBER: including storage incidental to transportation(172.604).
<br />
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