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Gross: <br />Tare: <br />Net: <br />Truck: <br />Customer: <br />E.A1RMEAD LANDFILL <br />21739 ROAD 19 <br />CHOWCI-IILLA, CA 93610 <br />P1-1 (559) 665-1310 <br />9E68840 <br />0400000137/ALL ENVIRONMENTAL <br />Comment: <br />0 5/7 9/20 lel <br />Ticket: 1117538 <br />Date: 11/16/2021 <br />Time: 14:53:17- 15:14:28 <br />Scale <br />56540 LB In Scale 1 <br />36620 LB Out Scale I <br />19920 LB <br />SHIPPER CARRIER <br />PER PER <br />Oen,' *isTsrPrethdin or <br />172. Subpart C-Shipping Papers. Such description consists of the following per Sec <br />tons 172 201 (Hazardous Material Table) and Sections 172.202 iinii 172 203 <br />Proper slopping name, heforaOus class. UN identification number, [elderly group <br />and Subsekel classleSi. <br />,,_'fl cur TObt! <br />or • damage In this shipmen <br />may be applicable. See 4! <br />United States Code, Section <br />14706(c (1 )(A) and (81. <br />Transportation Regulations go,errang the trensportetianiatheardrus meterlele The 1.9e•el1thie -column <br />an optional mnthun for identifying ilrirzerdoies materials on Bills of Lading per 172.201iall1) (rid ol Tele 49 <br />Code of Federal Regulations Also when shipping hazardous materials. the shipper's certification statement <br />prescribed in section 172.204(a) of the Federal Regulations as indicated on the 9111 of Lading does apply, <br />unless a specific exception from the requirement is privided in the Regulation for a particular material. <br />STRAIGHT BILL OF LADING — SHORT FORM A-83876, 9013, 9014 T-3841, [3841, 3843 <br />S8167 <br />Origin <br /> <br />Materials & Services <br /> <br />Quantity Unit <br /> <br />Dispatch Order: ALL-0029 <br />SANJ/SAN JUAQUIN COUNTY COVER/DIRT COVER <br /> <br />9.96 ton <br /> <br />VP0,) <br /> <br />Driver: <br /> <br />Deputy Weighmaster: <br /> <br />rts et,..,‘ re la <br /> <br />Susan Mann <br /> <br />Carrier acknowledges receipt of packages and any required placards. Carrier certifies emergency response inforn <br />bon was made available and/or carrier has the U.S. Department of 'transportation emergency response guidebc <br />or equivalent documentation in the vehicle. Property described above is received in good order, except as noted <br />This is to certify that the above named materials are properly classified, packaged, <br />marked, and labeled, and are in proper condition for transportation according to the <br />applicable regulations of the U.S. Department of Transportation. <br /> <br />Scanned with CamScanner