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Delivery Ticket CUSTOMER COPY <br /> IZOMPLETE <br /> f f lllf f II111 Illff�Illl Illll flll!11lf l!Illl lllf l VIII Illlf Illfl Ilfl IIlf <br /> WE, LDERS SUPPLY I <br /> Q COMPLETE WELDERS SUPPLY INC. 1 Illllll Illi 1IIll Illll Illll Illi llll <br /> L1549 N. BROADWAY AVENUE 668566337 <br /> Stockton CA 95205 <br /> B 209-462-3086 <br /> Y Cust®mer 01994 <br /> Order 0040924371-00 <br /> H JIM THORPE OIL, INC <br /> I 3 515 NEWTON ROAD <br /> P Order Date <br /> T STOCKTON CA 95203 Page 001 pF 041 <br /> 209-329-5481 <br /> Name JIM THORPE OIL, INC Territory 4a0DD3 Snip via PICKUP Initials pC <br /> Rel# Phone 209-329-5481 Salesperson QCCEAS Other Zone 06 UPSZone Q Order Type CC <br /> won Branch 000003 ODlippa <br /> Gas P10# PREPAID Route Date/71me 17-JAN-24 08:Q3AM <br /> status SEL Ship Date 01/17/24 Username <br /> danielc <br /> QTY H ID DESCRIPTION LINE QTy CYLI ERS OLUME/ UNIT EXTENDED <br /> SHIPPED UOM ITEM M NUMBER HAZARD CLASS NO. NUMBER ORDERED SHIP REIN IGHT AMOUNT AMOUNT <br /> ******* COD ORDER ******** <br /> ** Location: 3 ** <br /> 70 LB X UN 1845, DRY ICE, 9, PG III 1 DI PBK 7 D 70 1.990000 X39.30 T' <br /> (DRY ICE PELLET BULK) 04 - <br /> INTENTIONAL MISUSE OF DRY ICE <br /> MAY BE HARMFUL OR FATAL. <br /> *** HANDLE WITH CARE *** <br /> The temperature of dry ice is <br /> -109 degrees F. Cold enough to <br /> freeze skin cells and cause an <br /> injury similar to a burn. <br /> Always handle dry ice with <br /> protective gloves. A Safety <br /> - Brochure is available. <br /> ---- ---- - ' <br /> - --- ' QTY BINIGHT -------- ---------- - <br /> 1 EA HAZARDOUS MATERIAL HANDLING FEE 2 SUR HAZFEE BKORD LOC0 .00 13.93 13.93 N <br /> S btotal 153.23 j <br /> X 10.80 <br /> tat Sale 164.03 <br /> D Rcvd 164.03 <br /> VISA ****8144 THORPE/MARTIN <br /> En ry; Ma al <br /> Mercha t ID: 4 4506062D30 Terminal ID: 45060642 3023 Transaction ID; 06449L948 Au 02149A <br /> Trx t e; P E- UTH Hostresponsecode: CC <br /> My si natu e n this dnrii nt indicates I agree to a the credit card total acco ding rd is er ac ement —I <br /> This is to certify that the above named materials are properly FOR CHEMICAL EMERGENCY <br /> classified, described, packaged, marked and labeled, and are in Spill, teak, Fire, Exposure or Accident <br /> proper condition for transportation according to the applicable CALL CHEMTREC DAY OR NIGHT <br /> regulations of the Department of Transportation. 800-424-9300 <br /> Authorized Signature nk <br /> Received by <br />