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TRAIGHT BILL OF LADING - SHORT FORM - ORIGINAL - Not Negotiable SHIPPERS NUMBER S-165770 DATE: 09/26/2012 Shipper {from) Consignee (to) LAWRENCE LIVERMORE NATL LAB AERC CORRAL HOLLOW RD FOR NNSA * GT+ * 30677 HUNTWOOD AVE TRACY CA 9537E HAYWARD CA 94544- TECHNICAL CONTACT: JOB/WORK ORDER: CONTACT NAME: ROUTE: REFERENCE #: W120299432 Weight No. Description of Articles, Special Marks, and Exceptions(Subject to Shipping Type of Package HM (Subject to Correction) NMFC Item No. Class Rate correction) Units (fluorescent tubes) 138 lb 1 F/B DRUM on-Regulated waste, solid RECEIVE® DEC 0 4 2015 ENVIRONMENTAL HEALTH DEPARTMENT m as everd of damage or bes of ur 138 lb 1 IN THE EVENT OF EMERGENCY, TELEPHONE 1-(925)423-4205 - 2aHRs ,, .,hddescribedinNi.eGlofL-dbMwhlslne. LLNL Emergency Dispatch paaw 1-1theO^W"•theesni.,-aO W-OdNthe 63 kg «<Total Pieces ah1pp,r1 o l within two hours. Contact or Registrant Name, or Contract Number FREIGHT CHARGES Remarks: ARE: if this shipeent is to be delivered to the This shipment is for the U.S. Department of Energy and the actual Container 000261360 ® Prepaidtotal transportation charges paid to the carrier(s) by the consignor C12-06 ❑ Celled consignee.�tirout recourse on the consignor, or consignee are assignable to, and shall be reimbursed by, the U.S. Ship doc. S-165770 3rd Party the consignor shall sign the following Government and is subject to the terms and conditions set forth in the standard form of the U.S. Government Bill of lading and to any statement: The carrier shall not make delivery available special rates or charges (see Remarks) of this shipment without payment of freight (41 CFR 109-40.50 and 41 CFR 109-40.3) and all other lawful charges. R Yes ❑ No FOR: NNSA SECTION 13712/10721 RATES APPLY-TENDER NO. 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 rules that have been established by the carrier and are available to the shipper, on request. The property described above, in apparent good order, except as noted (contents and conditions of contents of packages unknown) marked, consigned and destined as shown herein, which said carrier (the word carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees to "try to Its usual place of delivery at said destination, if on its route, otherwise to deliver to another carrier on the route to said destination. it Is mutually agreed, unless otherwise specifically stated In Individually determined rates and contracts that have been agreed upon In writing between the carrier and shipper, 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 party at anytime Interested in all or any of said properly, that every service to be performed hereunder shall be subject to all the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth (1) In Uniform they are Freight Classification In effect on the date hereof, if this Is n , Sett forth n�theer shipment, classiflgtion2or tariff which governs the transportation classification thisrshhipmlentthis and the saidor e terms and conditionrrier shipment s are hereby agreed to by they are familiar with all terms and conditions of the said bill of lading, 9 p the shipper and accepted for him/herself and their assigns. Placards Required Label(s) applied This is to certify that the above named materials are propedy classed, described, packaged, Trailer Loaded b Shipper Driver marked, labeled, and are In proper condition for transportation according to the applicable y pPe regulations of the Department of Transportation (Applicable for Hazardous Materials Only) Freight Counted by. ❑ Shipper Shipper, Acting under contract with the ❑ Driver, Loose pieces U.S. Department of Energy: ❑ Driver, pallet said to contain ❑ Driver, pallets containing Carrier T+ / GO TRUCK LA CE PI ORE NATL LAB01 Vehicie/Car No: Per / Date vt Per KIMBERLY A_ FUGMANN Date 09/26/2012 Seal: TRANSPORTATION DEPARTMENT - PERMANENT POST OFFICE ADDRESS OF SHIPPER Page 1 of 1