|
STRAIGHT BILL OF LADING - SHORT FORM
<br />Shipper (from)
<br />LAWRENCE LIVERMORE NATL LAB FOR NNSA
<br />CORRAL HOLLOW ROAD
<br />TRACY CA 95376 -
<br />TECHNICAL CONTACT:
<br />JOBANORK ORDER: Protect 32149 Task 5325-10
<br />ROUTE'
<br />No.
<br />Shipping Type of Package HM
<br />Units
<br />ORIGINAL - Not Negotiable SHIPPERSNUMBER S-179476 DATE:
<br />- - — - - Consignee (to)
<br />ICLEAN HARBORS ENVIRONMENTAL SERVICES -
<br />:1021 BERRYESSA ROAD
<br />!SAN JOSE CA 95133 -
<br />!CONTACT NAME:
<br />REFERENCE 3!:_
<br />Description of Articles, Special Marks, and Exceptions
<br />(Subject to Correction)
<br />1 PALLET Non-regulated waste, solid (fluorescent tubes) (DCP0165-1)
<br />1 F/B DRUM Non-regulated waste, solid (fluorescent tubes) (DOP0165-1)
<br />2 METAL DRUM Non-regulated waste, solid (broken CRTs) (DOP0174-1)
<br />4 IN THE EVENT OF EMERGENCY, TELEPHONE 1-(925)423-4205
<br />—Total Pieces Contact or Registrant Name, or Contract Number LLNL Emergency Dispatch
<br />NMFC Item No.
<br />12/05/2013 ..
<br />Class - Rale
<br />*GT+*
<br />Weight —
<br />(Subject to
<br />correction)
<br />182 lbs
<br />FREIGHT CHARGES Remarks:
<br />ARE: if this shipment +s to be dell vexed to the This shipment is for the U.S. Department of Energ9y and the actual S.1 UN14-02 shipping tl S - 179476
<br />X Prepaid total transportation char es paid to the carriers) by the consignor Relference release number LSJO042 on invoice.
<br />consignee without recourse on the consignor.
<br />Collect or consignee are assignah a to, and shall be reimbursed by, the u. s. See attached packing list for containers numbers.
<br />3rd Party the consignor shaft sign the fellowsng j Government and is subject to the terms and conditions set Forth in i
<br />the standard form of the u.s. Government Bill of Lading and to any
<br />statment: The carrier Shan not wake delivery available special rates or charges
<br />(see Remarks) of this shipment.rithout payment of freight (41 LFR 109-40.50 and dl CFR 109-40.3)
<br />and an other la.rful charges. g Yes No
<br />I
<br />SECTION 13712/10721 RATES APPLY - TENDER NO.
<br />Received, subject to individually determined rales 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
<br />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,
<br />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
<br />to carry 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
<br />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
<br />party at anytime Interested In all or any of said property, 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
<br />Uniform Freight Classification in effect on the date hereof, If this Is a rail or rail water shipment, or (2) In the applicable motor carrier classification or tariff If this Is a motor carrier shipment Shipper hereby certifies
<br />they are familiar with all terms and conditions of the said bill of lading, set forth in the classification or tariff which governs the transportation of this shipment, and the said terms and conditions are hereby agreed to by
<br />the shipper and accepted for himtherself and their assigns.
<br />This is to certify that the above named materials are properly classified, described. packaged, Placards Required Label(s) applied
<br />marked, labeled, and are in proper condition for transportation according to the applicable Trailer Loaded by: i Shipper _1 Driver
<br />regulations of the Department of Transportation (Applicable for Hazardous Materials Only)
<br />Shipper, Acting under contract
<br />U.S. Department of Energy:
<br />Freight Counted by:
<br />1-! Shipper
<br />with the [ `Driver, Loose pieces
<br />Driver, pallet said to contain
<br />[- Driver, pallets containing
<br />ON BEHALF OF NN
<br />Per K�LY - - Date 12/05/2013
<br />TRANSPORTATION DEPARTMENT - PERMANENT POST OFFICE ADDRESS OF SHIPPER
<br />Vehicle/Car No:
<br />Seal:
<br />Page 1 of 2
<br />Carrier GT+ J GOVERNMENT TRUCK
<br />Pe ` Date
<br />93 1b
<br />93 1b
<br />•t
<br />RECEIV:D
<br />I
<br />C'EC 0 4 2015
<br />ENVIRONMENTAL
<br />EALTH DEPARTME
<br />(L_
<br />24 HRS Iron erlet dswbb d Iclarnan this ori lading while fn the
<br />_
<br />368 lb1
<br />off
<br />p...nalon of the ca.dv, the urns. agrees to notify the
<br />169 k
<br />9
<br />an�pparfcanflgnor wlthln Iwo fwure
<br />FREIGHT CHARGES Remarks:
<br />ARE: if this shipment +s to be dell vexed to the This shipment is for the U.S. Department of Energ9y and the actual S.1 UN14-02 shipping tl S - 179476
<br />X Prepaid total transportation char es paid to the carriers) by the consignor Relference release number LSJO042 on invoice.
<br />consignee without recourse on the consignor.
<br />Collect or consignee are assignah a to, and shall be reimbursed by, the u. s. See attached packing list for containers numbers.
<br />3rd Party the consignor shaft sign the fellowsng j Government and is subject to the terms and conditions set Forth in i
<br />the standard form of the u.s. Government Bill of Lading and to any
<br />statment: The carrier Shan not wake delivery available special rates or charges
<br />(see Remarks) of this shipment.rithout payment of freight (41 LFR 109-40.50 and dl CFR 109-40.3)
<br />and an other la.rful charges. g Yes No
<br />I
<br />SECTION 13712/10721 RATES APPLY - TENDER NO.
<br />Received, subject to individually determined rales 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
<br />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,
<br />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
<br />to carry 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
<br />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
<br />party at anytime Interested In all or any of said property, 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
<br />Uniform Freight Classification in effect on the date hereof, If this Is a rail or rail water shipment, or (2) In the applicable motor carrier classification or tariff If this Is a motor carrier shipment Shipper hereby certifies
<br />they are familiar with all terms and conditions of the said bill of lading, set forth in the classification or tariff which governs the transportation of this shipment, and the said terms and conditions are hereby agreed to by
<br />the shipper and accepted for himtherself and their assigns.
<br />This is to certify that the above named materials are properly classified, described. packaged, Placards Required Label(s) applied
<br />marked, labeled, and are in proper condition for transportation according to the applicable Trailer Loaded by: i Shipper _1 Driver
<br />regulations of the Department of Transportation (Applicable for Hazardous Materials Only)
<br />Shipper, Acting under contract
<br />U.S. Department of Energy:
<br />Freight Counted by:
<br />1-! Shipper
<br />with the [ `Driver, Loose pieces
<br />Driver, pallet said to contain
<br />[- Driver, pallets containing
<br />ON BEHALF OF NN
<br />Per K�LY - - Date 12/05/2013
<br />TRANSPORTATION DEPARTMENT - PERMANENT POST OFFICE ADDRESS OF SHIPPER
<br />Vehicle/Car No:
<br />Seal:
<br />Page 1 of 2
<br />Carrier GT+ J GOVERNMENT TRUCK
<br />Pe ` Date
<br />
|