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;TRAIGHT BILL OF LADING - SHORT FORM - ORIGINAL - Not Negotiable SHIPPERSNUMBER S - 173889 DATE: 06/06/2013 Shipper (from) LAWRENCE LIVERMORE NAiL LAB FOR NNSA Consignee (to) CLEAN HARBORS ENVIRONMENTAL SERVICES * CORRAL HOLLOW ROAD C LHA 10218ERRYESSA ROAD TRACY CA 95376 SAN )OSE CA 95133 TECHNICAL CONTACT: JOBWORK ORDER: Project 32149 Task 5325.10 CONTACT NAME: ROUTE REFERENCEfi No. Description *(Articles, Special Marks, and Exoeptiona NMFC Item No. Class Rate Weight (Subject Shipping Units Type of Package HM (Subject to Correction) --- Non-regulated waste, solid (resin beads) (DOP0066 - 1) correction) 1 DRUM 3671b 1 DRUM Non-regulated waste, solid (non -friable asbestos) (DOP0066 - 1) 78 lb 1 DRUM Ion -regulated waste, solid (fluorescent light bulbs) (DOP0167-1) 271b 2 DRUM on -regulated waste, solid (fluorescent tubes) (DOP0165-1)RECEIVED Non-regulated waste, solid (fluorescent tubes) (DOP016S-1) lC. � � � 2101b 2671 7 BOX DEC 012015 ENVIRON ENTAL HEALTH DE ARTMENT 12 IN THE EVENT OF EMERGENCY,TELEPHONE 1-(925)423-4205 24 HRS ��tbol �y,thhaam.l�y,orpilil 1,0091b «<Tolal Pieces Contact or Registrant Name, or Contract Number oor.��nara*w.n»o^k�tq>:..�e^aarw tMpe„� tlg ,,. ttdntae mere. 461 kg FREIGHT CHARGES I Remarks: ARE: ® Prepaid er this thiPent le to tx Oetivered to the pment is for the U.S.cepartreent of Ener and the actual This shi Energy charges paid to the carriers) by the consignor SJMI13-03 2hipping U S -113889 Reference release number L[.R0797 on invoice. Col len ctnwslgnee without r"mrst m the carttlgrar, total transportation ar consignee are assignable ta, and shall be reimbursed by the u.5. Government and is subject to the terms and conditions set forth 1n see attached packing list for containers numbers. o 3rUPany the contt9— shall s,9n the Following the standard form of the u. S.Government Bill of Lading and to any statement rhe carrier shall not nate delivery available special rates or charges (see Remarks) )algal or this thlpeetic without paymtnt of )alga (41 CFR 109.40.50 and 41 CFR 109-40.1) (41 t and all ether lase) thargeS p Yes ❑ NO i 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, an request. The property described above, in apparent good order, except as noted (contents and conditions of consents of packages unknown) marked, consigned and destined as shown herein, which sold 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 carry to its usual place of delivery at sold destination, If on Its route, otherwise to deliver to another carrier on the route to sold 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 211 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 property. that every service to be performed hereunder shall be subject to aR the terms and conditions of the Uniform Domestic Straight Bill of Lading set forth (1) In Uniform Freight Classlfccalion in effect on the date hereof, If this is ara0 or rail -water shipment, or (2) In the applicable motor carrier classification or tariff If this is a motor carrier shipment. Shlppar hereby certifies they are familiar with all terms and conditions of the sold bill of lading, set forth In the ctasslficallon or tariff which governs the transportation of this shlpment, and the said terms and conditions are hereby agreed to by the shipper and accepted for hlmrhersetf and their assigns. This is to certify that the above named materials are property daissirted, described, packaged- Placards Required Label(s) applied markK labeled, and aro in proper condition for iransportatton according $0 the applicable Trader Loaded by- Q Stopper ❑ Drive regulations of the Department of Transportation (Applicable for Hazardous Materials Only) Freight Counted by G Slapper ❑ Diver. Loose pieces Shipper, Acting under contract F I with the U.S. Depai in neni of Energy: G Diver- pallet said to contain []Driver- pellets containing Garner CLHA / CLEANRBORS ENVIRON LAWRENCE LIVERKORE HATL LAB FOR NNSA PAP Vehicle/Car No- �Y Per Dale Per SCOTT A. GRAHAM Date � � / Seal TRANSPORTATION DEPARTMENT - PrRMANENT POST OFFICE ADDRESS OF SHIPPER Page 1 of 2