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�I _ r__.y n -s- s --1 _ KI -4. #fe,.. t"k1a Chinnar'c iJiomkser_ S-192159 Date: 2/11/2015 alraignc our Us sawnsy-alsv.s- Shipper (frorn) Consignee (to) LAWRENCE LIVERMORE NAIL LRA FOR NNSA clean Barbara P.nvir rurtental Services, Inc. *^T HA* *CLHA* CORRAL HOLLOH ROAD 1021 Barryossa Road CA 95376 San Jose, CR 95133 Technical Contact: Contact Name: job/WOrkOrder. Projoct 32150 Task OPS.RHWH.SD Route: 1 Reference N: Weight No, Description of Artkles. Special Marks, and Exceptions Shipping Type of Package HM NMFC Teem Na. Clara Rate (Subject to (Subject to Conit+:tlon) Correction) !bets 3 DRUM, 85 -GAL Nan -regulated waste, solid (fluorescent straight tubes) (DOP0165-1) 392 lb I E® D_C04205 EN IRONMENTAL HEALJH DEPAR MENT IN THE EVENT OF AN EMERGENCY, TELEPHONE (925) 423-4205 -24 HRS a w.nt et d.m.e... em.n ra. matwW wwy.e,n on. saes iwi".dd, I. d,r --Wu -1 dr card.,. dr 392 lb T 3 c<Total Fitter Contact or Registrant Name. or Comracl Number LLNL Emergency Dispatch � caw.,amrer rt-,NreMr10"'be°,.dv..— 1 178 kg FREIGHT CHARGES N this shipment is to be delivered to the This shipment is tot the US. Department of Energy and the actual total Remarks: ARE cortvgnee without recourse on the transportation charges paid to the carner(s) by the consignor or consignee are SJUNIS-02 ; shipping document S - 192159; corwgnor, the constgnor shall sign the assignable to, and shall be reimbursed by. the U.S. Government and is subject Reference release number LBJ0236 on invoice; 0 Prepaid following statement The carrier shag not to the terms and conditions set forth in the standard farm of the US. Seo attar -hod packing list for container numbers. ❑ CoBect make delivery of this shipment without Government Bili of lading and to any available special rates or charges 34 Party payment of freight and all other lawful (41 CFR 109-00.50 and 41 CFR 109-40.31 changtL © Yes ❑ No (see Remarks) U.S. DOE SECTION 13712/10721 RATES APPLY -TENDER NO. Recefeed, subject to individually determined rates or contracts that have been agreed upon In writing between the ander and shipper, It appRable, otherwise to the rates, classifications and rules that have been established by the anter and are avalWa to the shipper. on request The property described above. in apparent good order. except as noted (contents and cooditiom of contents of packages urslatown) marked conslgntd and destined as shown hereln, which said carrier (the word amen Ming 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 said doWnistl n, If on its route, otherwise to deliver to another cardir on the route to said destination. his ffwhsapy agreed, unless otherwise specifically stated in individually determined rates and conbacts that have been agreed upon In writing between the carrier and shipper, as to each artier of a0 or any of said property over an or any portion of said route to destInathoo, and as to each party at anytime interested In all or arty of said property, that every service to be performed hereunder shall be subject to a0 the temis and conditions of the Uniform Domestic Slraigftt Bill of lading set forth (1) In Uniform Freight Wssifiation in effect an the date hereof, If this is a rail or nil -water shipment or (2) to tire appliable motor carrier classification or tariff If this is a malar carrier shtprmnt. Shipper hereby certifies they aro familia r with all terms and conditions of the said big of lad Ing, set forth in the classification or tariff which governs the transportation of" shipment. and the said terms and conditions are beMsy agreed to by the shipper and accepted for hhn/htrse[f and their asstgrs. This is to certify that the above named materials ase properly classified, described packaged, Trager loaded by ❑ Shipper ❑ Dirver Placards. Required: Label(s) applied: marked labeled, and are m proper condition (or transportation according to the applicable tegtdations of the Department of Transportation (Applicable for Hazardous Materials Only) Freight Cokmted by. D Shipper ❑ Driver, Loose pieces Shipper, acting under contract DE-rc52-07NA21344 1 with the U.S. Department of Energy: 0 Driver, pallet said to contain ❑ Driver, CH BEHALF OF NNSA palletscontarmng Carrier CLBA / Clean born Environmental Service, L= Veh cle/Car No. Seal Per. Date: Or Scott A. Ortshem per 2/11/0015 TRANSPORTATION DEPARTMENT -PERMANENTPOSTOF11t!VIISDRESSOFhMFkta PAVE i yr t