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STRAIGHT BILL OF LADING — SFIORT OM A-83876, 9013, 9014 T-3841, L3841,10, 1-11 STRAIGHT BILL OF LADING - SHORT FORM C y NOTICE:Shippers of hazardous materials must,enter 24-hour emergency Data P j �i ` Bill of Lading No. response telephone number under'Emergency Response Phone Number. Original—Not Negotiable Shipper No. 9 9 MP f arid��r�n�w k INeme of Carried Carrier No. T0: .� /+ FROM: Consignee LS N2Xfn tin Ship of. Rill kgp Street /22ZZ 51n (.Cur Street Destinedon 42 Code I, Orion Zi Cade `T-OS t Route: Vehicle No. SCAC Emergency Response Phone Number Shi ping +HM Kind of Packaging,Description of Articles Corvrrsidee rasa+rp sp«id or aeGiconal care c,e.><srn N hvr ting n• Weight' ,' Special Marks and Exceptions x1 must be so marked and Peciagsd as to ssYe sale tr crwr CHARGES Units P P ordinary,core.see Seddon 2te)d fludal fucrm Fillnt tAssr nim 2rlu. Correction)' Rate or Class -!f one shipment moves betwuen two ports by a REMIT C.O.O. C.O.D.fEE: TOTAL — carlier by water,the law requires that Ne hill al lading C.O.O.T0: PREPAIDD st�rrs whether vveight is'camier's or shippers weight. ADDRESS Amt. $ COLLECT❑ $ CHARGES'. $ Note-kMhero elle rate is dependent on value, shippers are requ%red to Subject to Section 7 of the corididans,d this shipment into be delivered W the cans!gnea vathou{ FREIGHT CHARGES state speciiEca4y in smiting the agreed ar declarad value of da property recourse on the consignor,the consignor shall sign the fallowing statement. The agreed or declared value of the property is hereby speclheally stated The carrier shall not make de!rvery of this shipment without payment of freight and all other Check Appropriate Box. by the shipper to be not exceed ng charges. $ per ❑Freight prepaid ISgnatore of ransighor) ❑Collect REMVED, mb;ect to the Class;(carte m:and fi lhy hied tariffs in effect on the data Of the Issue of this Btll of Loring One property deserted above in opparenr good ordeR except as noted(contents -nd coneenn of contents f packages unknawn). marked, consggred,and destined as Indicated ii which said carrier Ithe word carrier being understood tivoughout Nis contract as meening'any parson r corporation in posssssun of the property under the contract ag ees to carry to he usual place of delivery at all deadnetion, R on its route,otherwise to de!+aar to shadier career on Na route Po said AW r al It is mutually be agreed as to each carrier of ul or any of said&.party aver all or arty portion of Said route to destination mid as to each party et any time inttresad in all ar an 'o t. e Sedate thereof.d Ns is a relanr a raimed lv a'ern ser shallbe or(2)in[he aI I[able motor carie conditions Uniform Daif W c Straight Bil:l of Lad'np set forth(1!in Uniform ll ht Gassificti in effect an Pn 1 1 pp Jon or tape,d this is a motor carrier shipment. Shipper hereby certifies that he is fal vdh an :he terrors end epted[ans al the said h:0 of rating, set forth in the dassihcetion or Cerilf which go-ierns Ne transportation of this shipment, end the Bald terms and conditions are hereby agreed to by the ,h%peer and accepted ler himse!I and his assigns. Lark etut-poa...rol bz to driers".Heti ...N.steria5 as deaned in Ile U.S.th,pe er-0 of The format and coolant of hotel kers]:•' ranaper[a%n fhnl.hdoiv fle'l y Ns vanaPe Cation al harardays mBtNtEls.The ua.of dins colors^Is a.a the 9 Dean of rediriv dv-1 soon Note:Uabih limitation for loss rn optonal method far idenor' haeardous material Pa^y�^'<r letpe^draqu'remen[a e;desndbad ing9GAa efredaalite, m ry +ma ao..Bins of Ceding per 172.201[oyt)(ait of Tia 4g 172,Svbpen GSRpp:ng Pafsrs_Sn<hCeunptinncws:ua of Cha luravnng par Sep or damage In this shipment reds of Fedora!Risdulars.all.wfian shipping hazarCcus.blues.Na shi sn''s carVendm sta;amant tions 172.201(Hater Coos h<xterial Table)and sections n2 202 evJ 172.PW may he applicable. Soo 49 resorbed In EEcton 172.2oq(nl at the(Ederel Regu4dcna,ss iMi[tled on the e:a of Ladirg dopa all Plaw she r ,UN Idnok .venter,pal. United eclates Code. Sections sae a spacirt a epaon(rem tF.a requ4emsn:b P'addN ur tba R.g,yet'ron IG b pa�!:1:�'inatadat add subsid ar�p daamP 3lhbtarda.Cass g grey+, y >< 14706(c(1)(A)and(B). SHIPPER � '].'jp.L CARRIE PER as PER ,-r marked.and certify that the above namropedmaterin arep.porta or B.ed. paCkeged, Ce"wilcknmvledges recaipt of packages andanyrequired plaards,Carrier Cert&05amergencyrasponsainfenna- (qL!I app ble,regulations lof the ail and rja proper of Thansportfor aGa hon accordag m the don was made evalmble and/or carrier has the LLS.Department of Transparta6an Marginal response gaidtheak P P or equrea ent di cumentadon in the vehicle.Property desenbed tore is received in good order e+cept ss road. final r. lifial JD OCT 10 2014 ENVIRONMENTAL_ HEALTH DRARTME JT