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i ni5 mem®ranaum a an acnnomeogment mac a 6111 or La Ing has been Issued and is not Original Shipper No.
<br /> Bill of Lading,nor a copy or duplicate,covering the property named herein,and is
<br /> intended solely for filing or record. e
<br /> Carrier NO.
<br /> raa'I+�r;:��ta �k:Ti>.sst9'isar��itrrd l��x;. („nor"r —
<br /> Page Of Date - —
<br /> (Name a'urner) (SCAG)
<br /> bnbellgMOtavery.nameme.ev wmm-WTnwW epwW btlremnegnw'a name erp parewM pmWaeln 1pm ap.Sac+. FROM
<br /> TO: Shipper �'' L.COlR?!'�tk:Emi f:h"t7EifePx:f
<br /> Consigneect,Jsrfr*'.,,A(: %aaE 3c:�'� 'k2�i.ar��'a^;
<br /> Street ;I:>yE',C E- )=a1�•eahnrai npae. ,
<br /> street aro 6 5-t+ �h R4)B' >1-" , -
<br /> City state ,-. <ip Code y 1, �.,•_
<br /> Cstate &ea a zip code a r» P s7e
<br /> City ^4tD�" '^^ at n-.cmeagency Dorcas-ei.No.
<br /> Vehicle
<br /> Route Number
<br /> No of Units 1 °�`� , BASIC DESCRIPTION TOTAL QUANTITY . WEIGHT CHARGES
<br /> a Conca ner Type I; si'L t UN pr NA Number,Proper Shipping Name.Hazard Class,Packing Group NsSigm.Volume. Correction)
<br /> RATE (For Carty
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<br /> ENVIRONM NNTAL HU LTH
<br /> DER, RTMENTI
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<br /> PLACARDS TE NDERED: YES t7 NO p REMIT
<br /> C.O.D.TO:
<br /> Here—l+„wM..er.rale s mo.cl an vWe.InIl are repldratl ro sum I h.nby dada..Yul We mn,na pf IMt ADDRESS
<br /> iima ly ,Theapme.r dedree ww d III.aapadv,IIITalons:-me wna�e^mem are 101,and acmraley
<br /> 'ni.Ir Jun, valor el Ne pnII Is Mr WI'apxawey 0td Ey Ne 4,1111 W 1.n11 amve W N5 purger.1pp'n �'q e,
<br /> umr aawadng per amt end are Iasaiia, Datwg.e CQ Amt S ,_ PROEPPAID EU
<br /> n1'Mnme ase WplkWM¢rHlDmvm'orm tD.dNallm:mm�mmewrrTera li.aliq aex.m manmd as tveelleepa<araw.ens ere - COLLECTD S
<br /> rsleaae or a.sora dense len q in.ab.pper I.Ina snipe.1 dens nel 1el...e m air nvpequ in proper wnalgen ler -
<br /> me wmea Wbllq or sden a.aiw,me nmers eadny erw x Ilmiw ro Na.eam franapon aword�ng a appnwbk ^sP,gaW a saga,> �i:?Nndlir•. Snemenl^o..ml,om m n. TOTAL
<br /> pmnii,li ud,pmwms.see nA.FC Item+rz. asmalimalam natipnaigpvemnm w pnea-•v'o.r ,nv - rn�M 5lpro.alta,Plsn ase CHARGES 5
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<br /> m,ul Ee w.renes dna pedogee rs le ervure sale vanspormlbn.See Sedw.n 3^ r•4. _a edncry a, <npmPn•nrnaur o.ymmr oI FREIGHT CHARGES
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<br /> ng, nd.n .li$1&emenu.l Cnaym and$ecliPn 1(a)pI
<br /> Ine 0-.1 Tem6 Ind GVrtlgons rrota II W.1 Pum Yrklp[. $i9natYrem'PM,nwadl
<br /> (ah"i4wo::sra se.l rgmetlrdzt ❑
<br /> REQNED.[W,xr b N.tla[tlfi &xns end YanH 1^snM M Ne Illdtl,¢I<61RO Nb&II n1 L]pr. 1%urn Nld 6:<Pad pang In n,I— YI¢arty Pxtl prmep.Nal WPT PervCa{y
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<br /> Imb PI paccges uNno n),ry M d.awvgl and daxtlned en me dale o(.npmen:
<br /> ni, ,meemmne m n„drwn:1 an1„q. sem.< .d,
<br /> pessessm a1 ee pmpery a Tr me wnca7l a01 e.ra'[tM is,n rural IY a'"I"',x w"0.� g<vemirq tle>P?atlor.6.190 M dab nm:s are canervu ar+nerab%agaecviaYey In_syDtr tra
<br /> aeden II Mite Wit.wri 6 ddNel m ani torr wmer on..nw,Id sdld dnin fi. A IP rIon, Innnnkd Iw InTadf.,A.s ampn[.
<br /> Ny ayeH u m a%a wrM1r d LI er arty or ea!pgpeM over aP er dry pTM al eud rant iq des
<br /> SHIPPER -ZA62- :..Saut'a•h_..... _.,. . CARRIER :•'er.}iB'#2a>:... -,..
<br /> �eI
<br /> PER PER
<br /> DATE
<br /> PennSnenl pest-office Wool of Shipper. 4fia-�'.- r.-,.+^. .„,t SYLE.F3T5-e 02017 L.4S9 Ta1AS1512® I90m e2x-5908 v am•.Iatf9lmaerer car..
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