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r rlruIIIan r OIL.L. Vr L141JrrYf..7 <br /> ORIGINAL—NOT NEGOTIABLE Shipper No._ <br /> Adwill Chemical TrallBElp11 M1E (6y) Carrier No. D172534 <br /> Page of <br /> —� <br /> fNenmacenDate <br /> kr) (SCAr,'1 <br /> oncaema paaruyellhaYe.na weemcov mpa erq..r edo,e <br /> TO: pd,ayaeex aem.gu on.lwe•Dameee m sem apo,s.el. <br /> FROM: <br /> Padk SWhftu <br /> Consignee/�ft11C�(.'ICIII��Qa1Rllrl� CA1AiIf1Gr <br /> Street <br /> 6133 Ed1h MW NE Street 4U3 Ea I <br /> Ennorg Sheat <br /> City St06�ton <br /> CityState State CA zip Code 05215 <br /> Zip Cotle <br /> 24 hr.Emergency Conrad Tel.No. 1at W785e72Z5 <br /> Route _ <br /> Vehicle <br /> No.of Unitsn M 1r BASIC DESCRIPTION Number <br /> 6 Conrefner Type UN or NA Number,Proper Shipping TOTAL QUANTITY WEIGHT CHARGES <br /> _ pping Name,Hazard Cleea.Peaking Group Pr+Y9El.Vdlml9 (Subject to RATE (For Cerner <br /> 1)LM SK�*.Z Gallons,atc l Cprrecbonl use Only/ <br /> lAaway Nhib{A¢7)75ph) <br /> P <br /> _ <br /> 202017 <br /> ENVIRONMEN <br /> PA prMENT <br /> PLACARDS TENDERED; YE9 p NO O <br /> REMIT NT <br /> ^�?mvry'' nmo,el.'s v.c.n-•=•.o,. 1.ma, 1.op e.e,aevreo:p vele Iner.ev aecl.re lylye camnn amla C.O.O.TO: <br /> .yaee a.ua,ee wore of 1n.pmmnv, wvoxa:'ms aYugnmem uY e,ay e„a eowruu ADDRESS <br /> a9'YJ m geaantl.a»o•IN p�axrt/.a namcr snacllcar/ a:u.e ey me wcyar Ip <br /> be nab eseco,nG De:_ Cer+gye e0me py <br /> IN Dmoer.horowN <br /> .n nbgo vw.preeedelunlpmwecnsµ2 rOral.mlationmaq.arnera lYCar apYm iT° ea0 em tl Mor., Dadapae, C.O.D.FEE: <br /> Ina wnrsuarmmewn`:•a'a^aV OOn¢vmow,.na lne anmp.r noe ,rol ielova �aei°oNJ1°�ne�'°`artl°a,em vne Amt: $ PREPAID O <br /> Ire orn¢rt IWNt/elbtl be&n4.tl Ip ne apart �yb• p/�° •J'� I CTO S <br /> TiP.o.b Sole pwr..`o q Se.NMfG ler,7-,2 Nnr(grl ydllp 10 ppY[.eb S b eatlbn�d Me <br /> com ceNv raves+,q.o—Ior ep14n.1 can or abnlbn HNvnee,q w b mbnelwMl uw'lelrt,al ea['.rnmeHu IovwA'"y°i emY'aa .r w mrey,Rw.�1w'�"�reyl°°v swen0i..p„II,°i°. TOTAL <br /> I bemmedaa erw peC.p9eC u w.rwre.1.enl.Nquba se. M m.timer:n.tl nam CHARGES S <br /> .m 36a.Bib.l ladng GIt"eqs aM SwI.s d LA, Sworn I w!a 1re19a ana.v oln.r wrul tl, µ"'f'd nv.el: nrapn parm.a d <br /> 'ap CA,I.T.eNb oinm br Beal pl wtl,a'IIdX 9K°M Soman ifald en. FREIGHT DHARGES <br /> No <br /> gmn <br /> $16TIiIJ(8 xr [NrJ[ Ytl Y�ta gable <br /> FECSIVEC.eutllC lo'Jp CetJ[WY.e gooif eXacl pn 0Ye.1'aelaa &l a'lad IMS .a pn1 ^ <br /> e/y 0ea eWn n e( pyar a <br /> wtl I W tl p 9 IVWba tl ewrl pyrll el arty WM n1.1C.be In Y p�reYb eunY Yak.Y e. <br /> a '-9 nlupap. a..C.o I'd 1.rW <br /> mNad, :p.eC Wcee 1-1.1 C..q 11ra a Da'1°""d Mrtuafn pY Oa s¢ged ro.0 IM W d pgr9 eMPmMWpg°n ne Traag9 ay.. <br /> �meewwtle IMOI.yMM e4 NN N tlnplyl�F I11N1pn°nl. <br /> m d n nropeM..Cn N°[ t b 9 W ds<ru m SMpp Igro <br /> Is, <br /> .,NoorFall o1�moiosr 1% <br /> n .dluwmaprtC.n. —1. para Yq [ 'u'u aeptpbtl lobi tl°haMlaM:rtu paYirte°4, .[cMlbn,ne Fan�ry\Nae to Y��fnwM,e+� <br /> rGvf Y'¢ea(a ya. YM <br /> re en <br /> SHIPPER P&C&SWhwmt CalWnc ° CARRIER AdftqW <br /> ChWn W TrarapW Ince (syr <br /> PER x <br /> yr PER <br /> DATE <br /> P.zv,ent noel-nftlpe NI jrae,of ahjWo, r <br /> •. r.u.u.�..���1'�r+a"' QTVIR(`F.T/5.A ,m p/,f9 I,.gG11�afTGg® /ante ase-aaryl ..x,,.,41u•nonar rrvl <br />