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ri I J omr rI I V U V n u c n Carbon,and retained by the Agent 13 0 �V vi n Shipper's No. ' I PHILLIP WEST INDUSTRIAL SERVICES INC. {farrier) SCAC. Carrier's No120 1 . ED,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,ff applicable,otherwise to the rates,classifications and rules that have been :d by the carder and are available to the shipper,on request;and all applicable state and federal regulations; 395 WEST CHANNEL RD. BENICIA at , date 7 � G from the Property described below,in apparent good order,except as noted(contents and condition of contents of packages unknown),marked,consigned,and destined as indicated below,which said company (the word company being understood throughout this contract as meaning any person or corporation in possession of the property under the contract)agrees to carry to delivery at said destination,if on its route,or otherwise to deliver to anothercarrier on the route to said destination.It Is mutually agreed as to each carrier of all or any of said Property over all or any portion of said route to destination,and as to each party at any time interested in all or any of said Property that every service to be performed hereunder shall be subject to all the conditions not prohibited by law,whether printed or written,herein contained,including the conditions on the back hereof,which are hereby agreed to by the shipper and accepted for himself and his assigns. TO: (Mail or street address of consignee for purposes of notification only.) FROM: SHELL OIL PRODUCTS US. SERVICE STATION Consignee MARTINEZ REFINERY Shipper Street 1801 MARINA VISTA Street 2375 Grantline Road Destination MARTINEZ,CA. Zip 94303 Origin Tracy, CALIFORNIA Zi Route: Delivering Carrier , Trailer Initial/Number U.S. DOT Hazmat Reg. Number 5C� ¢ U DescriptionNo.of . exceptions packages H,M .• a a a GASOLINE MIXTURE _ 3 1203 II ERG#128 ontams water with<10% oil beanng maters and ma include extracted - Groundwater from service station facilities that would b non-hazardous vnder Federal and state waste classification dritena. —SOP L� fartine�Refiner ---– Receiving Gate to direct driver to the. ffluent reatme Plant Operator( 3202) For offloading directions. — S"AY-,L 1"Y'GEDE1"V 1"}Y-:9,6-1'OY'-1-37-t'-ti -f RIPR#66244 RemitC.O.D. Subject to Section 7 of conditions,If this C. 0. D. FEE: Vto: shipment is to be delivered to the consignee D AMT: without recourse on the consignor,the Address: consignor shall sign the following statement Prepaid ❑ The carrier shall not make delivery of this City: State: ❑ , Zip: $ shipment without payment of freight and all Collect s. � Note.-w here the rate is dependent on value,shippers are required to s espedrical m writing the agreed or declared value of the property. Charges Advanced other lawful charge - FREIGHT CHARGES The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding per (Signatureof consignor) ❑Prepaid ❑Collect NOTE Liability Limitation for lose or damage in this shipment may be p nble.Sae e9 U.S.C.1a706(e)(7)(A)antl(9). I a, EML This is to ceraly tat the ab—named matenats are pmpedy uassta:d. ud packaged,marredend labeled,era ere m YES NO-FURNISHED BY CARRIER proper eandilionfor tampodadon amorang to Ne appliabie mgua' o1lheDp _emaTraneportation. LJ Par DRIVER'S SIGNATURE: SPECIAL INSTRUCTIONS:. CARR 1 Chi'. �i > s 'i-e.L2 DATE: ' 7, C PER I DATE: < <' EMERGENCY RESPONSE _ Y, TELEPHONE NUMBER: - � J - Permanent post office address of shipper Monitored at all times the Hazardous Material is in transportation Including storage Incidental to transportation(§172.604). 9-BLS-C3 435(Rev.11/04) (19,Agent must detach and retain this Shipping Order and must sign the Original Bill of Lading.