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STRAIGHT-BILL OF LADING-'SH(1°T FORM-Original-Not Negotiable r , Shipper's No. PHILLIP WEST INDUSTRIAL SERVICES INC. pier) SCAC. Carrier's No. f ED,subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper,if applicable otherwise to the rates,classifications and rules that have been estaolished by ih�jiBSr� plgjttlF,s�jp �on request;and all applicable state and federal regulations; IENICIA at date 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 another carrier 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 shalt 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: (Mall or street acK.RLoL°Q9 inftR0 JV7@Y` "5ification only.) FROM: SERVICE STATION MARTINEZ REFINERY Consignee Shipper 1801 MARINA VISTA 2375 Grantline Road Street Street MARTINEZ,CA. 94303 Tracy, CALIFORNIA Destination Zip Origin Zi' Route: Delivering Carrier PS C_ Trailer Initial/Number U.S. DOT Hazmat Reg. Number rJ� No-of HM Description of articles, package ® , specialexceptions l --- - -- GASOLINE-MIXTURE-- --- -3 -UN-1-203--II--✓�� 1—- gr $ RIM28 - - --- ----- - --- ------- ---- - - N - -U__ -i - - -- - ontains_water-with<10%okhearin tens -and-m _in =d_ groundwater from service station faci lities tha would b e non-ha ardous i inder --------------------federal--andstate-waste-classifcation ri-feria.---=----------— SOP US Martinez Refinery Receiving Gate to direct driver to the Effluent Treatme t Plant perator x3202 �-or-off-loading_dir-ectian. SAP /INCIDENT#: 97V-1196 -7 --- RIPR# 4�9 a � Subject to Section 7 of conditions,If this f% 0. D. FEE:Remit C.O.D. to: CD AMT, shipment Is to be delivered to the consignee without recourse on the consignor,the ❑ Address: consignor shall sign the following statement: Prepaid The canter shall not make delivery of this ❑ City: State: Zip: $ shipment without payment of freight and all Collect 'ale.-where the rate lsdependent pnvalue,snwpe �e�w raa , ed'°state specifically"writing th �l'� � the agreed other lawful charges. . Charges Advanced FREIGHT CHAR ES rho agreed or dedamd value of the property is hereby yecigcally staled by the shipper to be not exceeding per (Signature of consignor) ❑Prepaid El Col Ct NOTE:Liability Limllaflarl for lose or damage In this shipment may be applicable.See 49 U.S.C.14706(c)(1)(A)and(B), IN.16 to cedly scut the above-named materials ars properly dassil ad,described,packaged,marked and labeled end are In PLACARDS 1, Ll YES NO-FURNISHED B ER proper condition for bammNWdon according to the sppli atae reguutbns of Ma Department of Tara p dation. QUIRE, Par REA DRIVER'S SIGNATURE: _Sr `IAL INSTRUCTIONS: S. :R: CARRIER: PE... iJ DATE: PER: C.C t_7 a ` DATE: EMERGENCY RESPONSE TELEPHONE NUMBER: Permanent post office ad ss of shipper V Monitored at all times the Hazardous Material is In transportation including storage incidental to transportation(§172.604). 29-BLS-C3 969(Rev.11/04)