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THIS-SNIPPING ORDER must be legibly filled d lnlni elible "'it1,or in Carbon,and retainee by td by the Agentnt . Shipper's No. PHILLIP WEST INDUSTRIAL SERVICES IN '- •tier) CSCAC. Carrier's No. JED,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 ,.shed by the carrier and are available to the shiper,on request;and all applicable state and federal regulations; 395 WEST CHANNEE RD. BENICIA at t date 42%1�-,—,/ 9 from the Property described below,in apparent good order,except as noted(contents and condition of contents of packages un^ klmarked,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 carder 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 addSHELLnOI L PRODUCTSnUS tion only.) FROM: SERVICE STATION MARTINEZ REFINERY Consignee Shipper Street 1801 MARINA VISTA Street 2375 W.GRANT LINE ROAD MARTINEZ,CA. 94303 TPACY, CALIFORNIA Destination Zi Origin Zi Route: Delivering Carrier Trailer Ig(ti umber U.S. DOT Hazmat Reg. Number No.of Hazard 1.D. • ._ , packages HM Description of articles,special marks,and exceptions Class Number GASOLINE MIXTURE 3 UN120 II VIRGA28 ---- - - ---- Contains watef with <10% oil beari g materials and rrAy lnelu a ext.' ,4 _:z__.---groundwater--�bm-ser�ic-e-statien-fa i-lities-th t-would- -tort• cwt — __.__. _-___ .---- federal and state waste classificlOw criteria. _ S�US Martinez Refinery __-- ---_ €v%ng_Gate to direct driver to r_ea -----_- _ r Foe off loading directions.-M41 - -ft:6N -#:-9947196-7---- ---- -- --- ------ -- — RIK#64162 Subjeca t to Section 7 of condifions,if this C. 0a Da FEE: Remit C.O.D.to: shipment is to be delivered to the consignee V DAMT: without recourse on the consignor,the El &6nslgnor shall sign the following statement: Prepaid The carder Shall not make delivery of this @ City: State. Zip. $ shipment without"Id"of freight and all Collect El $ Note.-where the rate is dependent on value,shippers are required to state specifically in writing the agreed or declared value d the property. other lawful charges. I'll; Charges Advanced `' FREIGHT CHARGES The agreed or dedared value of the property is hereby specifically slated by the shipper to be not exceeding per (Signature of consignor) ❑Pre aid El Collect NOM-Liability Limaadon tar lose or damage M MIS Shipment may ba applicable.Sea 0 U.S.C.14706(c)(1)(A)and(B). This is m testy Inst ft above-named materials ata properlyclassified,described,packaged,maned and labeled,and am,, Ll YES NO-FURNISHED BY CARRIER proper condition nor frerspoftbon according to the apprcabla regulations of be Depadmere of Tmrepodxllon- DRIVER'S SI NATURE: par SPECIAL INSTRUCTIONS: ''PER: RRIER: r��C7A ` ,:-I r� ; , DATE: a n FyE 10 ,: R; DATE: EMERGENCY RESPONSE TELEPHONE NUMBER: Permanent post office address of shipper Monitored at all times the Hazardous Material is in transportation including storage incidental to transportation(§172.604). 29-131-S-C3 969(Rev. 11/04) (`Agent must detach and retain this Shipping Order and must sign the Original Bill of Lading.