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ATTENTION SHIPPERS! FREIGHT ( !GES ARE PREPAID ON THIS BILL OF LADING U <br />is an acknowledgment that a Bill of Lading has been issued and is not the Original <br />This Memorandum Bill of Lading, nor a copy or duplicate, covering the property named herein, and is <br />intended solely for filing or record. <br />l <br />of <br />(Name of carrier) (SCAC) <br />3S MARKED COLLECT. 02766 <br />Shipper No. WAT <br />X(Rylf <br />Carrier No. <br />Date <br />On Collect on Delivery shipments, the letters 'COD" must appear before consignee's name or as otherwise provided in Item 430, Sec I <br />TO: Shell Oil Products US <br />Consignee MARTINEZ REFINERY <br />FROM: <br />Shipper <br />rte- • jj <br />`•� <br />Street <br />Street 1801 MARINA VISTA <br />City ' <br />C <br />state CA zip Code <br />City MARTINEZ State CA zip Code 94553 <br />24 hr. Emergency <br />Contact Tel. No. <br />CHEMTREC 800-424-9300 <br />P67 ;-^r <br />Route �..t?,A C ! — G= -) <br />Vehicle +I)i f <br />Number <br />No. to Units <br />&Container Type <br />H �A <br />'YI <br />BASIC DESCRIPTION <br />Proper Shipping Name, Hazard Class, <br />Identification Number (UN or NA), Packing Group, per 172.101, 172.202, 172.203 <br />TO�TY <br />efgtit, Volume <br />al6f;, et <br />WEIGHT <br />(Subject to <br />Correction) <br />RATE <br />CHARGES <br />(For Carrier <br />Use Only) <br />GASOLINE MIXTURE, 3, UN1203, PGII� <br />ERG #128 <br />Contains water with < 10% oil bearing materials and <br />may include <br />extracted <br />groundwater from service station facilities that would <br />be non -hazardous <br />under <br />federal and state waste classification criteria. <br />SOP US Martinez Refinery <br />Receiving Gate to direct driver to the Effluent Tre <br />itment Plant Operator <br />(x3202) for off loading directions. <br />SAP/INCIDENT #: 1340ii <br />RIPR #: ,/ 5 <br />PLACARDS TENDERED: YES=] NO 0 <br />REMIT <br />C.O. D. TO: <br />ADDRESS <br />Note—(1) Where the rate is dependent on value, shippers are required to state <br />specifically in writing the agreed or declared value of the property, as follows. "The <br />agreed or declared value of the property is hereby specifically stated by the shipper <br />IobenoIexceeding per <br />(2) Where the applicable tariff provisions specify a limitation of the carrier's liability <br />absent a release or a value declaration by the shipper and the shipper does not <br />release the carriers liability or declare a value, the carrier's liability shall be ifto <br />the extent provided by such provisions. See NMFC Item 172. <br />(3) Commodities requiring special or additional care or attention in handling or <br />stowing must be so marked and packaged as to ensure safe transportation. See` <br />Section 2(e) of item 360, Bills of Lading, Freight Bills and Statements of Charges <br />and Section 1(a) of the Contract Terms and Conditions for a list of such articles. <br />I hereby declare that the contents of this <br />consignment are fully and accurately described <br />above by the proper shipping name and are <br />classified, packaged, marked and <br />labellfed/ptacaroad, and are in all respects in <br />proper condition for transport according to <br />applicable international and national <br />governmental regulations- <br />) ,, <br />1 -1r `. signature <br />COD Amt: $ <br />C.O.D. FEE: <br />PREPAID ❑ <br />COLLECT ❑ $ <br />Subject to Section 7 0l the conditions. a this shipment is to be <br />delivered to the consignee without recourse on the consignor, the <br />consignor shall sign the following statement: <br />The carrier shall not make delivery of this shipment without <br />payment of freight and all other lawful charges. <br />}� <br />TOTAL <br />CHARGES $ <br />FREIGHT CHARGES <br />FREIGHT PREPAID Check box d charges <br />except when box at ❑ are to be <br />right is checked collect <br />(spwture a Consgnor) <br />RECEIVED, subject to the classifications and tariffs in enact on the date of issue of this Bill of Lading, the property <br />described above in apparent good order, except as noted (contents and condition of contents of packages unknown), <br />marked, consigned, and destined as indicated above which said comer (the word carrier being understood throughout <br />this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to <br />its usual place of delivery at said destination, if on its route, otherwise to deliver to another carrier on the route to said <br />destination. It is mutually agreed as to each center of all or any of, said property over all or any portion of said route to <br />St... PER Shell Oil Products US <br />destination and as to each parry at any time Interested in all or any said property, that every service to be performed <br />hereunder shall be subject to all the bill of lading terms and conditions in the governing classification on the date of <br />shipment. <br />Shipper hereby cerblies that he is familiar with all the lading terms and conditions in the governing classification and <br />the said terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns. <br />CARRIER "r r'' <br />PERON BEHALF OF SHELL / EQUILON I PER 1,R1:�.�• r-� -� <br />RECEIVING SITE SIGNATURE / DATE: <br />Permanent post -office address of shipper. <br />14 <br />