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a <br /> 183 <br /> 3909 Park Road, Suite D' BILL OF LADING <br /> WMONMEIVTAL SERVICES Benicia, CA 94510 <br /> GROUP (877) 748-3040 i�7' �{ ;r ?`�� • <br /> Westem Region _ <br /> DELIVERY DATE JOB A61 9��4 <br /> ;HIPPER/CUSTOMER POINT OF CONTACT <br /> SfVUL 4719.", FACT-4 _-TIM RAENTN <br /> =ADDRESS PHONE# _ <br /> r'? ,-f iJTzJ' <br /> :ITY STATE ZIP <br /> ,ARRIER/TRANSPORTER PHONE# <br /> 'ONSIGN7E.PE//FyA�CIUTI( POINT OF CONTACT <br /> 0DRESS PHONE# <br /> ATY STATE ZIP <br /> am <br /> qy "s X01)1 .ISL i7�-,.,;r�t.0 3� <br /> h y <br /> 7 <br /> -pecGal Handling Instruction and Additional Information <br /> F99YUlm U - :0T__'D <br /> 100) 448-03, '115; <br /> 'lacards Provided YES NO Emergency Phone#(8M 74$-3M <br /> HIPPER 5 CERTIFICATION I hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are dassifled packed, <br /> larked and la)eled,and are in all respects in proper condrdon for transport by highway,vessel and rayl according to applicable international and national government regulations <br /> SHIPPER)PRINT OR TYPE NAME SIGNATURE MONTH DAY raw <br /> C X <br /> 1 � <br /> CARRIER/TRANSPORTER)PRINT OR TYPE NAME SIGNATURE-~ A60KTK DAY <br /> I X <br /> CONS)GNEE/FACI PRINT ORTYPFtNAME SIGNA111RE <br /> 17L 1 <br /> WA#PSC-261' RV <br /> SHIPPER <br />