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�P 5x8 �:.tS�iaq`ti tilos � �,
<br /> Honic.Ea, CA 94510
<br /> h,)VY[tC3N1!/fFsWAL SI;Ei ('F`.w 8
<br /> qq' 74.&3040((''p8r,yyrryy!0 ✓7:Y:":1. .� % .tiCh1 �:8 .. P `e`:n
<br /> NXIL. .-In
<br /> .. ...__ 's - ..._.. ...
<br /> t}I LiViwf�Y[TAi E JOL3 iY 9.�sa.�.t+9 -
<br /> ;HIPPER/CUSTOMER (POINT OF CONTACT
<br /> ,Uf)t1ir:SS _..._.._...�..._ _�._...�.._..._._. .._._,__,..__.....____....._�PFEONE#
<br /> 250 OMM _..__M ______ _ _ _._.___ (2 J)825-'91:3`
<br /> 1ITY,STATE,ZIP
<br /> ,kilkIE:R/TRANSPORTER PHONE#
<br /> :ONSIGNEE;/FACILITY POINT OF CONTACT _
<br /> ,i.a113t?ESS �___-_.._ ... ......... _____ ._ PHC}fVF'ay
<br /> 30671 HUMVOOD_ A _ _ _(53.0)429-1129
<br /> ;ITY,STATE,ZIP
<br /> CA, 94544
<br /> __._... _....... .._._-.__— . ..... ._. ._ ....._� _..
<br /> Containers Total
<br /> US DOT'DeScriptian lrlclfxling Proper Shipping Name l dazard Class,'and 10 Numbad UOPA
<br /> No. Type Ouantity
<br /> 'UNIVERSAL GOWN hAKPSR FJ4U(SRSSCKNT LIGHT T AS (BROW
<br /> "".11H�.V����.A�•�A.�T�-'��.� '�"_.�-�fI C� ��.Y'.�.7'011$��(.�&1€11, �_...�1����3._..,_.,,.__,.........._._.........._,__.,........._.....__.....,....._._.
<br /> 6T1��d$�Q-•1dATT-��#5��'�..` 'T;�$i .��L��u ;��t�I�'"�i ��ftfzA�" ,_.......�___.�...._.r�._. �..�_._.__ __._.._
<br /> @l0 BATT'RRINS, DRY,,
<br /> r .
<br /> paciat Handling Inshructlon and Additions{Inforrnatfon: �„..„„.._,:......,................�..� �� �� ��� ��,.. .,��...•...,.�..,,...�,...,�._.�,W,..�.,��,..V.a..........,....... �
<br /> } HOUTUBEC-63 - FLUORISCI NT TUBES (CRUSHID) - REC15
<br /> I� •HHAST-���-•-=;-�Al�d3�G��--H�T.`f'$k�' T-�t�CY�� -( E -�•}—u---E� r -�).. l`�°:..03�.�,.�Ir�cA �E�-k3�-Ci`¢4��"-[�C�� �tix°�- a�.s:
<br /> HASTr-- RA 74 PROPOrA1a11t 24 HOUR MRGERCY CONTACT: (SHH) 451.-6346
<br /> iv,nards Prrovided YES_ NO:.. Emergency Phone#(877) 748-3040
<br /> HIPPI R'S CERTIFICATION:i hereby declared that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed,
<br /> larked,and labeled,and are in all respects in proper condition for transport by highway,vessel,and rail according to applicable international and national government regulations.
<br /> I tit t'If11NT 5T TYPE NAPJIE �«~�M � SIGNATURE MONTH DAY YEAR
<br /> .J
<br /> F.fiE21LR/rRANSPORTf:R)PFdN'r OR'FYE'E NAME P>RiWlj, E MONTH onY Yr�An
<br /> x
<br /> OIgSIGNEE/FACILITY)PRINT OR TYPE NAME _SIGNATURE^ MONTH DAY YaAR
<br /> Xt
<br /> >rrn;?r PSC-209-RV 9/07
<br />
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