COMPLIANCE INFO_2020 - Laserfiche WebLink

Home Browse Search

Shippers-- L.r� 'vu X71—IUFi— I f-UHfVI �/Q 2 NOTICE: of hazardous materials must enter 24-hour emergency Date_ � response telephone number under"Emergency Response Phone Number. Bill of Lading No. Original—Not Negotiable Shipper No. fName of Carrier] Carrier No. _ TCI: Consignee I 1 AliI �7b t 1" p^'t m FROM: /� Shipper /` role-Q..ICdJ nAA-S7-F J-C14 -5c/fits% cif C Street �� /I , , Destinationj� 9Tv Street 1 330 11-11-10-11A 9r i��INf�'�ilJ �, Zip Code q Z1) 111, Origin ®Lp a7 Route: I I '--A Zip Code q z � Vehicle No. SCAC Emergency Response No, Phone Number SNpping +HM Kind of Packaging,Descriptlot,of Amides �r"Wldring.apCFial o'addOW01 rkra or aannuun in itdrugdina or �/a l) gggb lin s Spectaf Marks and ElteepC ons 51`1�Mtn III tI ar rnre.Sere SO2 a 1pyn` j ea w area a sale rrsfnsPars arWn Mmh [[5tltf(Weight Rete or Class ra enc an_ken,3t3R Carrenl�ioIn CHARGES UX)luE2Sr4L Tt4IE9w►oMfT#,2� oLS�q j'.� O'U v��~t cif tee•6y w}terc moves die fauv tw between"mi, that the blit ofwei ladin,, C.Q.C) T{7. st5te whether welgfrt is•carriers or Shi is ht. C.O.O. G.O.D.FES: TOTAL B ACII Arnt. $ PRI❑ aMt sPeOrp t y rata is dependant on vehfe,shlpp,"a are required m Subject to Section 7 of the COLLEGTO $ CHARGES: $ state specific illy in wrihitg the»greed or declared value of U L property, recourse on the consignor,the pons�gn ghallisl"1 i following obe delivered o the const nee without The agreed or declared value of the property rs here sg FREIGHT CHARGES by the shipper to be not exceeding by PeWJI mated The carrier shall not mges. ake delivery of this shipment without payment of freight and all other Check Appropriate Box: $ per ❑Freight prepaid REtEriV o-subiect to the cJassihcatidns and Jawfulfy toed tariffs In effect on the date of the issue oP this Blllspf�Lgdnagg,otha dr] ❑Collect and rand d6n of contents of Pact t+ge5 unknown), merkgd, conal ed.and deeu I as Indicated above which said carrier ithe wnrd carrier 6ging unddrstpod fhraughout thin canmar t as rnttaning sfry ry or corporation in possession of the property under the cdn["NreJd-an to ca prr+Aerty descpibed above fn appareat good order; except as noted Icppnerw�hots arty, that r is mutually agreed as a Each carrier of all or any nf,said pproms its rxwal place ttf delivery st sa6of desLnatfnn, g on i[s rout¢, athrrwisteytn deliver La another aerrier on thea mute to rats the that avmy service Is!u5 pgor a rd hereunder shall he subJect w all tiha terms and conditions of the[Jnlorm 17omasbp Str&pi,abia Motor carrierght Gill of Levsin saC forth i1i in l7nildrm Fr¢ht Cf tthe he WdatMand ii it dhls s a rail ora hall water Shi � "y pnru°r'of Swd reuse LA desOngtion and Hs to gge�ch pc, at any pmt intereeEad in all or any of saki prop. ter'an end opndi[frw rn eif said ba gliding, set fpr[hf nl[hsecJoin hcs tan or tariff whlrh governs the trEn pertatien o[�this ymti r csrricr shi mens.Shf er iAPa and f3ccePCed for hirnSeP and his assigns.a. y� eas hcstons In affect on p PA hereby certifies that he is famHiar with all AAark with`R[ir•it d prl5aru,and ChE saki terms and conditions are hereby 8aed m by[he irarraportadan R pArtiPr'iera to dexdynate Hazardous pJraierials da ddrmed in ifut Lf.S. exTarr+nent of Tiro farm6C and content of limardous item liat'rs the res naihl egr+i We trNing ha the transportation of hazardous mhcer�ea.Tire r,sy OF u> wlwrxr is pony interpretaLiII of raqurremrrns as deecr+bed in as Nate:LiabiC limitation for loss an o of Fal eraGrod for Identifying hazardous rrretorlaJg on mire dt Lading, Ao shy of individual cam• COI nr Fdderar ctim 172.5 Alae when ahl Par'S 72 s a tWk77[IIiJ of Tide A9 772,Sub rt GSho Code al Fadergl Regulations prreoCrihdC In aeuYion 7 72.20.7(e)of tho Fsdprnaia lRagulM rwmm eta i d cased on th tai a�AtLsdl a¢�a 1-ro papers.Such uki]and corrsiyrs of the fakviing par c„aa or damage in this Shipment untm a s dos 5 7E.244[Harsrdpue 1Wateriol Te41e]and Reatfona'I72-262 erw 172.2D3: mJiy he applicable. Sea 4 9 pao�c dxceprion from the raqulremcrw Ig fx'tivided in the ps r name.lwzondous gudadon for a Partirdllar m%er•ioi. and auhsldrar dresses). `i°as. ��+tdreaNan aurnhar,pacibr,g yrpe,p• United States Goole, Sect ons SHIPPER III LLI�$ 7CC�{ 14705(c 0)iA]and(B]. PERCARRIER d rlpG qC5 276S cerd t o nam PER IJ and labeled, prep msteJ are properly Cla�glfiaty paoltegsd Carrier applicable regulations the u.S pa g dean for t�ahapartgtlnn acc;pr:l to aGRrrwuledgaa rape PC of p kggga and an ro sad p rmrnd of Tranq n fe9 tion was made aveileblg and pr yy placards•Carrier certiftau emergency response informa- p rfetion, ore equivalent made voil cerv•for has the U.S.QNUParement of Transportetlan emergency response guidebook 9 enmtiIn in the vehicle,Property described above is received in good order,except as noted.