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AH"1'�� 64'IEH01®PLa9�®RgpR Is an acknowledgement that a bill of lading has been issued and is not the Original Bill of Lading, nor SHIPPER NO.
<br /> 4H"1' 1 M PLS'A6tl UM a copy or duplicate, covering the propertynamad.hereinund is intended solely for filing or record.
<br /> Y
<br /> .` :...Y4'4 : § y E: ... f• CARRIER NO.
<br /> s:.,..........,u '::.ter . . :...:. : . . . . DATE
<br /> FRRIEIjiS7Asti7r Vit= ,. ("° r•It`te !7tc 1i nl s l t t�{' �-;4rlts`s %.owe l
<br /> ®
<br /> FROM
<br /> ONSIGNEE SHIPPER
<br /> t PJSD a ��lPlcztzc iv d0f sit
<br /> TREET Hulye:vtt•aud f-t stiff s STREET 1976 tftrJeE LowralP f t��
<br /> f'€.aylhc. _'o x Tr�tCy: �v SM
<br /> ESTINATION STATE ZIP ORIGIN STATE ZIP
<br /> CUTE VEHICLE NUMBER U.S. DOT Hazmat Reg. No.
<br /> [I)CCLI cull, D4.158.13 `2.Vs orlar lc it? .
<br /> 9 rv• y
<br /> 7NL
<br /> bye$ U?p!-S6';tfiea53u btr,dste (r 6F( ati Fjf �u Lin Stoma Jjb : - _sm. rA itor
<br /> S7r�5A rJ , pe'�� P to h telt to Ui1j-KvwtFGR
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<br /> 'bf'r� J y Fa JN €tic, Merouty owiCL oW, in uSeuFLiv tP;ds3 e.rEd, .rix, g. (6,1) 17:12 t ) I
<br /> Compmt F'is(.gasetdlt kn(him LI •R.
<br /> tc :er„ F.xe, nCj1C ,(:: I%W;ih. 8 I +v� R,endAufo' er€,Fiteree; _ Ile
<br /> a`( r -9 t:,.it.. .aF1,tt..s;:Y tis _„�t4vt.`r5 t�'+=••!_ LLe'!kC^Cs° t�l
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<br /> sidaEYdp, Gbit 4m71 titya',! Iia `t:z trac4ud-o-t'q Gwtei!ht5 s.3lcnr Eaaftea), ej . !# ICU-;ItFcf0r
<br /> / ,t da,4cpies
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<br /> Subject to section 7 of conditions, it this COD COD FEE:
<br /> emit COD to:
<br /> Shipment is m be delivered to the consignee M
<br /> Iw armed an Ne consignor, me consignor A
<br /> ddress: shall sign e olwwingg eutement Prepaid ❑
<br /> Thcanter she not make delivery of this -
<br /> Ity- State: Zip: shipmentwithout gaymem oureigd San oder $$ Collect ❑ $
<br /> awful ades.
<br /> )TE: Where the rate is dependent on value, shippers are required to state specifically In writing the TOTAL CHARGES FREIGHT CHARGES:
<br /> reed or declared value of the property The agreed or declared value of the properly is hereby
<br /> critically stated by the shipper to be not exceeding $ Per (Sonatureof coni nd $ E m ❑ Prepaid E] Collect
<br /> GEIVED, subject to Metal determined rates or contacts that have been abroad upon to writing between the cetier and shipper, Ifapplicable, otherwise to the miss, cmSeli'mrions and rules Ihat have been established by the caller and are switch
<br /> he shipper, on request and alt applicable state and federal regulations; the Forestry described above, In Speared good order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and dgstined as Indicate
<br /> are which said tympany (the word tympany being understood paread out this centrad as meaning any peman or corporation In possession of the property under me Scandal) agrees to carry to delivery at said destination, ti routs,
<br /> on IIs or otherwise I
<br /> er to another rester on me mute to saitl destination. It is mutually agreed as to each tamer of all or my of said place Mr over all or any income of said mule to designated and as to each pary at any time accuse ! In all or any of mod Prdperry mat eve,
<br /> vice to be performed hereunder shall be subject to all me conditions not prohibiled by law, whether printed or word n, herein decla red, Including the conditions on the back hereof, which are hereby ad reed to by the shipper and accepted for himself and h
<br /> igns.
<br /> ITS: Liability Llmitetion for loss or damage In this shipment may be applicable.See 49 U.S.C. 14706(c)(1)(A) and IS),
<br /> lis is to certify that the above-named materials are properly classified, described, packaged, marked, and labeled, and
<br /> e in proper condition for transportation according to the applicable regulations of the Department of Transportation PER:
<br /> t� FS •=
<br /> Tracy r dlllfi€ 3 �€1O�1I Ri�XI C €i�Uf1I@�II �mmvn t�F o)() - TEE Imo " IVfa�
<br /> -ZIPPER: CARRIER: USt ( 'dE 'El$ •`�ibe`) C#�a �3'?Q� �'6P•T
<br /> =R: f S >G�\ i�N e .�-^� p PER: JO
<br /> �3 DATE: to i - - '�T f� t Alf I
<br /> :MERGENCY RESPONSE NAME OR C NTRAGTfN&3Mf ER °
<br /> 'ELEPHONE NUMBER: G5OR OTHER UNIQUE IDENTIFIER:
<br /> 167 (Rev. 3117) v
<br />
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