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CONTAINER PICK-UP P—'IRNNo: 656926 <br /> CUSTOMER NUMBER: C'MMK�NO'° <br /> SHIPPED FROM: � �S'33� <br /> BRANCH: ye— <br /> DATE: ,O <br /> 7FG <br /> SHIP TO: UNIVAR USA INC. UNIVAR DRIVER: <br /> 2256 Junction Ave TRUCK/TRAILER#: G <br /> San Jose, CA 95131-1216 PREPAID E] COLLECT ❑ <br /> CARRIER:[�/�j L (/ <br /> IN CASE OF CHEMICAL EMERGENCY CALL CHEMTREC : 1-800-424-9300 <br /> OTY RM DESCRIPTION AND PRODUCT NUMBER DEPOSR <br /> The undersigned, on behaH of Univar <br /> Poly Drum 55 GAL (PM 248020)Act II or Contico USA Inc., acknowledges receipt of <br /> property described below, in apparent <br /> good order, except as noted (contents <br /> and condition of contents of packages <br /> unknown), marked, consigned, and <br /> destined as indicated, and agrees to <br /> transport or arrange for transportation <br /> \_ <br /> of <br /> ly D such properly to its usual place of <br /> delivery at such destination. <br /> Po = 55 GAL (PM 248020)ActII orConlico NO POSR <br /> SFEIW E%CEPTIONSiIE WRNS BELAY,LIST AN1'CCN- <br /> TAMERS OR MATERIALS RECEIVED NOT SNOWN.CRED" <br /> t WNL BE ALLOWED FOR ZETAS SUBJECT TO COUNT AND <br /> CONDITION VERIFIED AT OUR PUNT. <br /> J <br /> Poly Drum 15 GAL (P/N248100) <br /> OF EMEfY i <br /> Stainless Steel Drum 55 GAL(PM 248270) 1600,00 <br /> Stainless Steel Drum 15 GAL(PIN 248210) 1200.00 <br /> SERIAL No <br /> N Steel Drum 55 GAL (PM 333360) .00 <br /> SERIAL NO <br /> SERIAL NO <br /> Steel Dnun 55 GAL (PM 333360) NO DEPOSIT SERIAL NO <br /> SERIAL NO. <br /> Poly Pail 5 GAL (PM/643%3) All Pure Bleach $7.50 <br /> SERIAL NO <br /> Poly Drum 55 GAL(PIN 610679)Ferric Chloride 00 EMPTY CONTAINER CERTIFICATION <br /> I hearty certify that mese containers are'empty, <br /> as that term Is defined In the EnAkonmental <br /> Protection Agency regulations,40 CFR 261,7',and <br /> P*DW 55 GAL PM 610645 Bleach-All Pure that they have been property prepared for <br /> r* ( ) transporlatlon under Me regu ations of the <br /> U.S.Department of Transportation,49 CFR 173.29." <br /> P*Drum 55 GAL(PM 649068)Bleach-Hasa (please <br /> A�n NAME <br /> DATE: <br /> Replacement Bungs(PIN 306230) <br /> SIGNATURE: <br /> l Thb b W r;en that the above named materials are prooerN classaieQ Oesc DackafleQ marked and labawl,and are in <br /> far trensponation,according to the appllMrsa0Mla/regutkx��s oith nmam M Transponatbn. <br /> SHIPMVP rri-ENBYG I /! RECEIVED BY DATE UNIVAR USA INC. <br /> . ,�/yam ,'.� <br /> FORM REVISIONDATE: 623,96I&I .V/` / r� /.lig GRMNIC REVISgN DATE DS'11r9s <br /> ITE•VWR DRIVER COPY YELLOW-CUSTOMER COPY PINK-OFFICE COPY FOFMNO SJTDRM V•raun No: 001 <br />