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BILL OF LADING <br /> ,a <br /> � f :rr14 <br /> C I e a n E a rt h• DELIVERY DATE JOB N <br /> POINT OF CONTACT <br /> SHIPPER/CUSTOMER PHONE# <br /> ADDRESS <br /> CITY.STATE,ZIP PHONE# <br /> CARRIER/TRANSPORTER _ POINT OF CONTACT <br /> CONSIGNEE!FACILITY PHONE# <br /> l "r . <br /> ADDRESS <br /> CrTY,STATE ZIP Containers <br /> and ID Number) Total <br /> Proper Shipping Name,Hazard Class, No. Type �� <br /> AHM US DOT Description (Including <br /> I <br /> F I A 0 <br /> i <br /> fi{ <br /> B <br /> C <br /> D <br /> Special Handling Instruction and Additional Information <br /> OIL FILTM - RECII fill <br /> Placards Provided YES NO Emergency Phor #(877) <br /> SHIPPER'S CERTIFICATION This is to certify that the above named materials are properly classified,described,packaged,marked and labeled,and are i, jroper <br /> transportation according to the applicable regulations of the Department of Transportation. <br /> I(SHIPPER)PRINT OR TYPE NAME(fn 6r&y{ Df 119,4- C SIGNATURE •.TH <br /> x t,`\ n It ri X 1 1 <br /> (CARRIER/TRANSPORTER)PRINT OR TYPE NAME SIGNATURE I ,TM i DAY <br /> (CON IGNEE/FACILITY)PRINT OR TYPE NAME SIGNATURE <br /> tine ' ow <br /> X X <br /> FORM NO 209 REV 7 V20 <br /> SHIPPER <br />