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TM 10-6640-239-13 HAZARDOUS MATERIAL SHIPPING PAPER page    2      of        3       To: consignee From: shipper Street: Street: City: Zip: City: Zip: Phone #: Phone #: Delivering Carrier: Vehicle#: U.S. DOT HazMat Reg. #: Qty UNIT SIZE HM Shipping Description (Shipping name, Hazard Class, ID #, Packing Group) Total Amount Labels 4 150 grams Grease, Ground Glass Joint 600 grams 2 500 ml X Hydrochloric Acid, 8, UN1789, III 1000 ml Corrosive 12 500 ml X Hydrogen Peroxide, aqueous solution, 5.1, UN2014, II 6 liters Oxidizer Corrosive 1 4 L X Isopropanol, 3, UN1219, II 4 liters Flammable liquid 1 5 gals. X Isopropanol, 3, UN1219, II 5 gallons Flammable Liquid 4 1 liter Lubricating Oil, Vacuum Pump 4 liters 25 X Mercury Contained in Manufactured Articles, 8, UN2809, III 25 Thermo- meters Corrosive 2 500 grams X Methanol, 3, UN1230, II, Poison 1000 grams Flammable liq. Toxic 1 5 gal. X Octanes, 3, UN1262, II 5 gallon Flammable Liquid 13 1 gal. Oil, Bath 13 gallons 2 500 mg X Oxidizing solid, n.o.s. (Sodium Dichromate), 5.1, UN1479, I 1000 mg Oxidizer 2 230 cu. ft. cyl. X Oxygen, compressed, 2.2, UN1072 460 cu. ft. Non-Flammable gas, Oxidizer 2 1 gal X Paint related material, 3, UN1263, II  {Naphtha} 2 gallons Flammable Liquid 1 1 liter Paraffin 1 Liter This is to certify that the above named materials are properly classified, described, packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation. Signed:______________________________________________       Date: ___________ EMERGENCY CONTACT: ____________________________________


 


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