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TM 10-6640-239-13 HAZARDOUS MATERIAL SHIPPING PAPER page    3      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 5 2.25 oz Paste, Gasoline Indicating 11.25 oz 5 3 oz Paste, Water Indicating 15 oz 2 1 gal. X Petroleum Distillates, n.o.s, 3, UN1268, III  {Dry Cleaning Solvent} 2 gallons Flammable Liquid 13 4 L X Petroleum Distillates, n.o.s., 3, UN1268, II  {Petroleum Ether} 52 liters Flammable Liquid 2 500 grams Potassium Phosphate, Dibasic 1000 grams 1 500 grams Potassium Phosphate, Monobasic 500 grams 6 1 lb. cyl X Propane, 2.1, UN1978 6 lbs. Flammable Gas 1 500 grams Pumice, Technical 500 grams 2 2.5 kg Silica Gel 5 kg 2 1 lb Silicon Carbide 2 lb. 1 1 kg. Sodium Carbonate, Decahydrate 1 kg 1 500 grams X Sodium Hydroxide, solid, 8, UN1823, II 500 grams Corrosive 1 500 grams Sodium Sulfate, anhydrous 500 grams 7 2.5 L X Sulphuric acid, 8, UN1830, II 17.5 liters Corrosive 1 20 L X Toluene, 3, UN1294, II 20 L Flammable Liquid 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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