TM 10-6640-238-13 HAZARDOUS MATERIAL SHIPPING PAPER page    4      of        5       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 3 4 L X Petroleum distillates, n.o.s., 3, UN1268, III {Petroleum Ether} 12 liters Flammable Liquid 1 100 grams Phenolphthalein, ACS 100 grams 3 10 grams p-Naphtholbenzein Analyzed Reagent 30 grams 4 100 grams X Potassium Chlorate, 5.1, UN1485, II 400 grams Oxidizer 3 100 grams Potassium Hydrogen Phthalate 300 grams 2 500 grams X Potassium Hydroxide, solid, 8, UN1813, II 1000 gms Corrosive 5 500 grams Potassium Iodide 2500 grams 2 500 grams Potassium Phosphate Dibasic 1000 grams 1 500 grams Potassium Phosphate Monobasic 500 grams 12 1 1b. cyl X Propane, 2.1, UN1978 12  lbs Flammable Gas 1 500 grams Pumice, technical 500 grams 1 1 lb Silicon Carbide 1 lb. 1 125 grams X Silver Nitrate, 5.1, UN1493, II 125 grams Oxidizer 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:  _________________________________________________