Document Lpgvkye5kYyk3LLLkB5XyZVwX
: REQUEST FOR SHIPPING
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Attention j^C
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Address
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Description of Shipment /SO fjCc>c>Z>
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State lU. -J -
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Zip ^0 2- 7 PhonejTvr 2l/C7
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Chemical Name
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(if applicable) Haskell # -----:-------- :
Type of inner pkg
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MR#
X 7_____________________ __________________. ____________
Sample VoL/wt.
No. of inner pkgs--
;
Total No. of containers
. . .--
HAZARDOUS MATERIAL B NO. 17 ./TTaYES.",,.:,- , (IF YES. COMPLETE CLASSIFICATION BELOW)
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CHECK HAZARD CLASSIFICATION, ASTERISK SECONDARY CLASSIFICATION
............. ,, (SEE REVERSE SIDE FOR DEFINITIONS)
.EXPLOSIVES - CLASS AD----- B Q ~ CD
OXIDIZER
ETIOLOGIC AGENT
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FLAMMABLE SOLID CORROSIVE MATERIAL (LIQUID)
RADIOACTIVE MATERIALS (**)
POISONOUS LIQUID, CLASS B
POISONOUS GAS, CLASS A. . ........ ,
POISONOUS LIQUID, CLASS k . ;
., a,
POISONOUS SOLID, CLASS B
:1: 7D : - -CORROSIVE MATERIAL (SOLID)
FLAMMABLE GAS
a IRRITATING MATERIAL
NONFLAMMABLE GAS
a COMBUSTIBLE LIQUID (*)
FLAMMABLE LIQUID (*) (BELOW 100F)
a (BETWEEN 100F&200)
a a
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OTHER REGULATED MATERIAL AD B[] CD DD E
_____________ _______________________________CARCINOGEN OSHA STRONG
(*) FLASHPOINT--TAG. C.C. ........: . ; :.?E. . --y.
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(*n SHIPMENT MUST BE APPROVED BY THE RADIOLOGICAL SAFETY OFFICER
MATERIALS WHICH COULD POLYMERIZE OR DECOMPOSE IN TRANSIT ARE PROHIBITED
Basis tor.Hazard Classification (References etc.).
SPECIAL INSTRUCTIONS
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CHEMIST/SUPERVISOR
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REVIEWED & APPROVED --..........
TO BE COMPLETED BY COMMITTEE SHIPPING NAME___ LIMITED QUANTITY YESQ
NOD
______ ___ __- __^------------------.------------- ------.------- -
. DOT COORDINATOR OR DESIGNATE
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____:_______ ____________ ______ --^--77
- DUP040005067
Diana Lead Data Entry Coding Form:
DecCor.trol#.
272
BatesBegin.j DUP040005067 Doc Type. Form
BatesEnd: Year Date'
TotalPages 1993 Month Date.
1 Attaint?# If0____ I
J__ !l11 Day Date.
Title Stine-Haskell Request for Shipping Reference
jPrimary Author Last Name Robinson
| Fiist Name Middle Initial.| Benjamin
J
Secondary Authors
| Publication: |
|
Primary Keith McCleary or Ray Sobosinski Recipient (s):
CC's:
Names Stated
.Chambers Works Plant Jackson Lab Deepwater, NJ, Haskell
Doc Problems
....... . . . .
Case Produced In | Steven Thomas | Produced By. | DPT
jj Source Responsive to Plaintiffs 1st Re j
Dup/Cross Ref#'s: .. . . -. . . . ___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ J
Doc Control Comments:
Disk Box 1, January 2002. SH001001 - SH001002
Obj. Coder Nam 1 D. Green
J Obj Data Entry Nam I D. Green
I ObjDataDate 1 8/22/2002
N26921