Figure 2-5. IATA Shippers Declaration of Dangerous Goods

SHIPPERS DECLARATION FOR DANGEROUS GOODS

(Provide at least two copies to the airline)

Shipper

Air Waybill No.

DEFENSE DEPOT RICHMOND VIRGINIA

Page 1 of 1 Pages

RICHMOND, VA 23297

Shipper's Reference Number

(optional)

Consignee DISHOO

GOVERNMENT OF ISRAEL

MINISTRY OF DEFENSE

MAPA MESHUTAFIM

ISRAEL

Two completed and signed copies of this Declaration must

WARNING

be handed to the operator

Failure to comply in all respects with the applicable

Dangerous Goods Regulations may be in breach of

TRANSPORT DETAILS

the applicable law, subject to legal penalties. This

Declaration must not, in any circumstances, be

This shipment is within the

Airport of Departure

completed and/or signed by a consolidator, a

limitations prescribed for

forwarder or an IATA cargo agent.

(delete non-applicable)

PASSENGER CARGO

AND CARGO AIRCRAFT

AIRCRAFT

ONLY

Shipment type (delete non-applicable)

Airport of Destination

NON-RADIOACTIVE

RADIOACTIVE

NATURE AND QUANTITY OF DANGEROUS GOODS

Dangerous Goods Identification

Class

Pack- Subsi

ing

diary

Quantity and

Packing

Proper Shipping Name

Authorization

Divi-

Group Risk

type of packing

Inst.

sion

No.

XYLENES

UN130

III

1 STEEL DRUM (1A2)

309

X 0.94 LITRES

STORE IN A COOL, WELL-VENTILATED AREA AWAY FROM SOURCES OF HEAT,

Additional Handling Information

FLAME, SPARKS, COMBUSTIBLE MATERIALS OR OXIDIZERS. CONTAINERS MUST BE KEPT TIGHTLY CLOSED

TO PREVENT EVAPORATION OF FLAMMABLE LIQUIDS. 24 HOUR EMERGENCY CONTACT NUMBER

1-800-851-8061

I hereby declare that the contents of this consignment are fully and

Name/Title of Signatory

Quinton McHale, Packing Specialist

accurately described above by the proper shipping name, and are

classified, packaged, marked and labelled/placarded, and are in all

Place and Date

respects in proper condition for transport according to applicable

Richmond, VA 23297

3 Jan 95

international and national governmental regulations.

Signature

(see warning above)

Figure 2-5. IATA Shippers Declaration of Dangerous Goods