09-119 Seattle King County Public Health for AED Purchase - City of ...
09-119 Seattle King County Public Health for AED Purchase - City of ...
09-119 Seattle King County Public Health for AED Purchase - City of ...
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SHIPPER'S DECLARATION FOR DANGEROUS GOODSShipper PHILIPS MEDICAL SYSTEMS2301 5TH AVENUE SUITE 100SEATTLE, WASHINGTON 98121UNITED STATESAir Waybill No.Page 1 <strong>of</strong> 1 Pages(Provide at least two copies to the airline.Shippers Reference Number 87328722(optional)Consignee RECEIVINGCITY OF WOODINVILLE17301 133RD AVENUE NEWOODINVILLE WA 98072-8563UNITED STATESTwo completed and signed copies <strong>of</strong> this Declaration must behanded to the operatorWARNINGocER? 4.0o" ---VA .,I,iPowered by Ship•Hazmat®TRANSPORT DETAILSThis shipment is within thelimitations prescribed <strong>for</strong>(delete non-applicable)RAMMER CARGOARID•COOXASKI AIRCRAFTXMOWOOKKX ONI YAirport <strong>of</strong> DestinationAirport <strong>of</strong> DepartureSEATTLE - TACOMAINTERNATIONALAIRPORTNATURE AND QUANTITY OF DANGEROUS GOODSDangerous Goods IdentificationUNOrProper Shipping NameIDNo.UN3<strong>09</strong>0UN3<strong>09</strong>1Lithium metal batteriesLithium metal batteries packed withequipmentr Classor Division(SubsidiaryRisky99Failure to comply in all respects with the applicableDangerous Goods Regulations may be in breach <strong>of</strong>the applicable law, subject to legal penalties.Shipment Type (delete non-applicable)Packing1 GroupIIIINON-RADIOACTIVEI XRX10,111101XWETQuantity and Type<strong>of</strong> Packing1 FIBREBOARD BOXx 0.9 kg G3 FIBREBOARD BOXESx .4 'cgOverpack usedFPackingInst.968969rAuthorizationAdditional Handling In<strong>for</strong>mationEmergency Response Telephone Number: 18002553924Lithium Batteries: In case <strong>of</strong> fire avoid using water, use a Class D fire extinguisher, copper powder, or dry sand. If package is damaged, donot ship. Inspect internal contents and contact the shipper.Offered by Philips <strong>Health</strong>care Inc. 24 Hour ChemTel Emergency Contact Numbers:Domestic: 1-800-255-3924 (toll free)International: +001-813-248-0585(collect)I hereby declare that the contents <strong>of</strong> this consignment are fully andaccurately described above by the proper shipping name, and areclassified, packaged, marked and labelled/placarded, and are in allrespects in proper condition <strong>for</strong> transport according to applicableinternational and national governmental regulations. I declare thatall <strong>of</strong> the applicable air transport requirements have been met.Name/Title <strong>of</strong> SignatoryDexter Phanekham / Material HandlerPlace and Date<strong>Seattle</strong>, WA 12/18/20<strong>09</strong>Signature(see warning above)
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