ࡱ> NQM[ R^/bjbj4<ΐΐ| 0^^8,Tk%ss"$$$$$$$$O')6$Q$^$$$(%%###$$#$$###0E`z!#$;%0k%#'*!'*#'*#hJ#< $$"k%$$$$'*^ m: qSi/algqS['`'ir[hQЏ3ubUS Declaration on Safety and Fitness of Dangerous Goods / Hazardous Goods Sň'ir Packaged ۏ/nArrival%/Q/nDeparture( S'N###lQS Shipper6e'N###lQS Consignee:bЏN###*ЏlQS Carrier:9 TT*!k ###n ###*!k Ship s name & Voyage NO. :ň'/nR\ Port of Loading:xS'/nܑq\ Port of Discharging :'irhTS Y(u ~NvƋ+R&{Sb{vS Marks & Nos, of the Goods, if applicable, identification or registration number(s) Of the unit ecknxЏ Ty*0qSi{|+R0qSĉSSň{|**0SNvy{|Tpeϑ0ꕹp!og **0c6RS^%`)n^**0'ir:Nwm malgir**0^%`ceS*** Proper shipping name*,IMO hazard class/ division, UN number, packaging group**, number and kind of packages, flash point (!c.c.),control and emergency temperature**, identification of the goods as MARINE POLLUTANT**, Ems No.*** "l'lS VSOvSodium Hydroxide, Solid 81823a!QXe~400*N;`͑kg Q͑/Qϑ Total weight (kg) Net weight (kg) ;`͑10200CSKQ Q͑10000CSKQNNňЏ'irvb__ Goods delived as : % Bg' Break bulk cargo ( b~N Unitized cargo box % ce'Sň Bulk packages %ceňVSO Solid in bulk ~N{|W Type of unit : (Ɩň{ Container %f Vehicle %Pg Portable tank %_^e_ Open (\_ Close YT (WeFhQR  Inset  in appropriate box*NO(uN)RFUh/FUT Ty/f NYv YT1 ^(WT TMRR ^_ir 2  zzv*g~nm+T gkYOir NN!kvňir 3  Pϑ **Y 0VEqSĉ 0,{2wS,{3.4.6 >k ***e *Proprietary/trade names alone are not sufficient. If applicable : (1)the world  WASTE should proceed name;(2) EMPTY/UNCLEANED or  RESIDUE-LAST CONTAINED ;(3) LIMITED QUANTITY the should be added.**When required in item 3.4.6,volume 2 of the IMDG Code;***When requiredDN NUS0DeQeQX'irSň'`h~gUS0QXqSi'irЏSňO(ut[~gUS0Ɩň{ňЏqSi'irň{"$     ( * , 4 > T V ^ l | ~    L P @ B D P ɼ hGPCJo( h\LmCJo( hQCJ hG-`CJ hHCJo( hG-`CJo(hG-` jRhno( hno( hG-`o( hG-`CJ hG-`CJo( hG-`5hG-`5CJo( hG-`5CJ hG-`5aJhG-`5aJo(4$  , @ V n $Ifgdp9JgdG-`$a$gd!$a$gdG-` $1$a$gdG-`  " N offffff $Ifgdp9Jkd$$IfTlwF$C 0    44 layt!TN P @ D ".Rofffff]fff $IfgdSN $Ifgdp9Jkd$$IfTlF$C 0    44 layt!T P R X n r  "&(,rvz| ǺѺѺѭޜh1h^CJOJQJaJo(h1CJOJQJaJo(hG-`hSNCJOJQJaJo(hG-`CJOJQJaJo(hdQhmGCJo(h5V.CJOJQJaJo( hG-`CJ hG-`CJo(hG-`CJOJQJo(hG-`CJOJQJ4Rr>Ljv(4@$IfWDd`gdp9J_$IfWD2`_gdp9J $IfgdSN $Ifgdp9J  >@BJjt&68>Nf(,DFJTVXbhj&"&橢U hCCCJo( hnCJo( h>TCJo(hhG-`CJhG-`CJOJhG-`CJOJQJhG-` jSh~OJQJo(hG-`CJOJQJo( hG-`CJo( hG-`CJ jSh!OJQJo(<@NhjRkdP$$IfTl4\P$\ T` 044 layt!T $Ifgdp9J(&&&'xxxo $Ifgdw $Ifgdp9J~kdN$$IfTl40$l  044 layt!TffN0Sf[T[hQb/gffN0YXbf The following documents(s) and information are submitted: (Wgy`Q N cOyrkDefN 0VEqSĉ 0,{1wS,{5.4.40 In certain circumstances special information certificates are required, see paragraph 5.4.4,volume 1 of IMDG Code.yQXf NbNN96ňЏvqSi'ir/algqS['`'ir] cĉ[hQv^Qnx0WkXQNcknxЏ Ty0qSĉS0R{|0qSi'`T^%`ce DUSPhQ0SňqSi'ir Sňcknx0(ϑ[}Yh0h_/hLrcknx0EN0N N3ubQnxe0 Declaration: I hereby declare that the contents of this declaration are fully and accurately described above by the proper shipping name, UN No., Class and EmS No. The goods are properly packaged, marked, labeled/ placarded and are in all respects in good condition for transport by sea. 3ubNXTY T _ N 3ubUSMO~{z Declarer(signature): Seal of Declaration Unit 3ubNXTWYHhS###01 2011t^ 7g 1e No.: Year Month Date;N{:gsQ~{lh Remarks by the Administration:'}%`T|NY T05u݋0 Ow05uP[{ _ N 5u݋137######## Emergency Contact Person s Name, Tel, Fax and E-mail :dk3ubUSN_ NN vQ-N$NN3ubNYucTRbЏ96 NNYu;N{:gsQX[g0 This declaration should be made in tripartite, one is kept by the Administration for file, and two for the declarer and the ship respectively.       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