ShippersNameAddress（托运人名称,地址）.docVIP

Shipper’s Name Address 託運人名稱,地址 DECLARATION OF DANGEROUS GOODS 危險貨物申報書 DANGEROUS PACKING CERTIFICATE 危險貨物包裝證明書 Consignee’s Name Address 收貨人名稱,地址 Ship’s Stowage Location 積載位置 Ocean Vessel Voy No. S/O No. Container No. 貨櫃號碼 Place of receipt 收貨地 Place of delivery 交貨地 Ship’s Operator 運送人 Container Operator 貨櫃管理人 Port of loading 裝貨港 Port of discharge 卸貨港 Vanning Survey Req. Not Req. 裝櫃檢查 □ □ Marks No. 麥頭及號碼 Proper Shipping Name 正確貨物名稱 Commodity 品名 Inner Packaging/Quantity/Capacity 內包裝種類/材質/數量/容量 Outer Packaging/Quantity/Capacity 外包裝種類/材質/數量/容量 IMDG Class IBC Yes □ No UN No. Large Package □ Yes □ No Subsidiary Risk Limit Quantity Yes □ No Technical name or Chemical name *When the UN number have special provision 274 or Proper Shipping Name is ended with N.O.S. that shall be supplemented with technical name or chemical name Packing Group Excepted Quantity □ Yes □ No Total Weight Gross/Net Kg NET: GROSS: Flash Point ℃ ℉ Marine Pollutant □ Yes □ No EMS TAB No. Remark: Properties 危險貨物 性質 Appearance 外觀 Odour 氣味 Specific Gravity 比重 Ignition point 燃點 Toxicity LD/TLV 毒性質 Reactivity and/or Other Hazard 反應性及其它危險性 Prevention Measures, Protection Equipments, and Medical First Aid 防災處理, 防災裝備, 以及醫療處理 Emergency Communication 24hr緊急時聯絡 I hereby certify that 1. The container was clean, dry and apparently fit to receive goods. 2. No incompatible substances have been packed into the container. 3. All packages have been externally inspected for damage, leakage or sifting, and only sound packages have been loaded. 4. All packages have been properly packed in the container and secured. 5. The container and packages are properly marked and labelled. 6. When solid carbon dioxide dry ice is used for cooling purposes, the container is externally marked or labelled in a conspicuous place at the door end, reading：”DANGEROUS CO2-GAS DRY ICE INSIDE. VENTILATE THOROUGHLY BEFORE ENTERING.” 7. The dangerous goods declaration required