Hazardous Materials Bill of Lading
Shipper Name
Shipper Address
Consignee Name
Consignee Address
Date
Bill of Lading Number
Carrier Name
Description of Hazardous Materials
Proper Shipping Name
Hazard Class
UN/NA Number
Packing Group
Quantity
Type of Packaging
Additional Handling Information
Emergency Contact Name
Emergency Contact Number
Shipper Signature
Date
Carrier Signature
Date