HAZARDOUS MATERIALS TRANSPORTATION POLICY SHIPPER CERTIFICATION AND AGREEMENT

Transcription

1 HAZARDOUS MATERIALS TRANSPORTATION POLICY SHIPPER CERTIFICATION AND AGREEMENT Pursuant to BNSF Logistics Hazardous Materials Transportation Policy (the Policy ), BNSF Logistics, BNSF Logistics International and Royal Cargo Line, Inc. (collectively, Logistics) will not arrange for the shipment of Hazardous Materials as defined by the U.S. Department of Transportation (49 CFR 171.8) if (i) such transport is prohibited by the regulations governing the respective mode of transportation (i.e., Ground and Rail under 49 CFR, Air under ICAO/IATA and Ocean under IMDG) or (ii) the commodities are listed on Schedule A to the policy. If the Hazardous Materials (as defined in the policy) are not prohibited from being handled under the Policy, Logistics may arrange for the shipment of the hazardous materials subject to compliance certain procedures, including the completion of this Shipper Certification and Agreement. Please complete the following information, sign and return to: BNSF Logistics HazMat Team: FAX (479) Shipper Name: transport: intends to ship Hazardous Materials via the following mode(s) of Air Ocean Ground Rail Submit a Shipper s Declaration for Dangerous Goods for each type of Hazardous Material that Shipper intends to ship. Excepted Products: If any of the products to be shipped is a Hazardous Material that is not subject to the shipping paper requirements of 49 CFR, IATA/ICAO and/or IMDG, please attach a copy of the Material Safety Data Sheet for each type of Hazardous Material that meets this exception and check the following: Hazardous Material(s) not subject to the shipping paper requirements of: Air (IATA/ICAO) Ocean (IMDG) Ground Rail Future Hazardous Materials Shipments: If the Shipper intends to ship Hazardous Materials for which a Shipper s Declaration for Dangerous Goods is not attached, a new Shipper Certification and Agreement must be submitted for approval. CERTIFICATION AND AGREEMENT In connection with the Hazardous Materials being shipped by Shipper, Shipper hereby certifies as follows: 1. All hazardous materials are fully and accurately described by their proper shipping name, and are classified, packaged, marked and labeled/placarded, and are in all respects in proper condition for transport according to the applicable international and national governmental regulations (49 CFR, IATA/ICAO and/or IMDG, as applicable). 2. All documents must be legibly signed by an authorized principal, officer, partner, or employee of the shipper or its agent.

2 3. Shipper has provided proper hazardous material training to the employee(s) involved in the processing of the hazardous material(s) shipment and/or confirmed that such training has been provided to agents hired by the Shipper to handle hazardous material(s). SHIPPER SHALL INDEMNIFY AND HOLD HARMLESS LOGISTICS AND ITS SERVICE PROVIDERS FROM ANY DAMAGE, CLAIM, FINE AND/OR PENALTY RESULTING FROM SHIPPER S FAILURE TO COMPLY WITH THE APPLICABLE LAWS AND REGULATIONS GOVERNING THE SHIPMENT OF THE HAZARDOUS MATERIALS CARGO IDENTIFIED IN THE ATTACHED SHIPPER S DECLARATION FOR DANGEROUS GOODS. Shipper acknowledges and agrees that Logistics, based on the information provided by Shipper, shall tender Shipper s cargo to the carrier for transport; and, that carrier (not Logistics) will determine whether it will transport the cargo. Logistics does not warrant acceptance of cargo for transport by any carrier. [NAME OF SHIPPER] Signature Printed Name: Title: Address: Date:

3 SCHEDULE A PROHIBITED HAZARDOUS MATERIAL SHIPMENTS 1. Radioactive Materials - A highway route-controlled quantity of Class 7 materials 2. Explosives - More than 25 kg (55 pounds) of a Division 1.1, 1.2 or 1.3 material, or an amount of a Division 1.5 material requiring a placard under 49 CFR 172, Subpart F 3. Any amount of materials that are Toxic Inhalation Hazards (TIH)/ Poison Inhalation Hazards (PIH) or anhydrous ammonia (see list below) 4. A shipment of compressed or refrigerated liquid methane or natural gas or other liquefied gas with a methane content of at least 85 percent, in a bulk packaging having a capacity equal to or greater than 13,248 L (3,500 gallons) for liquids or gases 5. Any hazardous material that requires a motor carrier to have in effect more than $1,000,000 of Financial Responsibility as defined by 49 CFR Any contaminant or infectious material or any other material, the transportation of which is restricted by USDA regulation List of Poison Inhalation Hazard (PIH) or Toxic Inhalation Hazard (TIH) Chemicals September 18, 2007 HMRC Proper Shipping Name UN/NA# Chloroethanal UN Methyl-2-Heptanethiol UN , 5-Dichloro-2, 4, 6-Trifluoropyridine NA Acetone Cyanohydrin, Stabilized UN Acrolein, Stabilized UN Allyl Alcohol UN Allyl Chloroformate UN Allylamine UN Ammonia, Anhydrous UN Ammonia, Anhydrous UN Ammonia, Anhydrous UN Ammonia, Anhydrous UN Ammonia, Solution UN Ammonia, Solution UN Arsenic Trichloride UN Arsine UN Boron Tribromide UN Boron Trichloride UN Boron Trifluoride UN Bromine Chloride UN Bromine or Bromine Solutions UN Bromine Pentafluoride UN Bromine Solutions UN Bromine Trifluoride UN Bromoacetone UN Carbon Monoxide and Hydrogen mixture, Compressed UN Carbon Monoxide, Compressed UN Carbon Monoxide, refrigerated liquid NA Carbonyl Fluoride UN 2417

4 Carbonyl Sulfide UN Chlorine UN Chlorine Pentafluoride UN Chlorine Trifluoride UN Chloroacetone, Stabilized UN Chloroacetonitrile UN Chloroacetyl Chloride UN Chloropicrin UN Chloropicrin and Methyl Bromide mixtures UN Chloropicrin and Methyl Bromide mixtures UN Chloropicrin and Methyl Chloride mixtures UN Chloropivaloyl Chloride NA Chlorosulfonic Acid UN Coal Gas, Compressed UN Compressed Gas, toxic, corrosive, n.o.s. UN Compressed Gas, toxic, corrosive, n.o.s. UN Compressed Gas, toxic, corrosive, n.o.s. UN Compressed Gas, toxic, corrosive, n.o.s. UN Compressed Gas, toxic, corrosive, n.o.s. UN Compressed Gas, toxic, flammable, corrosive, n.o.s. UN Compressed Gas, toxic, flammable, corrosive, n.o.s. UN Compressed Gas, toxic, flammable, corrosive, n.o.s. UN Compressed Gas, toxic, flammable, corrosive, n.o.s. UN Compressed Gas, toxic, flammable, n.o.s. UN Compressed Gas, toxic, flammable, n.o.s. UN Compressed Gas, toxic, flammable, n.o.s. UN Compressed Gas, toxic, flammable, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, n.o.s. UN Compressed Gas, toxic, oxidizing, corrosive, n.o.s. UN Compressed Gas, toxic, oxidizing, corrosive, n.o.s. UN Compressed Gas, toxic, oxidizing, corrosive, n.o.s. UN Compressed Gas, toxic, oxidizing, corrosive, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN Compressed gas, toxic, oxidizing, n.o.s. UN 3303

5 Crotonalydehyde, Stabilized UN Cyanogen UN Cyanogen Chloride, Stabilized UN Cyclohexyl Isocyanate UN Diborane UN Dichlorosilane UN Diketene, Stabilized UN Dimethyl Sulfate UN Dimethylhydrazine, Symmetrical UN Dimethylhydrazine, Unsymmetrical UN Dinitrogen Tetroxide UN Ethyl Chloroformate UN Ethyl Chlorothioformate UN Ethyl Isocyanate UN Ethyl Phosphonothioic Dichloride, Anhydrous NA Ethyl Phosphonous Dichloride, Anhydrous pyrophoric liquid NA Ethyl Phosphorodichloridate NA Ethyldichloroarsine UN Ethylene Chlorohydrin UN Ethylene Dibromide UN Ethylene Oxide and Carbon Dioxide mixture UN Ethylene Oxide and Carbon Dioxide mixture UN Ethylene Oxide or Ethylene Oxide with Nitrogen UN Ethyleneimine, Stabilized UN Fluorine, Compressed UN Gas Identification set NA Gas sample, non-pressurized, toxic, flammable, n.o.s. UN Gas sample, non-pressurized, toxic, n.o.s. UN Germane UN Hexachlorocyclopentadiene UN Hexaethyl tetraphosphate and compressed gas mixtures UN Hexafluoroacetone UN Hydrocyanic acid, aqueous solutions or Hydrogen cyanide, aqueous solutions UN Hydrogen Bromide, anhydrous UN Hydrogen Chloride, anhydrous UN Hydrogen Chloride, refrigerated liquid UN Hydrogen Cyanide, solution in alcohol UN Hydrogen Cyanide, stabilized UN Hydrogen Fluoride, Anhydrous UN Hydrogen Iodide, anhydrous UN Hydrogen Selenide, anhydrous UN Hydrogen Sulfide UN Insecticide gases, toxic, flammable, n.o.s. UN Insecticide gases, toxic, flammable, n.o.s. UN Insecticide gases, toxic, flammable, n.o.s. UN 3355

6 Insecticide gases, toxic, flammable, n.o.s. UN Insecticide gases, toxic, flammable, n.o.s. UN Insecticide gases, toxic, n.o.s. UN Iron Pentacarbonyl UN Isobutyl Chloroformate NA Isobutyl Isocyanate UN Isopropyl Chloroformate UN Isopropyl Isocyanate UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Methacrylonitrile, Stabilized UN Methanesulfonyl Chloride UN Methoxymethyl Isocyanate UN Methyl Bromide UN Methyl Bromide and Ethylene dibromide mixtures, liquid UN Methyl Chloroformate UN Methyl Chloromethyl Ether UN Methyl Iodide UN Methyl Isocyanate UN Methyl Isothiocyanate UN Methyl Mercaptan UN 1064

7 Methyl Orthosilicate UN Methyl Phosphonic Dichloride NA Methyl Phosphonous Dichloride, pyrophoric liquid NA Methyl Vinyl Ketone, Stabilized UN Methylchlorosilane UN Methyldichloroarsine NA Methylhydrazine UN Isobutyl Isocyanate UN Isopropyl Chloroformate UN Isopropyl Isocyanate UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, corrosive, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, flammable, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, corrosive, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Liquefied gas, toxic, oxidizing, n.o.s. UN Methacrylonitrile, Stabilized UN Methanesulfonyl Chloride UN Methoxymethyl Isocyanate UN Methyl Bromide UN Methyl Bromide and Ethylene dibromide mixtures, liquid UN Methyl Chloroformate UN Methyl Chloromethyl Ether UN Methyl Iodide UN Methyl Isocyanate UN 2480

8 Methyl Isothiocyanate UN Methyl Mercaptan UN Methyl Orthosilicate UN Methyl Phosphonic Dichloride NA Methyl Phosphonous Dichloride, pyrophoric liquid NA Methyl Vinyl Ketone, Stabilized UN Methylchlorosilane UN Methyldichloroarsine NA Methylhydrazine UN n-butyl Chloroformate UN n-butyl Isocyanate UN Nickel Carbonyl UN Nitric Acid, red fuming UN Nitric oxide and nitrogen dioxide mixtures or Nitric oxide and dinitrogen tetroxide mixtures UN Nitric Oxide, Compressed UN Nitrogen Trioxide UN Nitrosyl Chloride UN n-propyl Chloroformate UN n-propyl Isocyanate UN Oil Gas, Compressed UN Organic phosphate, mixed with compressed gas or Organic phosphate compound, mixed with compressed gas or Organic phosphorus compound, mixed with NA 1955 compressed gas Oxygen Difluoride, Compressed UN Parathion and Compressed gas mixture NA Pentaborane UN Perchloromethyl Mercaptan UN Perchloryl Fluoride UN Phenyl Isocyanate UN Phenyl Mercaptan UN Phenylcarbylamine Chloride UN Phosgene UN Phosphine UN Phosphorus Oxychloride UN Phosphorus Pentafluoride UN Phosphorus Trichloride UN sec-butyl Chloroformate NA Selenium Hexafluoride UN Silicon Tetrafluoride UN Stibine UN Sulfur Dioxide UN Sulfur Tetrafluoride UN Sulfur Trioxide, Stabilized UN Sulfuric acid, fuming UN Sulfuryl Chloride UN 1834

9 Sulfuryl Fluoride UN Tellurium Hexafluoride UN tert-butyl Isocyanate UN Tetranitromethane UN Thiophosgene UN Titanium Tetrachloride UN Toxic by Inhalation liquid, corrosive, n.o.s. UN Toxic by Inhalation liquid, corrosive, n.o.s. UN Toxic by Inhalation liquid, flammable, n.o.s. UN Toxic by Inhalation liquid, flammable, n.o.s. UN Toxic by Inhalation liquid, n.o.s. UN Toxic by Inhalation liquid, n.o.s. UN Toxic by Inhalation liquid, oxidizing, n.o.s. UN Toxic by Inhalation liquid, oxidizing, n.o.s. UN Toxic by Inhalation liquid, water-reactive, n.o.s. UN Toxic by Inhalation liquid, water-reactive, n.o.s. UN Trichloroacetyl Chloride UN Trifluoroacetyl Chloride UN Trifluorochloroethylene, Stabilized UN Trimethoxysilane NA Trimethylacetyl Chloride UN Tungsten Hexafluoride UN Waste Allyl Alcohol UN Waste Hexachlorocyclopentadiene UN Waste Sulfuric acid, fuming UN Waste Toxic Liquid, corrosive, inorganic, n.o.s. UN 3289