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IMO DANGEROUS GOODS DECLARATION

This form meet the requirements of SOLAS 74 chapter VII,regulation 5;


MARPOL 73/78 Annex III,regulation 4 and the IMDG Code,General Introduction,section 9
Shipper 1 Reference number(s) 2

** HENKEL MALAYSIA SDN. BHD. ** PKGU21420300

Consignee 3 Carrier/Container operator 4

** CRP SYSTEM INCORPORATED

Container packing certificate/vehicle declareation Name/status,company/organization of signatory 5

QUANTERM LOGISTICS SDN BHD


DECLARATION Place and date

It is declared that the packing of the container has been carried out in
accordance with the General Introduction,IMDG Code,paragraph 12.3.7 or Signature on behalf of packer **
17.7.7
TO BE COMPLETED FOR SHIPMENTS
IN CONTAINER OR VEHICLES
Ship's name and voyage No. Port of loading 6 Remarks 7
** LOS ANDES BRIDGE PORT KLANG Emergency Contact : HEMTREC: +1 703-741-5970
Port of discharge 8
** MANILA NORTH
Marks and Nos. Number and kind of packages,proper shipping name/correct Goods 9
If applicable technical name*,IMO hazard class/division,UN number,packaging group**, Delivered as:
identification or flashpoint (in'C c.c.)**,control and emergency temperatures**,
registration number(s) identification of the goods as Breakbulk
of the container(s) MARINE POLLUTANT**,EmS No. and MFAG Table No.*** cargo

Unitized

cargo

VOLUME : 0.7384
DG Class : 3 Bulk

IMO No. : 3 packages

UNNO : 1987
P. SHIPPING NAME : ALCOHOLS, N.O.S. Type of

TECHNICAL NAME : Propanol


FLASH POINT : 40°C (104°F) Container

NETT WEIGHT : 178 KGS


GROSS WEIGHT : 233 KGS Open

INNER PACKAGING: 40pcs plastics jerrycans x 5L


OUTER PACKAGING: 1 WOODEN CASE Closed

UN PACKAGING CODE: 3H1


PACKING GROUP: 3 Tank container

EMS: F-E, S-D


MARINE POLLUTANT: N/A FCL

CNTR NO.: LCL

Distribution:

Yellow Copy -
SPU/Ship

Green Copy -
PSA

White Copy -
JOS

Blue Copy -
FCL Shipper

Pink Copy -

* Proprietary / trade names alone are not sufficient,If applicable: (1) the word "WASTE" should precade the name;
(2) "EMPTY UNCLEANED" or "RESIDUE - LAST CONTAINED" should be added; (3) "LIMITED QUANTITY"should be added.

DECLARATION Name / status, company / organization of signatory 11


I hereby declared that the contents of this consigment are fully and accurately
described by the correct technical name(s) proper shipping name(s), and are Place and date
classified,packaged,marked and labelled/placarded,and are in all respects
in proper condition for transport according to the applicable international and Signature on behalf of shipper **
national government regulations

Coloured boxes are mandatory to be filled up in type-written format

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