SHIPPER’S DECLARATION FOR DANGEROUS GOODS

Shipper
Air Waybill No. 20020407
INTERCOAR SAS
NIT N. 901030520-5 Page 1 of 1 Pages
CR 14 85 68 OF 406A
BOGOTA - COLOMBIA Shipper’s Reference No.
(optional)
Consignee
GAS CLEANING TECHNOLOGIES, LLC
TEL. +1 3059841022, CONTACTO: JORGE AREVALO
4953 N. OCONNOR BLVD IRVING, TEXAS 75062
ESTADOS UNIDOS (EE. UU)

Two completed and signed copies of this Declaration must be handed to the operator.
WARNING

Failure to comply in all respects with the applicable

TRANSPORT DETAILS Dangerous Goods Regulations may be in breach of the
This shipment is within the limitations Airport of Departure (optional): applicable law, subject to legal penalties.
prescribed for:

(delete non-applicable )
EL DORADO
BOGOTA D.C.
PASSENGER AND CARGO
CARGO AIRCRAFT XXX
AIRCRAFT ONLY

Airport of Destination (optional): Shipment type: (delete non-applicable)

DFW INTERNATIONAL AIRPORT TX USA NON-RADIOACTIVE RADIOACTIVE
XXXXXXXXXXX
NATURE AND QUANTITY OF DANGEROUS GOODS

Dangerous Goods Identification

UN or Proper Shipping Name Class or Division Packing Packing

Quantity and Type of Packing Authorization
ID No. (subsidiary hazard) Group Inst.

UN1230 METHANOL 3 (6.1) II 1 Fibreboard box x 1 L Y341

METANOL 1 Caja de Carton x 1 L

Additional Handling Information

+ telefono de contacto

I hereby declare that the contents of this consignment are fully and accurately Name of Signatory
described above by the proper shipping name, and are classified, packaged JORGE AREVALO
marked and labelled/placarded, and are in all respects in proper condition for
transport according to applicable international and national governmental Date 18 DE MARZO 2020
regulations. I declare that all of the applicable air transport requirements have
been met.
Signature
(See warning above)