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    Diclofenac

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    Sun Express
    The document is a multimodal dangerous goods form containing shipment details of toxic solid organic material from India to Ghana. It provides information on the shipper, transport document number, consignee, description of goods, packaging, container and certification details as required for transporting dangerous goods internationally.

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    © All Rights Reserved
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    Diclofenac

    Uploaded by

    Sun Express
    73 views2 pages
    The document is a multimodal dangerous goods form containing shipment details of toxic solid organic material from India to Ghana. It provides information on the shipper, transport document number, consignee, description of goods, packaging, container and certification details as required for transporting dangerous goods internationally.

    Original Title

    Diclofenac (1) (1)

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    © © All Rights Reserved

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    The document is a multimodal dangerous goods form containing shipment details of toxic solid organic material from India to Ghana. It provides information on the shipper, transport document number, consignee, description of goods, packaging, container and certification details as required for transporting dangerous goods internationally.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    73 views2 pages

    Diclofenac

    Uploaded by

    Sun Express
    The document is a multimodal dangerous goods form containing shipment details of toxic solid organic material from India to Ghana. It provides information on the shipper, transport document number, consignee, description of goods, packaging, container and certification details as required for transporting dangerous goods internationally.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Multimodal Dangerous Goods Form

    1 Shipper/Consignor/Sender (full style address is mandatory) 2 Transport document number


    Shubham Pharmachem Pvt Ltd BOOKING NO:
    : 205-206, Laxmi Plaza, Laxmi Industrial Estate, 4 Shipper's reference
    New Link Road, Andheri West, Mumbai - 400053,
    India 5 Freight Forwarder's reference

    6 Consigne Carrier:
    GEO MEDICORE LIMITED
    P.O BOX 2511 ACCRA Ghana
    SHIPPER'S DECLARATION
    I hereby declare that the contents of this consignment are fully and accurately
    described below by the proper shipping name, and are classified, packaged, marked
    and labelled/placarded and are in all respects in proper condition for transport
    according to the applicable international and national government regulations.
    8 This shipment is within the limitations prescribed for: 9 Additional handling information
    PASSENGER AND CARGO CARGO ONLY
    10 Vessel and Voyage number 11 Port of loading
    NHAVA SHEVA
    12 Port of discharge 13 Destination
    TEMA TEMA
    14 Shipping Marks *Number and kind of packages; description of goods Gross mass (kg) Net Mass Cube(m3)

    UN : UN2811
    Proper Shipping Name : TOXIC SOLID, ORGANIC, N.O.S. (Diclofenac
    Sodium)
    Technical Name /chemical name : Diclofenac sodium
    Class: 6.1
    Sub Risk (if any) :
    Paking Group :III
    232 200
    Marine Pollutant : NA
    Kgs Kgs
    Packaging type (Outer ) with quantity – 8 FIBRE BOARD DRUMS
    Inner packing details : DOUBLE LINNER HDPE BAG

    Flashpoint : NA
    EMS Code :
    IMO Label : 1G/Z 25/S/23 IND/112084965
    MFAG Number:
    Reefer Temp : Humidity : Ventilation :
    Boiling Point : NA
    Emergency Contact person name/number : SACHIN 8424959596
    Limited Quantity :
    Poisonous inhalation hazard :
    Notes :
    *Fields marked in red are mandatory to fill. Rest as per conditions if amy required.
    Total cube (m3)
    Other Details UN PACKAGING CODE - 1G/Z 25/S/23 IND/112084965
    15 Container identification no. 16 Seal number(s) 17 Container size & type 18 Tare mass (kg) 19 Total gross (incl. tare) (kg)

    CONTAINER PACKING CERTIFICATE 21 RECEIVING ORGANIZATION RECEIPT


    I hereby declare that the goods described above have been Received the above number of packages/containers/trailers in apparent good order
    placed/loaded into the container/vehicle identified above in accordance and condition, unless stated hereon: RECEIVING ORGANIZATION RE-MARKS:
    with the applicable provisions. **MUST BE COMPLETED AND
    SIGNED FOR ALL CONTAINER/VEHICLE LOADS BY PERSON
    RESPONSIBLE FOR PACKING/LOADING
    20 Name of company(stamp & signature are mandatory) Haulier's name 22 Name of company (OF SHIPPER PREPARING
    Shubham Pharmachem Pvt Ltd THIS NOTE) (stamp & signature are mandatory)
    Shubham Pharmachem Pvt Ltd
    Name/status of declarant Vehicle reg no. Name/status of declarant

    Place and date: Mumbai Signature and date Place and date Mumbai

    Signature of declarant DRIVER'S SIGNATURE Signature of declarant

    * DANGEROUS GOODS
    You must specify proper shipping name, hazard class, UN No., Packaging group, (where assigned) Marine pollutant and observe the mandatory
    requirements, under applicable national and international governmental regulations. For the purpose of the IMDG Code see
    5.4.1.
    ** For the purpose of the IMDG Code see 5.4.2.

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