MULTIMODAL DANGEROUS GOODS FORM
\r\n\r\n This form may be used as a dangerous goods declaration as it meets the\r\n requirements of SOLAS 74, chapter VII, regulation 5; MARPOL 73/78,Annex\r\n III, regulation 4 and section 9 of the General Introduction to the IMDG\r\n Code.\r\n
\r\n1.Shipper
\r\n\r\n {{ tableData.shipper }}\r\n
\r\n2.Transport document number
\r\n{{ tableData.transportNumber }}
\r\n3.Page of pages
\r\n{{ tableData.pageOfPages }}
\r\n4.Shipper's reference
\r\n{{ tableData.shipperReference }}
\r\n5.Freight forwarder's reference
\r\n{{ tableData.freightForwarderReference }}
\r\n6.Consignee
\r\n\r\n {{ tableData.consignee }}\r\n
\r\n7.Carrier (to be completed by the carrier)
\r\n{{ tableData.carrier }}
\r\n10.Vessel/flight no.and date
\r\n{{ tableData.vesselOrflightNoAndDate }}
\r\n11.Port/place of loading
\r\n{{ tableData.portPlaceOfLoading }}
\r\n12.Port/place of discharge
\r\n{{ tableData.portPlaceOfLoading }}
\r\n13.Destination
\r\n{{ tableData.destination }}
\r\n\r\n * 9.Additional handling information\r\n
\r\n\r\n 24 hr Emergency contact person :\r\n
\r\n 24 hr Emergency contact telephone:\r\n
\r\n
SHIPPER'S DECLARATION
\r\n\r\n {{ tableData.shipperdeclaration }}\r\n
\r\n\r\n 8.This shipment is within the limitations prescribed for: (Delete\r\n non-applicable)\r\n
\r\n\r\n 14.Shipment information Number and kind of packages; description of\r\n goods ( *see bottom)\r\n
\r\n{{ tableData.descriptionOfGoods }}
\r\n*UN No
\r\n*Imo Class(Sub risk)
\r\nSub Risk1
\r\nSub Risk2
\r\n*Proper Shipping Name
\r\n\r\n *\r\n Technical Name (if have)\r\n
\r\n*Packing Group
\r\n*EMS
\r\n*Packing Code
\r\nFlash Point (if have )
\r\n*Marine Pollutant(p or no)
\r\n*Package Quantity
\r\n*Package Type
\r\nInner Package
\r\nInner Package Type
\r\n*Gross Weight
\r\n*Net Weight
\r\nNA number
\r\n\r\n Reportable/Excepted/Limited Quantify\r\n
\r\n *\r\n Control Temperature\r\n
\r\n\r\n *\r\n Emergency Temperature\r\n
\r\nUNNO suffix/Sequence
\r\nIMDG Code Segregation Group
\r\nCONTAINER/VEHICLE PACKING CERTIFICATE
\r\n\r\n {{ tableData.packingcertificate }}\r\n
\r\n21.RECEIVING ORGANIZATION RECEIPT
\r\n\r\n {{ tableData.organizationreceipt }}\r\n
\r\n20.Name of company
\r\n{{ tableData.nameOfCompany }}
\r\nName/status of declarant
\r\n\r\n {{ tableData.nameStatusDeclarant }}\r\n
\r\nPlace and date
\r\n{{ tableData.placeDate }}
\r\nSignature of declarant
\r\n{{ tableData.signatureDeclarant }}
\r\n22.Name of company
\r\n{{ tableData.nameOfCompany }}
\r\nName/status of declarant
\r\n\r\n {{ tableData.nameStatusDeclarant }}\r\n
\r\nPlace and date
\r\n{{ tableData.placeDate }}
\r\nSignature of declarant
\r\n{{ tableData.signatureDeclarant }}
\r\n* DANGEROUS GOODS:
\r\n\r\n You must specify: UN No., proper shipping name/correct technical name,\r\n IMO hazard class (subrisk), Packaging group (where assigned), Marine\r\n
\r\nMULTIMODAL DANGEROUS GOODS FORM
\r\n\r\n This form may be used as a dangerous goods declaration as it meets the\r\n requirements of SOLAS 74, chapter VII, regulation 5; MARPOL 73/78,Annex\r\n III, regulation 4 and section 9 of the General Introduction to the IMDG\r\n Code.\r\n
\r\n1.Shipper
\r\n\r\n {{ tableData.shipper }}\r\n
\r\n2.Transport document number
\r\n{{ tableData.transportNumber }}
\r\n3.Page of pages
\r\n{{ tableData.pageOfPages }}
\r\n4.Shipper's reference
\r\n{{ tableData.shipperReference }}
\r\n5.Freight forwarder's reference
\r\n{{ tableData.freightForwarderReference }}
\r\n6.Consignee
\r\n\r\n {{ tableData.consignee }}\r\n
\r\n7.Carrier (to be completed by the carrier)
\r\n{{ tableData.carrier }}
\r\n10.Vessel/flight no.and date
\r\n{{ tableData.vesselOrflightNoAndDate }}
\r\n11.Port/place of loading
\r\n{{ tableData.portPlaceOfLoading }}
\r\n12.Port/place of discharge
\r\n{{ tableData.portPlaceOfLoading }}
\r\n13.Destination
\r\n{{ tableData.destination }}
\r\n\r\n * 9.Additional handling information\r\n
\r\n\r\n 24 hr Emergency contact person :\r\n
\r\n 24 hr Emergency contact telephone:\r\n
\r\n
SHIPPER'S DECLARATION
\r\n\r\n {{ tableData.shipperdeclaration }}\r\n
\r\n\r\n 8.This shipment is within the limitations prescribed for: (Delete\r\n non-applicable)\r\n
\r\n\r\n 14.Shipment information Number and kind of packages; description of\r\n goods ( *see bottom)\r\n
\r\n{{ tableData.descriptionOfGoods }}
\r\n*UN No
\r\n*Imo Class(Sub risk)
\r\nSub Risk1
\r\nSub Risk2
\r\n*Proper Shipping Name
\r\nTechnical Name (if have)
\r\n*Packing Group
\r\n*EMS
\r\n*Packing Code
\r\nFlash Point (if have )
\r\n*Marine Pollutant(p or no)
\r\n*Package Quantity
\r\n*Package Type
\r\nInner Package
\r\nInner Package Type
\r\n*Gross Weight
\r\n*Net Weight
\r\nNA number
\r\n\r\n Reportable/Excepted/Limited Quantify\r\n
\r\n *\r\n Control Temperature\r\n
\r\n\r\n *\r\n Emergency Temperature\r\n
\r\nUNNO suffix/Sequence
\r\nIMDG Code Segregation Group
\r\nCONTAINER/VEHICLE PACKING CERTIFICATE
\r\n\r\n {{ tableData.packingcertificate }}\r\n
\r\n21.RECEIVING ORGANIZATION RECEIPT
\r\n\r\n {{ tableData.organizationreceipt }}\r\n
\r\n20.Name of company
\r\n{{ tableData.nameOfCompany }}
\r\nName/status of declarant
\r\n\r\n {{ tableData.nameStatusDeclarant }}\r\n
\r\nPlace and date
\r\n{{ tableData.placeDate }}
\r\nSignature of declarant
\r\n{{ tableData.signatureDeclarant }}
\r\n22.Name of company
\r\n{{ tableData.nameOfCompany }}
\r\nName/status of declarant
\r\n\r\n {{ tableData.nameStatusDeclarant }}\r\n
\r\nPlace and date
\r\n{{ tableData.placeDate }}
\r\nSignature of declarant
\r\n{{ tableData.signatureDeclarant }}
\r\n* DANGEROUS GOODS:
\r\n\r\n You must specify: UN No., proper shipping name/correct technical name,\r\n IMO hazard class (subrisk), Packaging group (where assigned), Marine\r\n
\r\nTechnical Name (if have)
++ * + Technical Name (if have) +
Inner Package
-Inner Package Type
+Inner Package Type
-*Gross Weight