# Haz-Mat Transportation Services — Hazardous Materials Safety Interpretation

- **operation:** document
- **citation:** 04-0075
- **title:** Haz-Mat Transportation Services — Hazardous Materials Safety Interpretation
- **source type:** guidance
- **agency:** Pipeline and Hazardous Materials Safety Administration
- **status:** guidance
- **official:** true
- **published on:** 2004-05-18
- **effective on:** Not available
- **summary:** 04-0075 response to Haz-Mat Transportation Services concerning 172.204.
- **machine formats:** - **json:** https://regulus.evalyn.ai/document/phmsa-interpretation-04-0075.json
- **markdown:** https://regulus.evalyn.ai/document/phmsa-interpretation-04-0075.md
- **app url:** https://regulus.evalyn.ai/document/phmsa-interpretation-04-0075
- **source url:** https://www.phmsa.dot.gov/sites/phmsa.dot.gov/files/legacy/interpretations/Interpretation%20Files/2004/040075.pdf
**body:**

<<<PAGE 1>>>

MAY 18
2004
U.S. Department
of Transportation
400 Seventh St., S.W.
Special Programs
Research and
Washington, D.C. 20590
Administration
Mr. Jack Peters
P.O. Box 69206
Haz-Mat Transportation Services
Ref. No. 04-0075
Seattle,
WA 98168-9206
Dear Mr. Peters:
This is in response to your letter dated March 24, 2004,
accordance with the Hazardous Materials Regulations (HMR; 49 CFR
regarding the shipper's certification
on shipping papers in
shipper or his
Parts 171-180). Specifically you ask if the signature of the
certification.
agent must be in association with shipper's
The answer is yes. Each person who offers à hazardous material
transportation in accordance with the HMR by printing (manually
tor transportation shall certify that the material is offered for
shipping description,
or mechanically) on the shipping paper containing the required
The certification must be legibly signed by a principal, officer,
the certification contained in $ 172.204.
partner, or employee of the shipper or his agent; and (2) may be
legibly signed manually, by typewriter, or by other mechanical
associated with the certification statement)
Any additional signatures on a
shipping paper (not
$ 172.204 (d) and are not required under the HAD not satisfy
I hope this satisfies
your request.
Sincerely,
Office of Hazardous Materials Standards
172.204 (d)
040075

<<<PAGE 2>>>

Mar 24 04 01:17p
P. 1
BAH
$172.204(d)
FAX TRANSMITTAL COVER SHEET
Shipping Pappers
04-0075
HAZ-MAT TRANSPORTATION SERVICES
P. O Box 69206
Seattle, WA 98168
TO: (CO. NAME)_
U.S.D.0.T.
(RECEIPIENT)
(DEPARTMENT)
Ed Mazzallo.
RS PL
(FAX NUMBER).
202-366-3012
(PHONE NUMBER).
FROM:
(SENDERS NAME) JACK PETERS
(FAX NUMBER) (CALL FIRST) (907) 278-7900
OR (253) 840-2085
(PHONE NUMBER)
SAME AS ABOVE
(E-MAIL) jlpetersl@juno.com
DATE: 3/74/2604
_SUBJECT: Ihterpreta Tien
SignaLake
козмітсткия:
Hopefully
You Can settle This..
IT Seems That The
Signatake in The
"Shippers certification" box is redundant.
Frama practical peint of view bath should
be Signed:
@Fifitor

<<<PAGE 3>>>

Mar 24 04 11:09a
AECEIVED, subject to the classicalion and fails in ellect on the Use ol the issue of this Gill of Lading.
ICC NO, MC 153893
p. 1
FHOM
AT
AGENT'S NO
CONSIGNED TO:
it rare audress of consigne - for purposes at notification only)
ADDRESS
CITY
ROUTE
COLLECT ON DELIVERY
DELIVERING CARRIER
TRAILER NO.
TRUCK NO.
-and temil 10:
Prepaid
THIRD PARTY BILLING ADDRESS (Third-patty pilling does not relievs consigner or consignce of responsibility for all charges)
Cily
Third Parly
Collect
Billing
PACKAGES
NUMBER
HI.I
*
Sircel
Proper Shipping Name. Masalcous Class and UN or NA number lor Hazardous Materials.
DESCRIPTION OF ARTICLES. SPECIAL MARKS. AND EXCEPTIONS
Stale
Driver
Collect
(contents and condition ol contents ol packages unknown)
(SUD. TO COR.]
**WEIGHT
RATE
FREIGHT CHARGES
• the shipment mores beneen no points by a cartier by wasser, the lawy ro
Where the cate is dapenden on value, shippers are required l0 stale]
ques list the bill of lading stale whether it is "carrie's or shucar's vegn.
glipment is to bu defered lo ine consignco
Subyect lo Section 7 of condians, it this
allen evalue one properly. The consignar shall sign the following
ared or declared value of the properly is hereby specially stated by
without recourse on the consignos, the
Kenciver S.
the shipper lo be no exceeding il intrastate. see Section ss:
Statement:
SUBTOTAL
Jhis shipment without payinent of licight
The carrier shall not make Celivery of
on the pimperly described hercon.
and all winer lastel charges.
Agent of Carrior
C.O.D.
named materials are prapelly classilied, described. packagec, marked
FEE
he applicable regulations of the Deparmen of Transportatio
no labeled, and ara in proper condilion for transportation, according i
signature of Consisanti
Por
Signature of Shipper:
• CONPLETE THIS SECTIONIE SHIPMENT CONTAS HAGARDOUS HATE RIALS
RECEIVED the above specilice
he signafure here acknowiedg
roperly in appareni good order
only ine amount prepaid)
ADVANCES
(AM)
EMERGENCY CONTACT
EMERGENCY RESPONSE INFORIATION:
ELEPHONE HURDER. |
TIME
PREPAIC
REFER TO DOT EMERGENCY RESPONSE GUIDE HUNGEN:
FOR CONSIGNEE
TO APPLY
CAICIAL FREIGH BILL MUST ACCOMPAHY CLAIM FOR OVERCHARGE, LOSS OR DAMAGE
TOTAL
SHIPPER
BALANCE DUE
GAD
GARLILE P/U
DATE
TIRE
CARLILE DEL
DATE
THAE
ORIGINAL
DATE
AND
TIME
(EM)

<<<PAGE 4>>>

Mar 24 04 11:07a
p. 2
RECEIVED, subject to the classilication and tarilfs in elicat on ile date of ine issuc of this Bill of Lading.
IN M 153893
FRON
AT
AGENT'S NO.
paper seel in appren good order, except as noid contents and condition of contents of packages unknown, market, consigned and destined as allown below, which said company (ine word
a ten eat this his contact as meaning any person or corporalion in possession of the properly under ile contact agrees is carry lo its usunt place of delivery al said destinalion, it on it:
19
any i roll no your l a mostle at als toe is in and a to ace at al a die in ste are a or al rely are a see one are to final me is riga.,
ala, wine i too roules, within the entory of l highway operations, herwise civet ander caric on lie fould a said delination, it is mulbally agreed, as to each carric of all or
CONSIGNEO TO:
all desire durass of consiqute a lor nucloses of naillicalian oniy.)
ADDRESS
CITY
ROUTE
DELIVERING CARRIER
COLLECT ON DELIVERY
TRAILER NO.
TRUCK NO.
5
•
THIRO PARTY BILLING ADDRESS (Third-parly tilling does not relieve consignor or conslance ol responsiblily for'all charges)
Struel
Prepaid
City
State
Third Parly
Collect
Billing
Sticer
NUMBER
Cu.•
PACKAGES
*
Proper Shipping Name. Hatrous Cits and UNar NA number for Hazardous Materials.
DESCRIPTION OF ARTICLES. SPECIAL MARKS, AND EXCEPTIONS
Stale
Driver
Collect
(cantents and condition of contens of packages unknown)
(SUB. TO COR.)
*"WEIGHT
RATE
FREIGHT CHARGES
eves bate poins by a carrer by tested, the law /c
Where ing rate is dependent on value, shippers are regured to slate
Quares that in bit of lading siate whether it is "carrier's or shocer's weigh:"
stipment is to to defecd to ine consigncu
Subject lo Section 7 of concilions, it this
agreed or declared vatue of the proporty is hardby specilically sizied by!
without recourse un the consignor. the
Received s
the shipper lo be nol exceeding til intastale, see Section 11):
fically in vertin the agreed or declared value ol the property THe
Elalament:
consignor shall sign the lollowing
to apply in prepayment of the charges
SUBTOTAL
The carrier shall hot make clivcry of
on the property described horeon.
- PCt
this snipment without payment of freight
and all older lawlul charges.
Agent of Carrio,
C.O.0.
namad matarials are properly classified, described, packagec, marked
FEE
applicable regulations of the Department of Transportate
d labeled, and ara in proper condition for transportation, according
istpature of Consigner"
• COMPLETE THIS SECTIONS SIMPATENT CONTARIS HAZARDOUS MAYERIALS
Signature of Shipper:
RECEIVEO the above specitied
the signatele here acknowledget
property in appalent good order.
only thie amount prepaid.
ADVANCES
(AM)
ELEPHONE GIULIBER:
'ERGENCY CONTAI
TIME*
O APPL
REPAI
REFER TO DOT EMERCENCY RESPONSE GUIDE HUMIDEN: -
EMEAGENCY RESPONSE NIFORMATION:
FOR CONSIGNEE
DATE
ORIGINAL FRICH BILL MUST ACCOMPANY CLAIM FOR OVERCHARGE, LOSS OR DAMACE
TOTAL
BALANCE DUE
OR
SHIPPER
AND
CARLILE P/U
DATE
4Y
THIE
CARLILE DEL.
DATE
TIME
ORIGINAL
DATE
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