# Worldwide Services — Hazardous Materials Safety Interpretation

- **operation:** document
- **citation:** 05-0137
- **title:** Worldwide Services — Hazardous Materials Safety Interpretation
- **source type:** guidance
- **agency:** Pipeline and Hazardous Materials Safety Administration
- **status:** guidance
- **official:** true
- **published on:** 2005-07-08
- **effective on:** Not available
- **summary:** 05-0137 response to Worldwide Services concerning 172.204.
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- **app url:** https://regulus.evalyn.ai/document/phmsa-interpretation-05-0137
- **source url:** https://www.phmsa.dot.gov/sites/phmsa.dot.gov/files/legacy/interpretations/Interpretation%20Files/2005/050137.pdf
**body:**

<<<PAGE 1>>>

JUL 8 2005
U.S. Department
of Transportarion
400 Sevenin Street, S.YV.
Washington, D.C. 20590
Pipeline and
Administrarion
Mazardous Maierials Salery
Ms. Mary Beth Schommer
Reference No. 05-0137
UPS Corporate Dangerous Goods Manager
Worldwide Services
55 Glenlake Parkway N.E.
Building 3, Floor 7
Atlanta, GA 30328
Dear Ms. Schommer:
This is in response to your June 6, 2005 letter concerning the shipper's certification
statement in 49 CFR 172.204(c)(3) for hazardous materials offered for transportation to
UPS. An additional statement was added in a final rule published under Docket No.
RSPA-04-17036 (HM-215G; 69 FR 76044, 12/20/04).
You ask if UPS may show the statement on the shipping paper, above the current shipper
certification statement, as follows: For Air Shipments: "I declare that all of the
applicable air transport requirements have been met." These UPS shipping papers
will be distributed to your customers for use.
The answer is yes, the statement may be shown in this manner.
Please contact us if we can be of further assistance.
Sincerely,
cassin,
Office of Hazardous Materials Standards
'usan Gorsky, Acting Directo
172.204c)3)
050137

<<<PAGE 2>>>

Edmorson
§12. 204C)(3)
Shipping Papers
05-0137
55 Glenlake Parkway, NE
Ups
404.828.6000 Tel
Atlanta, GA 30328
June 6, 2005
Mr. Edward Mazzullo
Pipeline and Hazardous Materials Safety Administratior
J.S. Department of 1ransportatior
400 7* St. S.W.
Office of Hazardous Materials Safety
Washington, D.C. 20590
Re: UPS Shipping Paper Verbiage Approval to Meet 172.204(c)(3) Under 215G
Dear Mr. Mazzullo,
Enclosed you will find a sample of the current UPS shipping paper, as well as a proof of the
proposed shipping paper format that UPS would like to use to meet the verbiage requirements of
172.204(c)(3) under 215G. In the bottom left hand corner of the shipping paper proof, we have
added the statement For Air Shipments "I declare that all of the applicable air transport
requirements have been met." in the Shipper's Certification area.
We are requesting a written or emailed response as to the acceptability of the verbiage on the
vendor to produce and stock the new form so our customers will be in compliance in a timely
shipping paper proof in meeting the new requirement. Once approved, we will notify our printing
fashion. Contact me if you have any questions regarding the proof.
presentations and interacting at conferences in a casual atmosphere benefits all.
It was good to see you at the COSTA Conference in San Diego. Attending regulatory
Thank you in advance for your time and expertise.
Regards,
Mary Beth Schommer
Mary Beth Schommer
Worldwide Services
UPS Corporate Dangerous Goods Manager
55 Glenlake Parkway N.E.
Building 3, Floor 7
Phone: 404-828-7425
Atlanta, GA 30328
Fax:
404-828-4108
Email: mbschommer@ups.com

<<<PAGE 3>>>

)
02111408 5/05 MW
© 1998 by United Parcel Service of America, Inc.
DO NOT REMOVE THIS COPY
transport according to applicable
marked and labeled/placarded, and are in ail respects in proper condition for
absorbed above by the proper shoping name and are classmed, Da
hereby declare that the contents of this consignment are fully and accuratel
For Air Shipments. "I declare that all of the applicable air transport
SHIPPER'S CERTIFICATION
Hazardous Materials Description and Quantity
EMERGENCY CONTACT NUMBER
international and rational govermental
PASSENGER AIRCRAFT
HAZARDOUS MATERIALS/DANGEROUS GOODS SHIPPING PAPER A
REFERENCE NUMBER
CARGO AIRCRAFT ONLY
ACCOUNT NUMBER
NO. OF PACKAGES
SLICES
DATE A
INITIALS YA
USE ONLY
CARRIER
PERFORAYIOR
STUS
THIS
REMOVE
PLEASE
ups
PERFORATION
AT
STUB
THIS
REMOVE
FLEASE

<<<PAGE 4>>>

PULL HERE
COPY 6
NARDICO:
USE ONLY
INITIALS E
PART 2
NO. OF PAGKAGES!
ACCOUNT NUMBER
CARGO AIRCRAFT ONLY
REFERENCE NUMBER
HAZARDOUS MATERIALS/DANGEROUS GOODS SHIPPING PAPER
PASSENGER AIRCRAFT
Is Description and Quantity
EMERGENCY CONTACT NUMBER
I hereby declare that the contents of this consignmant are fully and accurately
02111408 PARTS 2 BLACK
Air Shipments. 1 declare that|
02111408 PARTS 2 RED
equirements have been mett.
PROOF
WALLACE
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