SHIPPER’S DECLARATION FOR DANGEROUS GOODS

Shipper
Air Waybill No.
Importrans Radiactivos LTDA.
Cra 15 # 44-68 Page 1 of 1 Pages
Tel: 3008184382
Cali - Colombia Shipper’s Reference No.
(optional)
Consignee
Importrans Radiactivos LTDA.
Autopista Medellín 2.5 Km 900 m vía Parcelas
Tel:8985388 - 3007426123
Bogotá - Colombia

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 )
Cali
PASSENGER AND CARGO
CARGO AIRCRAFT XXX
AIRCRAFT ONLY

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

Bogotá XXXXXXXXXXX
NON-RADIOACTIVE RADIOACTIVE
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.

UN 3332 Radioactive Material Type A Package Special 7 Ir-192 Solid Metal 1 Type II Yellow
Form A package Activity: IT:
DMS:
38X32X
32

USA/0723
UN 3332 Material Radiactivo Bulto Tipo A en Forma 7 Ir-192 Metal Sólido 1 Bulto II S-96
Especial Tipo A Actividad: Amarilla Revision 2
IT:
DMS:
38X32X
32

Additional Handling Information

CRE 7L

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 Heberth Nilson Molina Ambuila
marked and labelled/placarded, and are in all respects in proper condition for
transport according to applicable international and national governmental Date 23/07/2019
regulations. I declare that all of the applicable air transport requirements have
been met.
Signature
(See warning above)