RADIOACTIVE MATERIAL, Tracking Number EXCEPTED …

1 RADIOACTIVE material , Tracking Number _____. EXCEPTED PACKAGE. Date _____. Acceptance Checklist - 2013. The continued offering of non-compliant dangerous goods packages may result in the embargo of your dangerous goods shipments by FedEx Express. Directions: If RQ and UN2908, UN2909, UN2911, the following Check ( ) N/A, Y or N for each checklist item. additional information must be on the Declaration Y: Shipment complies. N: Shipment does not comply and is rejected. N/A Skip if N/A. N/A: Not Applicable Y N 22. Passenger and Cargo Aircraft or Cargo Aircraft RADIOACTIVE material , EXCEPTED Package Only Only limitations correctly indicated.

2 For Passenger (UN2908, UN2909, UN2910, UN2911) [ ; ]: and Cargo Aircraft, medical or research certification not required. [ ; ; USG-10]. N/A Yes No Y N 23. Name or symbol of radionuclide(s) ( , Ir-192, Y N 1. Package is in good condition and free of leakage, Iridium 192). [ , Step 6 (a)]. odor, or external damage. [ ]. Y N 24. Description of the physical and chemical form Y N 2. Complies with all applicable government and FedEx ( , liquid sodium iodide, solid metal, etc.) or variations. [ ] Special Form [ , Step 6 (b)].

3 Y N 3. Destination serviced (including AK and HI). [SRG] Y N 25. Number of packages and type of packaging N/A Y N 4. If 023 AWB (IP1, IXF, or ATA), correct statement(s) ( , 1 EXCEPTED Package or 1 fibreboard box, etc.). in the Handling Information box. [ ] [ , Step 7]. Y N 5. Shipper and consignee name and address marked If RQ, the following must be on the Package on the package. [ ] N/A Skip if N/A. Y N 6. RADIOACTIVE material , EXCEPTED Package label on the package. [ ] Y N 26. RQ marked on the package. [USG-04]. Y N 7.

4 UN Number marked on the label. [ ]. N/A Y N 27. OVERPACK is marked on the package if all markings and labels are not visible. [ ]. N/A Y N 8. Gross weight (in metric units) marked if the package exceeds 50 kg (110 lb). [ ]. N/A Y N 9. All dry ice marking, labeling, and documentation entries complied with. [Packing Instruction 954; (d); ; FX-19]. If RQ, the following must be on the Declaration N/A. Tracking Number may be completed by the shipper or the Dangerous Goods Specialist. Y N 10. Shipper and consignee name and address on the Shipment does not comply and has been Declaration.

5 For 023 shipments, shipper's address rejected. Due to the regulatory discrepancies includes country name. [ ; ] indicated, your shipment cannot be transported by FedEx. Y N 11. Page of Pages. [ ]. Returned to shipper using DOT-SP 14691. Y N 12. Typewritten or computer generated. Some fields may be handwritten. [FX-12] Shipper Contact Name: Y N 13. RADIOACTIVE indicated. [ ]. _____. Y N 14. RQ before or after the basic description. ( : RQ, UN Number , RADIOACTIVE material , EXCEPTED Shipper Contact Phone Number : Package, 7; or RADIOACTIVE material , EXCEPTED Package, 7, RQ.)

6 [USG-04] _____. Y N 15. UN Number , preceded by prefix.[ , Step 1]. Y N 16. Proper shipping name. [ , Step 2]. Inspected Y N 17. Class Number 7. [ ; , Step 3] By _____. Y N 18. Activity of radionuclide(s) in Becquerels ( , Bq, MBq, GBq, TBq, etc). [ , Step 7] Emp # _____. N/A Y N 19. OVERPACK USED [ , Step 8]. Y N 20. 24-hour emergency response telephone Number . [USG-12]. Y N 21. Name, title, place, date, and shipper's signature (may be typewritten for US domestic shipments, including US Territories). [ ; ] For further assistance, call 1-800-Go-FedEx (1-800-463-3339), then press 81 to be connected to the DG.

7 Hotline. EFFECTIVE: 01/01/13 2013 FedEx Express - All rights reserved. This document is an uncontrolled, EFFECTIVE: 01/01/2013_v2 Page 1 of 1 reference-only, copy. Dangerous Goods Acceptance Checklist Page 1 of 1. Sample Package- 2013. The highlighted numbers correspond to those found on the 2013 FedEx Express RADIOACTIVE material , EXCEPTED Package Acceptance Checklist. A Shipper's Declaration and additional markings are required if the shipment is a Reportable Quantity (RQ). 1 5 6, 7. FedEx Express offers IATA-endorsed seminars to help you understand dangerous goods regulations and avoid costly fines.

8 Refer to our seminar schedule at Need to monitor the status of your shipment? for more information. Ask your account executive for information about FedEx Insight . Want immediate notification of status? Ask about FedEx Priority Alert . service. EFFECTIVE: 01/01/2013 This document is an uncontrolled, reference-only, copy