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### ORIGINA L& ON ECOP Y Federal Aviatio nAdministratio n

. 80 0 Independenc e Avenue , S.W . Washington , D C 2059 1 Attention : Hearin g Docke t Clerk , AGC-43 0 Wilbu r Wrigh t Building—Suit e 2W1000 ' ON ECOP Y Lis aGamache-Wortman , Responden t P.O.Bo x 1279 3 Olympia , W

A98508-279 3 Scot t R . Morris , Complainant' s Counse l Attorney , Offic e o f

th e Regional Counse l Northwes t

Mountai nRegion , ANM- 7 Federal Aviatio nAdministratio n 160 1 LindAvenue , S.W . Renton , W A9805 7 TEL : 425-227-141 7 FAXL_425-227-100 7 

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### The Honorabl e RichardC . Goodwin , Administrativ e Law Judg e Offic e o f Hearings , M-2 0 U.S . Departmen t

o f Transportatio n 120 0 New Jerse y Avenue , S.E . Eas t Buildin g Groun dFloor , Roo mE l 2-32 0 Washington , D C 2059 0 TEL : 202-366-213 9 Attorney-Adviso r ^—-^202-366-512 1 Lega l Assistan t (FAX y 202-366-75 3 6

' Servic e wa s b y U.S . Mail . Fo

r servic e i nperso no r b y expedite dcourier , use th e followin g address : Federa l Aviatio nAdministration

, 60 0 Independenc

e Avenue , S.W. , Wilbu

r Wrigh t Building—Suit

e 2WI00O , Washington

, D C 20591 ; Attention : Hearin

g Docke t Clerk , AGC-430.Ma rI G 1 1 12:32 p p . 2

02 7 AN C 713 2 660 3 

### 027-713 2 660 3 Shipper' s Nani « »n d Addres s LIS AGAMACH E BO X 57 0 SEWARD , A K99999 9 US A Shipper' s Accoun l Numbe r Cmtomer' s ( 0 Nurnba r -001259131 8 Tel : 360-628-939 9 No t Neqoii.ibl e Ai rWayfaH I Issu e J B y ALASK AAlHLINt S & H 0 R I Z 0 M AI R ^ ^ P.O . BO X 6B40 0 SEATTLE . WT A9B16 8 a00-Z2S-17S 2 AIASKACARG0.COM ' Consignee' s Nam e an d Addn»9 s LIS AGAMACH E • HFP U SEATTLE , W A9999 9 US A Cwiwooea' t Accoun t Numbe r Als o (toiif y



### Tel : 360-628-939 9 Tel : (swin g Canier' a Agen l an d Cit y

Asent' a lAT ACod e Aixoui l No . Airpor t o < Oepartur e (Addr . o f Flrs l Caniar ) eri d Rniueeis d Roulin g Anchorag e Acccjrtir g tnrorrrtaljo n US AGAMACH E BO X 57 0 SEWARD , A K99999 9 US A Gr^nera l Carg o -001259131 8

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### 395. 0 0.6 3 248.6 5 HOUS E HOL D GOOD S

1 4 395. 0 248.8 5 Dims : 3 4 x4 0 x4 8 x1 1 X 1 x 1 X 1 3 GE N UN K Volume : 37.78 5 Prapal d Weigh t Charg e



### 248.8 5 1 Collec i

Valuatio n Charg e Ta x 

### 1.96 Othe rChaige t MY C 23.7 0 

### se c7.9

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Tota l Othe rChai^e a Du e Agen t Tota l Othe rClwrge a Du e Cturia r 31.6 0 Shippe roartilie e that th e janicuiar t o n ll w(se e harao f are cnrae t en d tha t Inacta ra * an ypar t o f th e conalgwniit i contaln e dangafou a goode . euci ) par t l e properl ydeecrtlw d li yrtam a an d l a i n pivpa rcondltiiH i lo reanUd e b yai raccordin g t o th e applicabl e Dangerou e Oood i Regulation* . I coneen t t o th e Inepecdo n o f thi a cargo . F o rLIS AGAMACH E SlonalureofSWeoerorNaAoan t 

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ALA**^ * AIRLINE S & HORIZO N A t P.O . BO X 6890 0 SEATTLE . W A9816 8 800-225-275 2 ALASKACARG0.CO M SHIPPE R LIS AGAMACH E BO X 570 SEWARD , A

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# n Tota l Loca l Charges : VA T0.70% : Gran d Total : US D US D US D 

### 0.0 0

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RECEIPTSTATEMEN T

Th e undersigne d acknowledg e th e receip t o fabov e mentione d consignmen t complet e an d i n goo d ' - condition . Date : J9-May:2p09 _ Time : .1?JP. 1 , Registration : Driver : .UsaGamach e Signature : ^:t._^.^yv X GJ^v^vv^JX-fl -M a r1 6 1 1 12:33 p

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HI S SHIPMEN TDOE S NOTCONTAI N lANGEROU S GOOD S 

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