Port of Entry   Ashland Cascade Locks Farewell-Bend Klamath Falls Portland Bridge Umatilla Woodburn

Date of Entry to Oregon		Name of Carrier		Shipper
Base Plate	Vehicle Base State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Newfoundland/Labrado Northwest Territory Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Aguascalientes Baja California Baja California Sur Campeche Chiapas Chihuahua Coahuila Colima Distrito Federal Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz Yucatan Zacatecas Guatemala El Salvador	Driver's Name		RAM Permit in Vehicle? Yes No
RAM Permit/Temp Permit Number		Shipment Tracking Number (optional)		Commodity Description & UN/NA Number   2977 - Uranium Hexafluoride 2978 - Uranium Hexafluoride 3327 - New Fuel 2908 - Empty Packaging 2910 - Empty Packaging 3321 - Solid Oxides 2915 - Radioactive Material, Type A package Other - Please Enter 4 Digit UN Number
Shipment Origin Areva, Richland, WA Perma-Fix, Richland, WA Paducah, KY Scoville, ID Maryland Heights, MO Other - Please enter City and State			Shipment Destination Areva, Richland, WA Perma-Fix, Richland, WA U.S. Ecology, Richland, WA Energy Solutions, Clive, UT Port of Oakland, CA Mercury, NV WIPP, Carlsbad, NM Springfield, OR Other - Please enter City and State
Have you registered this shipment at another port of entry in Oregon? Yes No If yes, which one   Ashland Cascade Locks Farewell-Bend Klamath Falls Portland Bridge Umatilla Woodburn
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