DOD MULTIMODAL DANGEROUS GOODS DECLARATION
This form may be used as a dangerous goods declaration as it meets the requirements of SOLAS 74, Chapter VII, regulation 54;
MARPOL 79/78, Annex III, Regulation 4.
1. SHIPPER/CONSIGNOR/SENDER
2. TRANSPORT
DOCUMENT NUMBER
3. PAGE 1
OF
PAGES
4. SHIPPER'S REFERENCE (TCN)
6. CONSIGNEE
5. FREIGHT FORWARDER'S
REFERENCE
7. CARRIER (To be completed by the carrier)
24-HOUR EMERGENCY ASSISTANCE TELEPHONE NUMBERS:
DOD
NON-EXPLOSIVE
HAZMAT:
(800) 851-8061/
(804) 279-3131
AT SEA:
COLLECT:
(804) 279-3131
DOD HAZ CLASS 1
(EXPLOSIVES) ONLY:
COLLECT:
(703) 695-4695/4696
or DSN: 225-4695/4696
(Watch Officer)
CHEMICAL/BIOLOGICAL
WARFARE MATERIAL:
(410) 436-6200
DSN:
584-6200
DOD SECURE HOLDING:
(800) 826-0794
(For TSPs/drivers emergency
secure holding issues, accidents,
delays, and incidents)
OIL/CHEMICAL SPILLS:
NRC & TERRORIST HOTLINE:
(800) 424-8802
AT SEA:
COLLECT: (
202) 267-2675
DOD RADIOACTIVE
MATERIALS: COLLECT
ARMY:
(703) 695-4695/4696
USAF: (301) 981-5058
DLA: (800) 851-8061
AT SEA:
COLLECT: (804) 279-3131
USN/MC: Use 24-hour
emergency response number
provided by activity.
8. THIS SHIPMENT IS WITHIN THE LIMITATIONS PRESCRIBED FOR: (X as applicable)
MILITARY VESSEL COMMERCIAL VESSEL
19. ADDITIONAL HANDLING INFORMATION
10. VOYAGE DOCUMENT NUMBER AND
SAILING DATE (To be completed by the carrier)
11. PORT/PLACE OF LOADING
12. PORT/PLACE OF DISCHARGE 13. DESTINATION
DESCRIPTION OF GOODS (UN No., PSN, HC, SHC, PG, number and kind of package, and additional information
as required by regulations)
14. SHIPPING
MARKS
GROSS MASS
(kg)
NET MASS/QTY
(kg/l)
15. CONTAINER IDENTIFICATION NO./
VEHICLE REGISTRATION NO.
16. SEAL NUMBER(S) 17. CONTAINER/VEHICLE AND TYPE
18. TARE
MASS (kg)
SHIPPER'S DECLARATION. I hereby declare that the contents of this consignment are fully and accurately described above by the Proper Shipping Name,
and are classified, packaged, marked, and labeled/placarded and are in all respects in proper condition for transport according to applicable international and
national government regulations.
20. RECEIVING ORGANIZATION RECEIPT
Received the above number of packages/containers/trailers in apparent good order and condition, unless stated hereon:
a. RECEIVING ORGANIZATION REMARKS
b. HAULER'S NAME
c. VEHICLE REGISTRATION
NO.
d. SIGNATURE AND DATE e. DRIVER'S SIGNATURE
a. NAME OF COMPANY/MILITARY UNIT b. NAME/STATUS OF DECLARANT/CERTIFIER
c. PLACE AND DATE d. SIGNATURE OF DECLARANT/CERTIFIER
DD FORM 2890, SEP 2015
HIGHWAY/RAIL
9. CONTAINER PACKING CERTIFICATE OR
VEHICLE PACKING DECLARATION,
DD FORM 2781, IS ATTACHED
(X if applicable)
21. SHIPPER PREPARING THIS FORM
PREVIOUS EDITION IS OBSOLETE.
Adobe Designer 9.0
INSTRUCTIONS FOR COMPLETING DD FORM 2890,
DOD MULTIMODAL DANGEROUS GOODS DECLARATION
Item 1. Shipper/Consignor/Sender. Enter the address and telephone
number where the HAZMAT was certified.
Item 2. Transport Document Number (Ocean container shipments only).
The vessel manifest number to which the Multimodal Dangerous Goods
Declaration will be attached may be entered in this block. The shipper need
not enter this number. The accepting operator may enter it at the time it is
assigned. Leave blank for breakbulk shipments. Shipper enters container "V"
number.
Item 3. Page __ of __ Pages. Enter the page number and total number of
pages. Example: Page 1 of 1.
Item 4. Shipper's Content Reference Number (TCN). Enter the 17-
character TCN.
Item 5. Freight Forwarder's Reference. Leave blank.
Item 6. Consignee. Enter the six-digit DODAAC and/or the in-the-clear
geographical location of the ultimate consignee (if known). For shipments of
infectious substances, enter also the full address, name and telephone
number of a responsible person for contact in an emergency.
Item 7. Carrier. Enter Vessel Carrier Name. To be completed by the carrier.
24 Hour Assistance Telephone Number(s). Circle applicable emergency
number(s).
Item 8. Shipment Within the Limitations Prescribed for Military Vessel/
Commercial Vessel/Highway/Rail. Mark X in the appropriate block.
Item 9. Container Certification/Vehicle Declaration. Declarant must mark
X if applicable. U.S. Coast Guard or port officials may require verification of
the container certification/vehicle declaration. DD Form 2781 is a detailed
checklist which meets USCG/Customs requirements. DD Form 2781 must be
signed and attached to DD Form 2890.
Item 10. Voyage Document Number and Sailing Date (To be completed by
the carrier). Enter the voyage document number and the date of sail.
Item 11. Port/Place of Loading. Enter the three-digit POE code and/or the
in-the-clear geographical location of the port of embarkation.
Item 12. Port/Place of Discharge. Enter the three-digit POD code and/or
the in-the-clear geographical location of the port of debarkation.
Item 13. Destination (in the clear). Enter destination address.
Item 14. Shipping Marks.
1. The identification number prescribed for the material as shown in Column
(4) of the Section 49 CFR 172.101 table;
2. The proper shipping name prescribed for the material in Column (2) of the
Section 172.101 table;
3. The hazard class or division number prescribed for the material, as shown
in Column (3) of the Section 172.101 table. The subsidiary hazard class or
division number is not required to be entered when a corresponding
subsidiary hazard label is not required. Except for combustible liquids, the
subsidiary hazard class(es) or subsidiary division number(s) must be entered
in parentheses immediately following the primary hazard class or division
number. In addition: The words "Class" or "Division" may be included
preceding the primary and subsidiary hazard class or division numbers. The
hazard class need not be included for the entry "Combustible liquid, N.O.S."
For domestic shipments, primary and subsidiary hazard class or division
names may be entered following the numerical hazard class or division, or
following the basic description.
4. The packing group in Roman numerals, as designated for the hazardous
material in Column (5) of the Section 172.101 table. Class 1 (explosives)
materials; self-reactive substances; batteries other than those containing
lithium, lithium ions, or sodium; Division 5.2 materials; and entries that are not
assigned a packing group (e.g., Class 7) are excepted from this requirement.
The packing group may be preceded by the letters "PG" (for example, "PGII");
5. Enter additional information from the IMDG, chapter 5.4, as required (i.e.
Marine Pollutant, Flashpoint, Toxin Inhalation Hazard, RQ, etc.).
6. Enter the number and kind of packaging.
Item 14. Shipping Marks (Continued).
7. Except for transportation by aircraft, the total quantity of hazardous
materials covered by the description must be indicated (by mass or
volume, or by activity for Class 7 materials) and must include an indication
of the applicable unit of measurement, for example, "200 kg" (440 pounds)
or "50L" (13 gallons). The following provisions also apply: For Class 1
materials, the quantity must be the net explosive mass. For an explosive
that is an article, such as Cartridges, small arms, the net explosive mass
may be expressed in terms of the net mass of either the article or the
explosive materials contained in the article.
8. Ammunition transported by Government Vehicle, Unit will enter the total
net quantity for non-explosive material in metric measure. U.S. measure
may be added in parentheses underneath the metric measure. For
ammunition, enter the total number of rounds/articles and NEW in kg.
Exception: Net total quantity is not required for bulk packages, empty
packages and cylinders of Class 2.
9. Radioactive material. The description for a shipment of a Class 7
(radioactive) material must include the following additional entries as
appropriate:
a. The name of each radionuclide in the Class 7 (radioactive) material that
is listed in Section 173.435 of this subchapter. For mixtures of
radionuclides, the radionuclides required to be shown must be determined
in accordance with Section 173.433(g) of this subchapter. Abbreviations,
e.g., "99 Mo," are authorized.
b. A description of the physical and chemical form of the material, if the
material is not in special form (generic chemical description) is acceptable
for chemical form).
c. The activity contained in each package of the shipment in terms of the
appropriate SI units (e.g. Becquerels (Bq), Terabecquerels (TBq), etc.).
The activity may also be stated in appropriate customary units (Curies (Ci),
milliCuries (mCi), microCuries (uCi), etc.) in parentheses following the SI
units. Abbreviations are authorized. Except for plutonium-239 and
plutonium-241, the weight in grams or kilograms of fissile radionuclides
may be inserted instead of activity units. For plutonium-239 and
plutonium-241, the weight in grams of fissile radionuclides may be inserted
in addition to the activity units.
Item 15. Container ID Number/Vehicle Registration Number. Enter ID
number of the container or vehicle registration number. A dash (-) or blank
space is acceptable before the check digit.
Item 16. Seal Number(s). Enter seal number installed on container.
Item 17. Container/Vehicle and Type. Enter type and size of container
(20 or 40 ft.) or vehicle description (e.g., HUMVEE).
Item 18. Tare Mass (kg). Enter tare weight of the container.
Item 19. Additional Handling Information.
If applicable, provide additional handling instructions.
Enter the Emergency Response Guide (ERG) Number(s) of the HAZMAT
and attach the specific ERG page to DD Form 2890.
If applicable, drivers transporting regulated HAZMAT on European
highways must be provided Transport Emergency Cards (TREMCARDS) in
the host nation language which must be attached to the shipping papers.
Item 20. Receiving Organization Receipt. Leave blank as this will be
filled out by the receiving organization. Signing this block states that the
shipment is in good order, unless otherwise noted.
Item 21. Shipper Preparing This Form.
a. Name of Company/Military Unit. Enter the name of company.
b. Name/Status of Declarant/Certifier. Enter the name and status of the
person signing the form.
c. Place and Date. Enter the place and date the material was certified.
d. Signature of Declarant/Certifier. The person who certifies on behalf of
DoD that the shipment complies with the applicable regulatory
requirements must sign the form.
DD FORM 2890 (BACK), SEP 2015