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Form 4294 - D RECEIVING SHEET 3 -B O -S O O M V , N A M E O F SHIPPER: Purchase O rder No. 36-SB-105-X Worthington Pump & Machinery Corp. 5Lo0s7 5 AnSgaenlteas Pe1 1,A veC.alif. This report properly dated and signed should be forwarded to Auditor of Disbursements, Omaha, as soon as material described thereon is received. POINT O F SHIPMENT_____________________________ Consignee John Snorf, W.S. Foreman, Las Vegas, Nev. QUANTITY W. B. NO. F. B. NO._ CAR. I NT. o-wiil—-Til vy -L-T- ±\j n ri DESCRIPTION #12QH0 single stage Worthington turbine pump with 30 ft. of 10” ID column, steel linesbaft., water lubricated bearings, 10 ft. of 10" suction pipe. 10" galvanized strainer, BIO pumphhead lA on which will be mounted a 25 h.p., 3 phas 60 cycle, 220/440 volt, 1750 r.p.m. vertical hollow shaft drip-proof induction m mot or. WEIGHT Company Scale - JJ-* FNOetB D3E0N VdEaRy,s --f-r-ei-g-h-t- -a-l-l-o-w-e-d -t-o- -La-s- -V-e-g-a-s . Deliver^ 2, 3 weeks. Shipper PURCHASE BILL OR INVOICE Amount A' '/r _______INT. OF ROAD. ______ INT. OF ROAD-S omber______ -DATE- -DATE-DATE MATERIAL RECEIVED-ABOVE MATERIAL RECEIVED AND INSPECTED: -------------------------------------------------- ----- -— STOCKMAN -HOW SHIPPED-CHARGES-CONTAINERS WEIGHT RECEIVING CLERK