Laserfiche WebLink
24-Hour Emergency Phone Tracking Document Number: <br /> Number: 888-785-7225 <br /> D185709 <br /> ACTMedical Waste Tracking Document <br /> environmental services <br /> o o Facility Name: Manteca UNfled School Distri d(SI er l �Name: �mh� <br /> a 1700 Thomas St <br /> o z Address: Phone: <br /> '.a <br /> Shipping Description(s) #of Cont- Cont. Size Estimated Actual *Treatment <br /> Type Weight Weight <br /> UN 3291, Regulated Medical Waste, N.O.S. <br /> 6.2,PG 11 <br /> UN 3291, Regulated Medical Waste, N.O.S. <br /> Z j^D F z J � <br /> � fi.2,PG l l (Pathological Waste) j� <br /> a , <br /> a UN 3291, Regulated Medical Waste, N,O.S. <br /> ° 6.2,PG 11 (Chemotherapy Waste) <br /> LL <br /> Z <br /> ra <br /> Z Non-Hazardous Pharmaceutical Waste <br /> a <br /> CL <br /> s <br /> N <br /> Non-Regulated <br /> Other(specify): <br /> *A=Autoclave,l=Incineration,M=Microwave <br /> Advanced Chemical Transport, Inc. CA Hazardous Waste Registration:4026 <br /> 1210 Elko Drive,Sunnyvale,CA 94089 EPA ID#: CAR000070540 <br /> m z Motor Carrier Permit: 0194741 <br /> 0 <br /> ❑ 1210 Elko Drive ❑ 2010 Mission Ave. ❑ 265 Riggs Avenue ❑ 13722 Carmenita Road <br /> Sunnyvale, CA 94089 Escondido, CA 92029 Merced,CA 95341 Santa Fe Springs,CA 90670 <br /> 0 408-548-5050 760-489-5600 209-7224228 714-545-2191 <br /> ~ MWTS Permit#TS-42 MWTS Perm #TS-100 MWTS Permit#TS-8 <br /> Print Name: ; i�1 yn �} Signature: Date: �f <br /> a Name: DOT#- <br /> 00 <br /> 13 z Address: State Transporter#or Permit: <br /> w3 <br /> N K <br /> Print Name: Signature: Date: <br /> Z I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> Q3 marked and labeled,and are in all respects in proper condition for transport according to applicable govemmental regulations. I certify that this shipment does <br /> a not contain regulated hazardous and or radioactive waste. I am aware that there are significant penalties for submitting false information including the possibility <br /> LL of fines and imprisonment, <br /> 3 � <br /> LU <br /> W Signature:`( fly 1`� l Print Name, Date f <br /> i I <br /> ❑ Advanced Chemical Transport ACT Medical ❑ Advanced Chemical Transport ❑ Advanced Chemical Transport <br /> 1210 Elko Drive 2010 Mission Ave, 265 Riggs Avenue 13722 Carmenita Road, <br /> w z Sunnyvale,CA 94089 Escondido,CA 92029 Merced,CA 95341 7 - F�-2S'91 S A�90670 <br /> LL 0 408-548-505D 760-489-5600 2D9-722-4228 1- +1tE9T <br /> ZMWTS Permit.#TS-42 Permit#TSIOST-66 MWTS Permit#TS-10D MWTS Permit#TS-8 <br /> N <br /> ~ THIS IS TO CERTIFY THAT THE WASTE IDENTIFIED ABOVE WAS <br /> RECEIVED AT THE TRANSFER FACILITY CHECKED ABOVE. Signature&Date: <br /> ACT Medical Healthwise Services Medical ❑ Waste Management Healthcare ElOther <br /> z 2010 Mission Road Waste Disposal Solutions <br /> p Escondido,CA 92629 4800 E.Lincoln Ave Fowler 4280 Bandini Blvd <br /> F- 76D-469-5800 Celifomie 93625 Vernon,CA 90058 <br /> Z u Permit#TSIOST-66 559-8343333 323-307-0514 <br /> in a Permit#TS-39 Permit#TSIO5T-81 <br /> W <br /> O THIS IS TO CERTIFY THAT THE WASTE IDENTIFIED ABOVE WAS <br /> RECEIVED AT THE DESTINATION FACILITY CHECKED ABOVE. Signature&Date: <br />