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w'}s fi x ' <br /> j at <br /> {4 {2 <br /> R MANIFESTN <br /> . � U P 'C�i t 1f '.. <br /> TEL <br /> NUI <br /> t 1 <br /> S� Lc�dl, 95240 <br /> T �t Trt tion israVtded is me and correct and that the generated materials;are properly c�a tiifW,descitbed, <br /> r c atxcT are.Tti proper cariaTitionfc>r`tran tion aeeordTrig to the applicable reg0ations of the <br /> U.S. Df TrTNSpottatian. <br /> —- ` 0146-2019 <br /> NAME t,f A*W, RERt2MISITA7iYE( SiGNATORE OF REPRESENTATIVE DATE <br /> : SIE)F. SC "TTNG,T SPOATING'ORUNLOADINGiWAS7E BNIT7AL5 REGI TIONN*Rm <br /> �lpi <br /> iF <br /> eeao RP 5997 <br /> t TELEPHONE NUM <br /> (510) 742 <br /> DATE MEDICAL WASTECOLLECTED <br /> 01-1609 <br /> Wtf lmlx. M..R' fioant wt !Cent. wG3 rca;c w4* <br /> s�� # + above is furs attd 6rrecY and that onlyu�tnetlkal waste$are contained In this load.I am aware that <br /> t s� zTtay ;nfatleiivre t�#mytragsp sirta ' registration arWor the pririleg f4, tili 44n ta'te4.thodzed facilites. <br /> � 01-16-2019 <br /> IT2CFlStE fPrin SIGNATURE OF SEN iATIVE " DATE <br /> R TION NUMBER <br /> `� s 6QilUNLft�tldGW IN `REGI ON NUMBER <br /> 3i s <br /> IME MEDIMWASTE COLLECTED <br /> F7 <br /> wr : ® it <br /> ,tt lite�TlrttTirs ,t l a' <br /> �. U... t.Mamie <br /> •a s t <br />