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$ AlkPS. - is 1111111111 <br /> compliance, Inc . <br /> 37,, <br /> TakeAwaylrm Recovery System Trackinc <br /> Complete sections 1 through 5 on this triplicate form. Keep "Shipper" (I <br /> completed form for your records, place remaining copies in the plastic <br /> the box. For detailed instructions, information regarding contents, and <br /> Packaging and Shipping instructions enclosed in this shipping box or , <br /> www.sharpsinc.com. <br /> All items below must be filled out completely. <br /> 1. Shipper's printed name complete address & telephone: <br /> Hard Luck Tattoo <br /> 7 N Sacramento St <br /> Lodi, CA 95240 <br /> ; r <br /> 2. Description of contents: Used Healthcare Materials 3. Signature of Shil <br /> �Y n✓4.. � r ry3 yJ+ <br /> 4. Date Shipped (Fecha de Envio) 5. Weight of Pack< <br /> TRACKING FORM (MANIFEST) DIRECTIONS FOR SHIPPER <br /> Check above, everything must be filled out completely. YOU MUST SIGN #3 <br /> Keep "Shipper" (bottom) copy for your records. <br /> Make sure #3 is signed and #4 is completed with the date container was shin <br /> Put this Tracking Form in the provided ziplock bag on the outside of box and <br /> Comments <br /> }' TO BE COMPLETED BY DISPOSAL SIS <br />