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COMPLIANCE INFO_1975-2015
EnvironmentalHealth
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4500 - Medical Waste Program
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PR0450024
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COMPLIANCE INFO_1975-2015
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Entry Properties
Last modified
2/5/2025 2:48:59 PM
Creation date
7/3/2020 10:18:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1975-2015
RECORD_ID
PR0450024
PE
4524
FACILITY_ID
FA0002493
FACILITY_NAME
GOLDEN LIVING CENTER HY-PANA
STREET_NUMBER
4545
STREET_NAME
SHELLEY
STREET_TYPE
CT
City
STOCKTON
Zip
95207
APN
10425005
CURRENT_STATUS
01
SITE_LOCATION
4545 SHELLEY CT
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4524_PR0450024_4545 SHELLEY_.tif
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EHD - Public
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— _ �,•� ® MEDICAL WASTE TRACKING _ _ W 1 URSER <br />ti IE"` tN CASE OFEMERGENCY CONTACT: CNEUTREC 1 k ANffST aot•10�WSto <br />to 9: 301 - 10 CUSTOMER NO, 21132 NDFRODC970 <br />1. GeneTatoes Nam, Address and TeWoofm NutRh@r <br />A . S - 569 limmilillumilmill <br />exam VS <br />4545 M COMM <br />STQCVM, CA 95207 <br />(209) 417-0271 4!25!2012 <br />P <br />�U <br />3. Gaineiraftft Ce"M i thereby decime that the ax teMs of Ws cmsgramnt are fully and ac <br />by the fuopar rtaniB. !are Ossified, packaged rttarkad and Iabeif0d/piE <br />are in aE in proper condltiott transport rd'rng to applicable ' and nat$OrWi' <br />X, E!mmmw Name (Ziviue2 <br />4. TRANSPIORM 1 ACORfift <br />Stec1e, Inc. Thi3 13 a <br />I -C 5 ii, Shrift St <br />Famno,CA 93722 <br />a 40 <br />TRANSPORTERCERTIFICATION- Recut of medical waste as deacdbed above. <br />Shij�es�t q Fermat Numbers: e <br />Hauler Pago <br />r <br />14 <br />Date <br />Phone e: <br />AWkab1aPeM*WnWm <br />INTERMEDIAM HANDLER ITRANSPORTER CERTIFICATION: Rw*t of medical waste as described above. <br />Priatfiype Name Signature <br />WMSITROPM03AWREW. <br />Date <br />s.t_. <br />ORIGINAL <br />- T"T'T'e <br />., ME*r!5� TT1!'�iu4 �rrtww� Mu . <br />Y_ <br />, <br />717I, <br />`j <br />r <br />7'iw"i#uk rwrr#U� Zvi.. <br />.. 49yAN, <br />P <br />�U <br />3. Gaineiraftft Ce"M i thereby decime that the ax teMs of Ws cmsgramnt are fully and ac <br />by the fuopar rtaniB. !are Ossified, packaged rttarkad and Iabeif0d/piE <br />are in aE in proper condltiott transport rd'rng to applicable ' and nat$OrWi' <br />X, E!mmmw Name (Ziviue2 <br />4. TRANSPIORM 1 ACORfift <br />Stec1e, Inc. Thi3 13 a <br />I -C 5 ii, Shrift St <br />Famno,CA 93722 <br />a 40 <br />TRANSPORTERCERTIFICATION- Recut of medical waste as deacdbed above. <br />Shij�es�t q Fermat Numbers: e <br />Hauler Pago <br />r <br />14 <br />Date <br />Phone e: <br />AWkab1aPeM*WnWm <br />INTERMEDIAM HANDLER ITRANSPORTER CERTIFICATION: Rw*t of medical waste as described above. <br />Priatfiype Name Signature <br />WMSITROPM03AWREW. <br />Date <br />s.t_. <br />ORIGINAL <br />
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