Laserfiche WebLink
C <br />(Please r. or Print) <br />0 <br />n <br />• <br />Phone mber+ <br />20 <br />MURIM• ' •, <br />• <br />State - Zip <br />n l <br />LargeSmall Quantity Generator With Onsite Treatment. (Generates < 200 lbs./mo.) <br />Wl-- Large Quantity Generator Orgy. (Generates 200 or more lbs./mo.) <br />Quantity Generator With Onsite Treatment.- 11 or • r • <br />I declare under penalty of law that to the best of my knowledge and belief the statements <br />made herein are correctand true. I hereby• • all necessary► r• .• <br />pursuant to the California Medical Waste Management Act and incidental to the issuance <br />of • and the operation of business. <br />