Laserfiche WebLink
Feb, 25, 2016 11:51AM <br />Barnett Medical Se s, Inc <br />®a 3670 Enterprise Ave <br />Hayward Ca 94545 <br />EP CAL000404096 <br />Transporter ID##4891 <br />aerator: <br />Wine Country Care Center - Lodi <br />321 West "l imer Road <br />Lodi, Cod 95240 <br />• ♦. I 1$ 1 hil r. <br />Contact: Pat <br />No, 8337����Prc22/56 <br />Date: <br />Manifest #: 73929 <br />Customer# 2500 <br />Frequency of Service weekly <br />Pricing $455-5 per Wonth FLAT -RATE <br />Work: (= 534-3769 <br />❑ Transfer Facility. <br />0 Destination Facility; <br />is Allamat• Transfer Facility <br />D Alternate Destination Faallity <br />O Destination Feolllty <br />Daniels SharpslneNBMS <br />Barnett Medical SeMeoi0tio <br />Daniels sharp9mart <br />Curtis Bay Energy <br />Photo Waal Recycling (no <br />3970 Enfetprise Ave <br />2385 Arch ad #200 <br />4144 E. Thersee Ave <br />3200 Hawkins Point Rd <br />2980 Kamer Blvd #C <br />Hayward CA 94546 <br />Stockton CA 95216 <br />Fresno CA 93725 <br />HalUmore MP 21226 <br />San fiafael CA 94901 <br />(510) 4294911 <br />(510) 429-8971 <br />558-aid-e252(a10) <br />8843228 <br />011dk200s-WMI-0036 <br />(415) 45MB07 <br />9 gal <br />Permit 0TXO8T-106 <br />Pemtlt!#7B/OM" <br />40 gal <br />Permit *PWR122Y64 <br />Data <br />—�pate� <br />8 gal <br />44 gal <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2 PG 11 <br />Sharas 0ontainets <br />Regulated <br />Medical Waste <br />ehormimoulical <br />Irace Che motherap <br />Size Qty: <br />Size <br />Qty: Wt <br />Slze qty: <br />Wt: Sire qty: Wt <br />Up to: <br />3 gal <br />2 gal <br />20 gal <br />8 gal <br />12 gal <br />4 gal <br />38 gal <br />9 gal <br />18 gal <br />6 gal <br />40 gal <br />�_ TN -- ) <br />17,821 <br />20 gal <br />8 gal <br />44 gal <br />18 gal <br />38 gal <br />12 gal <br />Weight <br />mal <br />Size Qty <br />Weight <br />Product Delivered: <br />b,.t!lght. <br />Pathogen: <br />Item # Description: Qt: <br />Rental Waste; <br />Arnalgam!Size Qtyl5iXer:Size Qty Developer: Size Qty <br />Lead: Size qt Other:Slz® Qt <br />Other: Type SIZE <br />Notes: ..r...,_. , –I— "I-- <br />ea <br />.._._ea adds tub beyand (6) <br />Generator Certification: I hereby certify that thacontmnto of this consignment are fully end owurtrtely described ahove try proper shipping name <br />and are elawlffled, pecked, marked, and labeled, and are in all aspects in proper condition for transport according to <br />applicable government regulations. <br />I further declare that this shipment of waste is free of hazardous and mercury waste as defined by the US cod a of federal <br />regulatio a d/or japproprlat• stets nho and reguNtlons, <br />Generator (customer) / ✓ l <br />Name ofaut zed person (print) ienarure D e <br />Route Driver e f <br />Name nUuthorized person (print Signature gto <br />%-artificate of Destruction <br />Incineration Name of authorized person (print)Date <br />Brett Espicha `^' 05/06/2015 <br />Certificate of Destru coon <br />Autoclaved Name of authorized person (print) Signature Date <br />Received Tune Feb, 25, 2016 11:52AM No. 1498 <br />