Laserfiche WebLink
Feb. 25, 2016 11:51AM No, 8337_..P. 23/56 <br />Barnett Medical Ser , Inc 510=429-9911 Ph Date: D3�s� <br />T30620 San Antonio St 510-429-9914 Fax Manifest #: ?560 <br />Hayward Ca 94644 Customer# <br />Transpnder 10#4891 <br />('orator. Contact: Pat Wort:: (209) 334-3793 <br />Wine Gauntry Care Center - Lodi weekly <br />X21 �q Tur,-rerr�ed Frequency of service <br />Lodi. CA 95240 Pricing $455 per t4onth FLAT -RATE <br />o Transfer Facility: <br />DeatinOon Facility: o Alternate Tr®nefer Facility <br />o Destination radlity <br />a Alternate A®stination FacifiW Ahernal0 Transfer Facility <br />Semen k4edloa(Serylces,1no <br />Barnett Medlogi 8arvimsjnc Heaithwi9e Services <br />Photo Waste Recycling Ino <br />Curtis 9ey Energy <br />Daniels shtarpemaR <br />30920 San Antonio St <br />2365 Arch lid 11200 4800 E. Lincoln Ave <br />2880 Kamer Blvd #G <br />3.200 Hawkins Point Rd <br />4144 E. Therese Ave <br />HE; uafd CA 94644 <br />Stockton CA 95215 Fowler CA 93625 <br />San Refaal CA 04901 <br />Baltimore MD 21229 <br />Fresno CA 93726 <br />(510) 429-9911 <br />permit#TS-87 <br />(510) 429-®611 8558943333 <br />Permit 9T8/08T--106 Permit#TS-89 <br />(415) 4598607 <br />permit #PWR122164 <br />(410) 354-3228 <br />Pelmlt02005-WMI-0038 <br />559-884.6262 <br />Permit t1TWOST6s <br />Date <br />,,,_Dates a i{J <br />8 gal <br />44 gal ®� <br />18 gal <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2 PG 11 <br />Sharps Contalners <br />Regulated Medical Waste <br />Pharmaceutical <br />Trace ChernotherapV <br />iz Qty: <br />Size Qty: Wt <br />Size Qty: <br />Wt: size Qty: Wt <br />Up to: <br />3 gal <br />2 gal <br />20 gal <br />8 gal <br />IZ gal <br />4 gaj <br />38 gal <br />9 gal <br />18 gal <br />6 gal <br />40 gal ^�- - <br />12 g21 <br />20 gal <br />8 gal <br />44 gal ®� <br />18 gal <br />38 gal <br />12 gal <br />Size Qty <br />Weight <br />'I <br />Pathogen: <br />Product Delivered: <br />Welght: <br />Item # Description: Qt: <br />I <br />ftntal Waste.• <br />Amalgarn:Siz® Qty Fixer.5ize Qty Developer: Size_ Qty <br />Lead=Sl7n Qt Other-Slze Qt <br />Other: Type Size Qt <br />Notes: upta s Per _ours: 3 <br />ea addl tub beyond (ti) <br />Generator Certification: I hereby certiry thatvteeontents ofthis consknmentare fury and 60CUretely described above by proper shippIng name <br />and are classified, packed, marked, and labeled, and are In all aspects in proper06ndltlon for transport according to <br />applli*Ale 0overnrn ant regu)atlons. <br />Generator (Customer) <br />Route Driver <br />Certificate of oestrucrion <br />incineration <br />i furtherdedare thatthis <br />regu Jatlons and/or appro <br />el bazo <br />-- <br />Name o(au[horized person (prh <br />Name Outhorized person (print) <br />Name of autharited person (prtnd <br />Brett �spicha <br />ofwaste Is free ofhazardoueand mercurywaste as defined by the US code offederal <br />e rules and regulatinns. <br />signature <br />CertlFlcato of Destruction <br />Autoclaved Name ofautharized person (print) signature <br />Received Time Feb. 25. 2016 11:52AM No. 1498 <br />07-115— <br />Date <br />Date <br />05/13/2015 <br />Date <br />