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Feb, 25. 2016 11:52AM <br />Barnett medical Ses, Inc <br />�a 3670 Enterprise Ave <br />Hayward Ca 94545 <br />EPAOCAL000404096 <br />TransporterlD#4891 <br />aerator: <br />Fine Countiv Carle Center - Lodi <br />321 UA?stTumerRoad <br />Lodi, CA 952,40 <br />OTransferFeallty: <br />0 Destination Facility. <br />Daniela 8harpsmarVOM8 <br />Bemed Medical 5ervicea,lno <br />0070 Enterpnse Ave <br />2896 Arch Rd V4a <br />Hayward CA 94545 <br />S D600h CA 86216 <br />(610) d29-9911 <br />(510) 429-9911 <br />Size Qty: Wt: <br />Permit 0TS/OST--106 <br />Dale <br />Daha,/ <br />No.8337 P. 31/56 <br />510-429-9911 Ph Date: i7TWL9C15 <br />510-266-0945 Fax Manlfeat #- 702'1 <br />Customer# =560 <br />Contact, Pat Work_ idos) a34•Wso <br />Frequency of Servloa :meekly <br />Pricing $465 per Month FLAT-R.p7E <br />0 Allemate Transfer Facility <br />Daniels Sharpsmurt <br />4144 E. Therese Ave <br />Fresno CA 93725 <br />6594Z"252 <br />Permit # TWOST-69 <br />0 Attemate Deadnalion Psaitity <br />Curtis pay Elreryy <br />8200ltawkim Polm Rd <br />13sttimors MD 21226 <br />(410) 35432,28 <br />Perrnit # 2005-WM1-0036 <br />0 Destination Facility <br />Photo Waste Recycling Inc <br />2980 Kemer Blvd #f- <br />9an Rafael CA 94901 <br />(416) d8A•8807 <br />Perrnitfi PWR 122764 <br />Waste Collected: UN 3291 Regulated Medical Waste rt.o.s, 6.2 PG II <br />,Sharps Containers <br />Regulated <br />Medical Waste <br />Ph at: <br />Trace ChallrotheraP_y <br />Size Qty: <br />Size <br />Qty: Wt <br />Size Qty: Wt: <br />Size Qty: Wt <br />Up to: <br />3 gal <br />2 gal <br />20 gal <br />8 gal <br />12gal <br />4 gal <br />38 gal <br />9 gal <br />18 ,gal <br />6gal <br />40 gal <br />( <br />12 gal <br />20 gal <br />8 gal <br />44gal <br />18 gal <br />38 gal <br />12 gal <br />Weight <br />Size Qty Weight <br />P 4ductDelivered: <br />Weight: <br />EgAo e <br />Remit Description; Qt: <br />Dental Waste: <br />Amalgam: Size Qty Fixer:Size Qty Daveloper.Size Qty <br />Lead:Size Qt_ Ot:her.Size Qt <br />Other: Type Size Qt <br />Notes: upto(0)4Q`a per MO. -e> ours: 8-0 <br />ea eddl tub 12Q,yond (6) <br />Generator Certification: <br />Generator (Customer) <br />Route Driver <br />r. <br />certificate of Destruction <br />Incineration <br />I hereby ceftlfy that thacontents ofihls coneignment ore fully and accurately described above by proper shipping name <br />and are classified, packed, marked, and labeled, and els In allaapects in proper Condition for transport according to <br />pppllcable government regulations. <br />I further declare that thlr shipment of waste Is free of hazardous and mercury waste as defined by the US ooda of 00ml <br />regulations and/or appropriate state rules and regulations. <br />of out <br />9 <br />of authorized per n (print) Signature <br />Name of authorized person (print) <br />Brett Espicha <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) Slgneture <br />Received Time Feb,25. 2016 11:52AM No,1498 <br />.T <br />Date <br />07/09/2015 <br />Date <br />