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Feb. 25. 2016 11; 53AM <br />rsarnett Medical Se s, Inc <br />®i owl 3670 Enterprise Ave <br />Fir Hayward Ca 94646 <br />F;PWAL000404096 <br />TraMponer IDwoi <br />Aerator_ <br />wine Cdit ntriv Care Center - Led! <br />321 West i un-ier Read <br />Lodl, CA 95250 <br />510-429-9911 Ph <br />510266-0945 Fax <br />Contact: Pat <br />No, 8337 P. 36/56 <br />Date: Owl11Z0-95 <br />Manifest #: 76126 <br />Customer# 2660 <br />Frequency of service WLQeicly <br />Pricing $455 per Month FLAT -RATE <br />Wok (M 3.;4 -z -T9; <br />Cl Transfer Facility: <br />M 1394nedon Facility. <br />O Alternate Tran4for Faollity <br />Q Artemate Deatinsdon Facility <br />Q bestlnadon FedlIV <br />Daniels Sharpamar-OM$ <br />Aawski Medical 3erv(ces,lno <br />Daniels Shsrpsmart <br />Curtin Bay Energy <br />Photo Waste Recycling Ino <br />3870 Enterprise Ave <br />2385 Arca Rd 6200 <br />41" E. Therese Ave <br />3200 Hat I" Point Rd <br />28130 Kerner Blvd #C <br />Hayward CA 84545 <br />Stocilon CA 95215 <br />Freeno CA 83726 <br />Baltimore N1D 21226 <br />Sen Rarest CA 949D1 <br />(610)429-0011 <br />510)42943011 <br />558-834.0252 <br />(410)354.3228 <br />(416)ASO.0007 <br />38 gat <br />40 gal <br />Par IISTB/OeT106 <br />I/ <br />Permit#TWOST-SS <br />Permit #2005-WA41-0036 <br />Permit # PwR 172764 <br />Date <br />a s— <br />1.8 gal <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2 PG It <br />Sharps Containers <br />Rgggyl.Qt <br />4 Medical <br />Waste <br />Pharmaeeutice[ <br />lace Chemotherapy <br />Size Qty: <br />Size <br />Qty: <br />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 />1.2 gal <br />4 gal <br />Ggal <br />38 gat <br />40 gal <br />:2 k_/ <br />9 gal <br />12 gal <br />18 gal <br />20gal <br />8 gal <br />44 gal <br />1.8 gal <br />38 gal <br />12 gal <br />Weight <br />mal <br />Size Qty <br />Weight <br />IPMdUCt Delivered: <br />Weight: <br />Pathogen; <br />item # Description: Qt: <br />Imetal Waste: <br />Amalgam: Slze Qty Fixer: Size Qty Developer: S(2a Qty <br />Lea d: Size Qt Other: Site Qt <br />Other: Type Size Qt <br />Notes: upto(q)40's per MO,<> $25 Hours: <br />ea addl tub beyan6 (6) <br />Generator cerdfication: <br />Genemtor (Customer) <br />Route Driver <br />Certificate of Destruction <br />Incineration <br />I hereby certify that the contents of this cohSIgnfiantare fully and scotrrately described above by proper shipping nam® <br />Arid pra clesslfled, packed, marked, and labeled, and are In a118Bpeets In proper condition Ibr transport according 60 <br />applicable guvarnmenj regulations, <br />I further declare that this shlpment of WeSM 19 fres of <br />regirlatlons and/or appropriate state ruses ago regufa, <br />Name of authorized person (print) S(gl�tirre <br />iIQ 14A, <br />Nome or uthorized person (print) Slgnoture <br />Nome or authorized person (print) <br />®rete Espicha <br />Certificate of Desttuttlon <br />Autoclaved Nome of authorized person (print) <br />Received Time Feb,25, 2016 11:52AM No -1498 <br />SlBnature <br />rdous and mercury waste as defined by the US cod <br />Date <br />08/12/2015 <br />Date <br />