Laserfiche WebLink
Feb. 25. 2016 11:53AM <br />Barnett Medical Se s, Inc <br />3670 Enterprise Ave <br />Hayward Ca 94545 <br />EPA#CAI-000404096 <br />Transporter ID#4891 <br />/--Iierator: <br />Wine Count>ry Cure Center - Laths <br />321'J'J�wt Turner Road <br />Lodi, OA 96240 <br />510429-9911 Ph <br />510-266-0945 Fax <br />Contact: Pat <br />No. 8337 P. 41/56 <br />Date: 0911512015 <br />Manifest #: 8-1136 <br />Customer# 2560 <br />Frequency of Service weekly <br />Pricing . $455 per Month FLAT -RATE <br />WOW 902) 03d.3760 <br />0 Transfer Facility: <br />XI Deslinalion Faclllty: <br />O Alterrreta Tram fifer Facility <br />O Alternate Destination 1=aailipr <br />D Destination Facility <br />Daniela SherpsmavjSM5 <br />Bamett Medloal 9ervloee,lnc <br />Daniels Sharpsmart <br />Curtis Bay Energy <br />Photo Waste Rsayding Ino <br />3670 5ntelprlsa Ave <br />2364 Arch Rd 9200 <br />4144 E. TheregeAve <br />3200 Hawkins Point Rd <br />2960 Komar Blvd #0 <br />Hayward CA 8Q643 <br />(610) 4295911 <br />Stockton CA 96215 <br />429-9911 <br />Fresno CA 93725 <br />569-034-6252 <br />Dallimore MD 21226 <br />Sen Rateel GA 94801 <br />6gal <br />(510) <br />1 JEJ <br />(410) 3554-428 <br />(415) 459-0807 <br />Data <br />Permit #TWOST-10e <br />Dat���� <br />Permit 0 T6/03T-6$ <br />Permit # 2005-WMI-0036 <br />Permit # PWR 12,2764 <br />Waste Collected; UN 3291 Regulated Medical Waste n,o.s. 6.2 PG 11 <br />Sharps Contalners <br />Regulated <br />Medical Waste <br />Pharmaceutical <br />Size Qty: <br />Size <br />Qty; Wt <br />Size Qty: <br />Up to: <br />3 gal <br />2gal <br />20gal <br />8gal <br />4 gal <br />38 gal <br />9 gal <br />6gal <br />40 gal <br />1 JEJ <br />12gal <br />S gal <br />44 gal <br />18 gal <br />12 gal <br />Weight <br />'~al <br />Size Qty <br />Weight: <br />Fath9gen., <br />Trace Chemotherapy <br />Wt: Size Qty; Wt <br />12 gal <br />18 gal <br />20 gal ^� <br />38 gal <br />Weight JELoduct Delivered: <br />Item # Description: Qt: <br />Arnalgam,Size Qty Fixer, Size Qty Developer: Size qty <br />Lea d: Slze Qt Other. Size Ql <br />Other: Type Size Qt - <br />Notes; uW0)40'5 perM 0.<} 1i75 Hours: Fr -5 <br />c -a addl iuU beyond ($) <br />Generator Certification: I herebycertlthat the contents of this conelahmentare fully and accurately described above by proper shipping name <br />and oro claadf od, pack®d, marked, and labeled, and are In all aspects In proper r:ondition for transport accordln$ to <br />appltcablegovernment regulations. <br />I further declare that this shipment of waste Is free of hazardous and mercury waste as defined by the U5 code Df federal <br />regulations and/or appropriate state Man and naguloons. <br />Generator (Customer) <br />Route Driver <br />"Certificate of Destruction <br />Incineration <br />Name ofauthorized person (print) <br />11. ► /IN <br />Name of E(tithorized person <br />Name of authorized person (print) <br />Brett Esplche <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) <br />Received Time Feb. 25. 2016 11:52AM No, 1498 <br />Y6y - el ~ <br />Signature <br />A-- -- <br />Signature <br />Signature <br />Date <br />ate <br />Date <br />09/16/2015 <br />date <br />