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■ Feb.25.2016 11:53AM <br />Barnett Medical Se s, Inc <br />s <br />3670 Enterprise Ave <br />Hayward Ca 94645 <br />EPA#CAL000404096 <br />7ranspoRetiD#4881 <br />Aerator; <br />Wine Codlrlitlj v Care Center - Lodi <br />,tai Viest sumer R ud <br />Lodi, CA 9524a <br />510-429-9911 Ph <br />510-266-0945 Fax <br />Pst <br />Contact: <br />Frequency of service <br />4Qg$76 <br />Pricing <br />weekly <br />No, 8337 IP. 43/565 <br />Date: 81137 <br />Manifest #: <br />Customer# 2550 <br />Mix: �a) 33d-3794 <br />®'Transfer Facilib; <br />03 Des4oadon Paelllty: <br />Cl Alternate Trensfer Faclllty <br />D Altemeta Destination Facility <br />0 DeatInAllon Facility <br />Donlels 5harpamartBMS <br />Barnett Medir*l Servim,ino <br />13016111 Sharpsmart <br />Cunle Bay energy <br />Pboto Weets Recycling Inc <br />3670 Enrerptlee Ave <br />2,385 Arch Rd #200 <br />4144 F— Theme Ave <br />3200 Hawkins Point Rd <br />2980 Kerner Blvd 00 <br />Hayward CA 94046 <br />Stockton CA 95219 <br />Fresno CA 93725 <br />BalEimore MD 21226 <br />San Raise) CA 94901 <br />(510) 429-9911510) <br />429-9911 <br />55$-834-6252 <br />(410) 354-3226 <br />(41 S) 459-8807 <br />12 gal <br />varrnit A TWOST-100 <br />permit # TSIOST-55 <br />perrtlN K 7.006-WMI-003fi <br />ermli # PWR 122764 <br />- =—Date <br />.-p.—DalaW/Y— <br />6gal <br />40 gal <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2 PG II <br />2Mrps Contalner5. <br />UM&ted <br />Medical Waste <br />Pharmaceutical <br />Trac <br />emothera <br />Size Qty: <br />Size <br />Qty: Wt <br />Size Qty: Wt: <br />Size <br />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 />is gal <br />6gal <br />40 gal <br />12 gal <br />20 gal <br />8 gal <br />44 gal <br />18 gal <br />38 gal <br />12.ga1 <br />Weight <br />"-')al <br />Site Qty Weight!' <br />Product <br />ered: <br />Weight: <br />pathogen: <br />Item # <br />Description: Qt: <br />Amalgam: Size Qty Fixer: Size Qty Developer!Si2e Qty <br />Lead; Size Qt other:Slze Qt <br />Other:lyp® Size Qt <br />5 <br />Notes: ' <br />Generator Certification; I hereby certIN that the contents of this consignment: are fully and atcurately descrlbed above by proper ship ing name <br />end are classified, packed, marked, and labeled, and are in a(laspects In proper condition for transport according to <br />applicable government regulations. <br />Generator (Customer) <br />Route Driver <br />Certificate of Destruction <br />incineration <br />Certificate of Destruction <br />Autodaved <br />Received Time Feb,2 <br />I further declare that this shipment of waste Is free of hazardous and mercury waste as defined by ins US code of federal <br />regulations and/or approprlgP9 state rules and regulations. <br />14r <br />Name of outhorl d person (prlht) Signature Oet® <br />s ri' a� <br />Narne authorized person (print) Signature Dare <br />Name of authorized person (print) Date <br />Brett Espicha 09/23/205 <br />Name of authorized person (prlrit) Signature Date <br />2016 11:52AM No -1498 <br />