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Feb, 25. 2016 11:54AM <br />Barnett Medloal Se s, Inc <br />3670 Enterprise Ave <br />Hayward Ca 94645 <br />EPAOCAL000404096 <br />Transporter 10PA891 <br />�terator: <br />Wine Country Care Canter - Lodi <br />,q21 West Turner F�oarj' <br />Lodi, CA 9:,240 <br />510-429=9911 Ph <br />510-256-0945 Fax <br />Piat <br />Contact. <br />weekly <br />Frequency of service <br />4Ogp"' <br />Pricing <br />No, 8337 <IP. 48/56; <br />Date: <br />Manifest #: <br />Customer -4 2560 <br />Work: �$4-S75D <br />O Tranefer Faculty: 0 Doatinallon Facility: d Alternate Transfer F6cIlny O Altemeie Deatinatlob Facility Q Devinadon Facility <br />Donlele SharpsTart/SMS.I. Bamed Medical Servlces,lno Danlels Sharpsmart Cunis Bay Energy Photo Waste Recycling Ino <br />3670 Enterpdee Ave 2395 Arch Rd #200 4144 E. Therese Ave 8200 Hawkins Point Rd 2990 Kamer Blvd #C <br />haywaM CA 94846 Stockton CA 90215 Fresno CA 93725 Beltimore Mb 21226 San Rafael CA 94901 <br />(510) 429-9911 (510)42D-9911 659-684-6252 (d10) 354-3228 (416)469-88V <br />Per It 0 TS/OST-106 Psrmit 0 TSIOST-0 PermI1820GS-WMI-0036 Permit PWR 122704 <br />Date— <br />Waste <br />ata <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s, 6.2 PG 11 <br />Sharps Cal3talners <br />Re ula d M ' <br />1 W ste <br />PharMmutical <br />Trace Chematheraoy <br />Size Qty: <br />Size Qty: <br />Wt <br />Size Qty: <br />Wt: Slze 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 />18 gal <br />6 gal <br />40 gal <br />('00 <br />12 gal <br />20 gal <br />S gal <br />44 gal <br />18 gal <br />38 gal <br />12 gal <br />Weight <br />-" gal <br />Size qty <br />Weight <br />ProcitictDC11mmd <br />weight., <br />Eath9gew, <br />Item # Description: Qt: <br />Dental ste: <br />Amalgam.5lze Qty Fixer:5ize Qty Doveloper:size Qty <br />Lea d;SlzE Qt Other: Size Qt <br />Other. Twe — —Size—Qt- <br />Notes, <br />SizeCit <br />Notes, Hours <br />Generator Certification: <br />Generator (Custlomed <br />Route Driver <br />Certificate of Destruction <br />Incineration <br />I hereby certify Kiat th a contents of this consignment are fully and ecctlrately described above by proper shipping name <br />qnd are clossifled, packed, marked, and labeled, and are In allaspects In proper condltlon for transport according to <br />eppllwble government It3gulations. <br />I further dedere that this shipment of waste Is free of hazardous and mercury Waste as defined by the US cod a of feder a I <br />regulations and/or appropriate mte rules and regularions. <br />_ - y i � oY l <br />Name of authorized person (print) Signature Date <br />QAJ <br />Name cf uthorized person (print) Signature to <br />Name of authorized parson (print) ure Date <br />Brett Espicha 10/30/2015 <br />Certificate of Destrueian <br />Autoddved Name of authorized person (print) Slghature Data <br />Received Time Feb.25, 2016 11:52AM No,1498 <br />