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Feb, 25. 2016 11:54AM <br />Barnett Medical Se s, Inc <br />®� 3670 Pnterprlse Ave <br />Hayward Ca 94545 <br />EPOCA!_000404096 <br />Transporter 1004591 <br />�`)erator: <br />Wane CountIry Cara Center - U161 <br />321 Wei t Tomer Road <br />Lod;, CA 852401 <br />51.0-429-9911 Ph <br />510-266-0945 Fax <br />Contact: Pat <br />wieekl y <br />Frequency of Service <br />aog�75 <br />Pricing <br />No, 8337 P. 50/565 <br />Date: . 1-61 ii <br />Manifest #: <br />Customer# 2560 <br />Wvrk; �W-q) nA-3760 <br />0 Tflnsfar Facility: <br />® bsatInation F9oility; <br />0 Alternate Transfer Faellliy <br />O Alternate Deatination Foollity, <br />0 Deatination Facility <br />Danlela ahapsmartiBMS <br />Barnett Medlaal sarvioe9,lnc <br />Daniels Sharpgmart <br />Curtis Bey Energy <br />Photo Wasts Recycling Inc <br />3670 1=nterprise Ave <br />2385 Arch Rd #200 <br />4144 E. Therese Ave <br />3200 Ht;wklna Point Rd <br />2980 Kerner Blyd NO <br />Hayward CA 94545 <br />Stockton CA 95215 <br />Fresno CA 0726 <br />Baltimore MO 21229 <br />San Rafael OA 94901 <br />(810)4293911 <br />(510)429.9911 <br />5S9-894.6292 <br />(410) 864-3228416)459-8807 <br />Kart)it#PWR122704 <br />1Perrnit#T6/0ST109 <br />Permit#TS/OST-55 <br />Permi1#2005-WMW030 <br />Date-—�ete(I <br />b ls� <br />Waste Collected: UN 3291 Regulated Medical Waste mo.s. 6.2 PG II <br />har s la ners <br />Regulated M9dical Waste <br />Pharmaceutical. <br />Trace Chgmothemw <br />Size Qty: <br />Size <br />Qty: Wt <br />s'I�zP Qty: Wt: <br />Size Qty: <br />wt <br />Up to: <br />3 gal <br />2 gal <br />20 gal <br />8 gal <br />12 gal <br />4 gal <br />88 gal <br />9 gal <br />18 ,gal <br />6 gal <br />40 gal <br />Q <br />12 gal <br />20 gal <br />a gal <br />44 gal <br />1S gal <br />3B gal <br />12 gal <br />Weight <br />mal <br />Size Qty Weight <br />Eroduct Delivered; <br />Weight: <br />the en: <br />Item# Description: at., <br />Qental Waste: <br />Amalgam: Size Qty Fixer: Size Qty_ Developer: Size Qty <br />Lea d:SIZe QI_ Other: Size Qt <br />Other: Type Size Q <br />Notes: our9 $-5 <br />Generator Certification: I herebycartlfy that thecontentsofthis conslgnmentare <br />'fully and accurately described above by proper shipping name <br />and ate OwslRed, packed, marked, and labeled, and are In all aspects In proper canditian for transport according to <br />applicable government regulations. <br />Generator (Customer) <br />Route Driver <br />Certificat a of Destro ctioh <br />incineration <br />I Nrther declare that this shipment of waste 161YeG of hazardous an4 mercurywaste as defined by the U5 and a of federal <br />regulatlo s And/or appropriate state rules and reguledona. <br />Name ofauthorr&d parson (print) Signature <br />Name of juthorited person (print) Signature <br />Name of authorized person (print) <br />Brett Espicha <br />Date <br />D to <br />DAte <br />11/11/2015 <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) Signature pate <br />Received Time Feb, 25. 2016 11:52AM No -1498 <br />