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Feb. 25. 2016 11:55AM <br />Barnett Medical Se s, Inc <br />i 3670 Enterprise Ave <br />Hayward Ca 94545 <br />EPA#CCAL000404096 <br />Transporter IDiA4t391 <br />)erator: <br />Wine 'iwoc:ntiry 08ra Ce;Vker- - Lodi <br />&V Rosd <br />Lod, . r M,2140 <br />510-429-9911 Ph <br />510-266-0945 Fax <br />-Contact: Pst <br />Frequency of Service <br />,10y"si <br />Pricing <br />No. 8337 P, 53/561; <br />Date: - -k:.; i¢ <br />Manifest #: <br />customer# ' ?6601 <br />Work: C402-),534,3740 <br />0 Tran:�far Faolllty: <br />M Destination Foolllty. <br />0 Alternate TMnsfer paolllty <br />0 Alternate bestlnallon Facility <br />0 bestination Facility <br />Daniels Sharpsmard®M®' <br />Barnett Medical Servlces,lno <br />Daniels Sharpsmart <br />Curtis Bay Energy <br />Photo Waste Recycling Inc <br />9870 �nlerpriseAve <br />2386 Arch Rd #200 <br />4144 E_ Therese Ave <br />3200 Hawkins Point Rd <br />2960 Kerner Blvd #C <br />Hayward CA 94545 <br />Btoalon CA 95215 <br />Fresno CA 92726 <br />eelrlMoro MD 21226 <br />San Rafael CA 04801 <br />(510) d2ma11 <br />(51o) 42@.9911 <br />5os>w4.t262 <br />(41o) 354-3228 <br />(415) 459$801 <br />7-0gal <br />Permit #TSJOST-10e <br />Permits Taro3T-s5 <br />Permit # 2005-WMI-0038 <br />Permit $ PWR 122764 <br />12 sal <br />Welwht <br />Waste Collected: UN 3291 Regulated Medical Waste n,o,s. 6.2 PG li <br />SharpLQDtainers <br />Regulated Medlcal <br />Waste PharD3jacetutical <br />Trace Chemet i CiY <br />Size Qty: <br />§I&e Qty: <br />Wt Size Qty: Wt; <br />ze Qty: Wt <br />Up to: <br />3 gal <br />2 ga l <br />20 gal <br />a gal <br />12 gal <br />4 gal <br />38 gal <br />9 Rai <br />1a gal <br />6gal <br />40 gal <br />17TC) 12 gal <br />7-0gal <br />8 gal <br />44gal <br />18 gal <br />38 gal <br />12 sal <br />Welwht <br />mal Size Qty Weight Emduct Wivered: <br />Weight: Pathogen: 11tem# Description: Qt: <br />Arnalgam:Sl7e qty Fixer! SIZQ_Qty Developer:Size qty <br />Lead: Size Qty_ other_ Size Qt <br />Other; Type Size <br />Notes: <br />19-®y0 <br />� <br />-34 0 <br />Generator Certification: I hereby Certify that the contents of this coMlgninant ar0 fully and accurately described above by proper shipping name <br />and are classlfled, packed, marked, and labeled, and are In all aspecU in proper condition For V9n3porrocaording to <br />applicable government regulations. <br />GeneratQr (Customer) <br />Route Driver <br />Certificate of Destruction <br />Incliteratlon <br />I further dedare that this shipment of Waste Is free of hazards <br />regulations and/or appropriate state rules and regWaagpe. <br />Name of authorl2ed person <br />Name ofapthorized person (print) <br />Name ofauthorized pOrSOn (print) <br />Brett Espicha <br />Signature <br />�s <br />mercury waste 36 def Ined by the US codeof federal <br />Date <br />12/03/201S <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) Signature , Date <br />Received Time Feb. 25, 2016 11:52AM No -1498 <br />