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0. pBLN�eAL AAutC 1 G flti a#t" <br /> ®i® S s IN CASE of EMERGENCY <br /> -® to #: 30I - 16 t ct DF ®� Pe <br /> o <br /> 1.Generators Narne,Addms and Telephone Number <br /> A N: <br /> IWSPMNG HOPE CARE CE <br /> $320 GkM1=1 CIR <br /> S70CMI, CA 95210 <br /> (209) 473-3009 3123121113 <br /> 6039969-002 <br /> 2&DESCRIPTION of WASTE 2e• CONTAINERTYPE 2C.NM OF 2D. VOLUME <br /> tiB.PGII "°$ 7 - 90 G&3 (13i*$ (22 cv ft) Cu Et <br /> *i. .as 9 - 37 Gal. Tub (Biot (4,9 Cu tt) <br /> a} 71 Cu Ft <br /> O 6� til M e.e.as, 19 - 44 1 Tub(Bio) (S.9 cu t{t) Cu R <br /> F t. eoT1321 -• 20 Gal Tub(Bio) (2.7 Cu. i t' <br /> cc Q 62 PGN <br /> Z 6UN t, Med ,a.o.s. TB15 - 20 Gal Tub (path) (2.7 Cu ft) GuR <br /> W Ou R <br /> 62.P69 M n.o:.< pJj - 20 Hal Tub (Chem) (2.7 cu ft) R <br /> 62,PGUv p <br /> Cu R <br /> Cu R <br /> harmaceutiCal Waste R <br /> 3.GwwaWs Cerdth:atlau n hereby re that the of aft oonoWwaant are and e=r4gy ALS <br /> 92 <br /> saCu R <br /> bi the r are and ,and <br /> e qt d respects in r tra to a and <br /> tdnadT <br /> yped Name Si re tate `� <br /> n.TRANSPORTERi <br /> Sterile, Inc. acAppNoWe(559 - Q <br /> Q 4135 West Swift Ave. <br /> CR I r na,Ca 93722 4in 19 3 Through shipment <br /> a RTER E FICA N' of a <br /> P Neireaft <br /> S.INTERN QLER 2/TRANSWFRoss: -a <br /> Appheable Pam*Numbers <br /> INTERMEDIATE HANDLER/TRANSPORTER C FICA N:R as desWbed above, <br /> PrhvType Nam Sgnature Date <br /> a INTERMEDIATE HANDLER 3 ITRANSPORItA 3ADDRESS- Phone e: <br /> e Permit <br /> Nunibsm- <br /> INTERMEDIATE HANDLER/ RTER CE ATiON:Reow d madhW waste mad' as . <br /> - PdrWType Name Sonwre Date <br /> 7.t2 Y IN ION <br /> T s 10at 0 to: North So Law,UT <br /> eaec Fadlir. 86.Aftnuft Fughr. <br /> Sledcyde Inc Its!1 i Incl Inc <br /> a 4135 W. FT AVEN00 1 C 2775 <br /> u. FRESNOCA 93 NORTH SALT LAKE CITY.UTSan CA 77 VERNON.CA SOW <br /> z (559)276- ( 1) -1565 (6t0) -1781 { <br /> ,uTS31ITSIOSM <br /> 22 CIMV I ndneraft PMO 91- ,P-116 <br /> I}.a's�y..e.ri "11( <br /> TREATMENT FACILRfY. I c:erti y that I have been by the applicablestate a to accept un medical and stat I have <br /> __ !" ted imment cxNined t rim' . <br /> Pd NameDoe <br /> .P <br />