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08/14/2018 <br /> 111-13111692 0001060244 <br /> Medical Waste Tracking Document <br /> ROtrtB Na TR207 <br /> Customer: <br /> LINCOLN P05T ACJ)i1;1032 N Unooln St 24-HOur Emergency Response (800)424-9300 <br /> Stockton,CA 95203-2409 <br /> 'Cmstomer SetVice (85S)508-0392 <br /> D tion of waste ContalnerType 140.of 1b.or <br /> DN(Regulated Medical Waste(Bio))1-7.000000 gal <br /> Containers Volume <br /> UN3Z91,Regulated Medical Waste,N.O.S.,6.2,PM 77 GAL <br /> UN3291,Regulated Medical Waste,N,6:s.,6.7'P <br /> GII 31 GALLON(RequlaW medical waste(Bio))31.000000 gal <br /> --- <br /> UN3291,)regulated Medical Waste,N.O.S.,6.2,PG11 43 GALLON(Regulated Medical Warts(No))43.000000 gal <br /> Transporter 1: Totals <br /> WM Healthcare Solutions,Inc. Applicable Permits <br /> 1996 Don Lee Place Ste.C Escondido 5688-MW-172 Phone#: (760)489-5009 <br /> Escondido,CA 92029 Vernon-5688-MW-157 Rhone*: (323)307-0514 <br /> Transporter I A ledge t of pt of Materials <br /> Signature Print/Typed Home a Date 6— <br /> Trans Permit 0 Date <br /> All r Signature <br /> Printe-d Nam® <br /> AutOdavVTransferfadlt Transfer Facia h _Inn grattan Facaiiy Incineration Fad9 Aft! ent Bad& <br /> WMRS Vernon WMHS Escondido Covanta Energy HEST SerOcces Aernerpa RedPak Healthwise SgMccs' <br /> 4280 Uandini 13tvd 1996 Don Lee Place SzSiTriana Blvd SW 1420 40th Street North Servi=aC,LLC4300 E.Urcoln Av. <br /> Vernon,CA 90059 suite C Huntwilla,AL 35806 Fargo,ND 58102 9600 E.Avenue' Fowler,CA 9362$ <br /> Phone(34 307-0514 rzoondido,CA 92029 Phone 956)882-101.9 Phone(701)2817373 Hesperia CA,92345 Phone(559)1334-3333Permit#. -r5/QST BI Phone(760)189-5009 Permit*:709-1104 Pearill:4-1T8-0203 Phone(760) ft <br /> 26 Permit TS-69 <br /> Permit M.TS-7,1 Permit*:TS I( <br /> Signature SignetjraSignature— signature Signature nattrrx, <br /> Date Dain Date — Date Date Date <br /> vepancyTraiaunent Fadliq Cartificardmi of IlCacelpt and DoAnx-Effo-n <br /> *1 certify that the content.-of the listed conialner(s)have been received,treated,and <br /> d1sposerl cff at one or more of the facilities lndlcated above In accordance with all local,slate, <br /> and federal regulationg-^ <br /> :omments <br /> AUG 12018 <br /> WM Healthcare Solutions <br /> Generator's Certiflcation:"I hereby dedeire ti-at the commis of this consignment are fully and acffura"descrfbed above by the proper shippIng name and are'cta=64 package <br /> marked Ond labdediplacardi-d,and are in all respells In pfwar condlifon for transport try highway=orc4ng to applicab(c IntEmintional and national government regulzticns,Including <br /> appricablB state reguiavons,' <br /> Sign re Printfryped Name Date <br /> 601/0ti 'd "N AdW6 �H 'E 'add <br />