Laserfiche WebLink
0 <br /> X�Amond ffimedic.-d Inc MEDICAL WASTE TRACKING DOCUMENT# 306522 <br /> 11255 Mo arch Simvi, Suite c <br /> Qyrrnv�, CA_q2,q41 <br /> I TOR Frolu <br /> 210,')-472-5t)�ri FAX MEDASEND <br /> wwm I�Aedasey.W.corn <br /> cwojo� Balance Due- <br /> ................ .......................... . <br /> GENERATOR(Pick-up LocMon) .. GENERATM I SHIPPER CERTIFICA-FID-N <br /> ------------------------------------------------------- ...........................i w to 00ft that OR mltelibein W' ,ara ameffiod,packpd, <br /> post ACUL-Pu-12 w a =a lab*d m Fwppzr condition fow iiawportatioA 2ccordffig to thb <br /> Iti3:Z 1i ItnceiZtr Si "a <br /> Dent pamTwof T a m <br /> &00=a,CA 95203 <br /> '69.466,534! i . <br /> TIME <br /> U1, q 11 51A P4 <br /> .. ............. <br /> QENI5UTM3 ACKNQWLEDQEN&.Wr <br /> TRA 1 W'OPTR RF(TTSTRXNQN 6146 GcwhtOr UnMAInds DWY U143291 P.Pgahod Diohamdous Waste m <br /> defm&dbv(j§/,EPA,jCALEPA,Dae,snA CE)PI-i vj31T be sicaspucl hy <br /> 11258 Mon%c)a Non-t!onfbr:tdn&�nLte wZ not be accepted. <br /> cyff&n Grove-CR gm i <br /> -NOO-'1raisfer-Station;#?,QhowchMa,CA <br /> SIGNATURE -7 <br /> DAT)� 5.9-1 <br /> .... ............. ...... <br /> ................. <br /> .1144 E Tbarom Avenue <br /> u the t­aAq=wf'rwffSmtRfiV8,I ua �Ihk 11m�Conlmtg&PC ed <br /> 1-'1158rto,CA"721 db henk <br /> HIP Pwtaged kr Mipment in wcordmice with au 2ppuzible repIgtiolm <br /> T80ST-5-5 <br /> .................. .................. .......... ....... .......... <br /> ................... ......................_,­­------- ---------------------------------- <br /> .................... <br /> Quawty weight item code <br /> Dew"Oh Rate -AMMint <br /> .......... ....................... .............. ............. <br /> PU52 'M0N=,YNMDICAL WA.StE'SMVICEM ........................ <br /> j SHRVICE 5115. 5122 <br /> CONIPiFITION <br /> �.RZD RAG <br /> .................................. ------------- ----------------...... .................... <br /> -----------------........------------­- <br /> Regolated Me&cal Waste 6,2, .391§ PG 11 ' <br /> INCEDASF—ND SIGNATURE:' DA,7 R <br /> 60l/56 'd zS�l "N Adtio :� 6 [0z '0 [ 'add <br />