Laserfiche WebLink
02/27/2019 831-13530092 0002169648 <br /> 0m.nwl Waste Tracking DocumentRoute NO. TR301 <br /> -Customer: <br /> LINCOLN POST ACUTE 24-Hour Emergency Response (800)424-9300 <br /> 1032 N Lincoln St <br /> Stockton, CA 95203-2409 Customer SerVice (855)508-0392 <br /> Description of Waste Container Type ----—No.of 1b <br /> Containers Volume <br /> UN3291, Regulated Medical Waste, N.O.S., 6.2, PG11 17 GALLON (Regulated Medical Waste(Bio)) 17.000000 gal <br /> UN3291, Regulated Medical Waste, N.O.S-,6.2, PGII 31 GALLON(Regulated Medical Waste(1310))31.000000 gal <br /> UN3291, Regulated Medical waste, N.O.S., 6-2, PG11 43 GALLON(Regulated Medical Waste(Bio))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 Phone (323)3070514 <br /> Transporter:1 A=c��nldDv—Aedgemenf of Receipt of Materials <br /> Transporter <br /> SignaturePrint/Typed Name I <br /> Date <br /> Transporter Permit <br /> Date <br /> Address <br /> Signature <br /> Printed Name <br /> AUtoclav�-,�nsfer Farilityl-TranSfPr Facility Incineration Facility Incineration Facility <br /> WMHS Vernon Alt TIreatment Faclllty,4 Procminq= <br /> Covanta Energy IIESI Services Aemerge RedPak <br /> WM LODI <br /> 4280 Bandini Blvd Healthwise Services <br /> 52SI TrIana Blvd SW 1420 40th Street North Services S.C-,LLC 4800 E.Lincoln AV. <br /> Vernon,CA 90058 1333 E.Turner Rd Huntsville,AL 55805 Fargo,ND 58102 9600 E.AvenueFowier,CA 93625 <br /> Phone(323)307-,0514 Lodi,Ca 95240 Phone(256)882-1019 Phone(701)282-7373 Hesperia CA,92345. Phone(5.59)834-5333 <br /> Permit#: TS/OST 81 Permit T/S 34 5Permit#:709-1104 Permit#:IT5-0203 Phone(760)983-2808 Permit#,TS-89 <br /> Signature— Permltt:TS/OST 135 <br /> Signature— Signature Signature— Signature <br /> Date I Vol. Date Date Date- — Date <br /> )Iscrepanryreatment Facility ert cation of ke—c-e-113pt and Destruction <br /> "I certify that the cantents;of the listed container(s)have been received,treated,and <br /> disposed of at one or more of the facliltlas indicated above In accordance with all local,state, <br /> and federal regulations," <br /> 'ornments <br /> Generator's Certification.7 hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name and are Classified,package, <br /> marked and labeled/placarded,and are In all respects in proper condition for transport by highway according to applicable international and national government regulations,including <br /> applicable state regulations." <br /> Signature Print/Typed Name <br /> Date <br /> 601/9l 'd zS� [ "N AdSt :� 6[H '01 'add <br />