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1!�I 1 U�� I�1 1 �(� <br /> ! !! <br /> Nlll[ !lIII�I� <br /> 01/08/2019 831-13530091 <br /> 0002115976 <br /> Medical Waste Tracking Document ftutc No. 78207 <br /> LINCOLN POST ACUTE <br /> 1032 N LJAMIn St 24-HOUr Emergancy Response (800)424-9300 <br /> Stockton,CA 95203.2409 Cuss omersmice 503-039-2 <br /> [jescriptlart of waste Container Type No.of 1b.or <br /> UN3291,Regulated Metlk-Al Waste, Container Type <br /> N.O.S.,6.2,PGII 17 GALLON(Regulated MMMadlcual Weste(1310))17,000000 gal <br /> ed <br /> UN329t,Regulated Medical Waste,N.0-5,,6-2,PG11 32 GALLON(FlegUlatod Medlual Waste(31o))_31,OOM gal <br /> eg Medical <br /> W. (5jo))'.3� <br /> PUN3291,Regulated Medical#W.,w, 6.2, Container <br /> 43 GALLON(Regulated "t, <br /> led Medical Wa5te(wo))43,000090 gal <br /> Transporter 1: <br /> Totals <br /> WM Healthcare Solutions,Inc. A PerrhIM, <br /> 1996 bon Lee Place Ste.C <br /> rz= <br /> Esbandido,CA 92029 rkfldo-569a-mw-nn Phone A. (760)489-30og <br /> Vernon-5698-MW-157 Phnfl@ (323)307-0514 <br /> Transporter IF R liot of materials <br /> 519nature PrInt/Typed Name <br /> Transpo 2- Permit a <br /> Add signature Date <br /> printad Name <br /> r Spurter I Ac Mate"'a% <br /> ai <br /> ,,:r Prlritj-ryp�ad Name C, <br /> Trains" <br /> Add <br /> Facility Alt Treatment FacM p <br /> "W''NS a <br /> escandloo Coyonta Energy KE7- StrvIces <br /> q2131mancilhiii 19N ban Lag PIKe Aemerge RLdpak ffelthw4c Services <br /> ". ""1) Do 525tTdana em 5W 1420 Oft Streot North SmIces S.C..LLC 4600 E.Lincein AY, <br /> 'vernion.CA 900511 Suite C Huntsville,AL 35805 FOYM NO 5a WZ <br /> e <br /> n <br /> Zwo(321).:107-0514 Escenndidlo,CIA 92o2q 9600 F-Avenue ter,CA 1:1625 <br /> TROSTRI Phone(760)489-SM PhOnc(256)'381-1019 Phone(70112x2.7173 Hesperia CA,92345 1`559)634.3333 <br /> Permit a-,15-73 Permit 0.709-1104 PCF Kit V.-MQ03 phone(7r�o)963 nos pe <br /> r Permit N.TSIOST S35 <br /> sl9rigitinv SInature- stgnituat 5r leve 5-, <br /> Date; Date We si - <br /> I - - I Date !Datc ' - oate <br /> curry <br /> lhrod Otstructio . <br /> -1 wift that the contant5 or the listed crintainz(t)havepeen Mneved,heated,and <br /> 614mkd of at one or more Of the MC111da IndicaLed abova In acrordisrice vAth.)Il local,aiije,, <br /> and federal rcgwhVJws,' <br /> ommants <br /> JAN 0 8 2019 <br /> %14M Healthcare SOIUtlonS <br /> onerataOs CcrKrxtion:1 hereby doimfe that the<*Atcra of this wnsignmcni are Uy and accqrotcly dascritmd above by the Proper WMAng name slid OM ClaW(led,tackay t <br /> marked and lebeWplacardw,and are In ail m5mas In proper condition for transport by <br /> walkable state regulation$." highwiryaccord1mg taapplIcableinjel <br /> atrial g6vemment requiationt,IncludirlE <br /> Signature PrlrTt/TVped Hisme bwroftriaI and nalI% ki <br /> 601/H 'd "N Ndq� : € 610z '01 ') dV <br />