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III <br /> If <br /> I IIIA <br /> Illlllill <br /> 12/25/2018 831®13530092 <br /> 011212592 <br /> Medical Waste Tracking Document <br /> �.AWBVM��WXL<bqs�= Routz No. TR207 <br /> customer, <br /> LINCOLN POST ACUTZ <br /> ID32 N Unculn St 24-Hour ginnergenCy Response (600)424-9300 <br /> Stockton,CA 95203-2409 Customer Service (853)503-0392 <br /> DeSerilpffon f Waste Container Type No.of (b.or <br /> CAntalners Volume <br /> UK3291,Regulated Mcdical Wage,N.O.S.,6.2,PGU 17 GALLON(Regulated Medical Wake(Bio))17.000000 pal <br /> UN1291,Regulated Medical Waste,N.O.S.,6.21 PGll' 31 QULLON(Regulated Medic:51 Waste(Bio))31.600000 gal <br /> UN3291,Regulated Medical Waste,N.O.S.,6.2,PG71 43 GALLON(Regulated Medical Waste(Blo))43-ONOOO gal <br /> cd 'o"OiWa <br /> 291p,'Regudated I <br /> Transporter 1: Totals <br /> WM Healthcare Solutions,Inc. Applicable Permits! <br /> 1996 Don Lee Place Ste.C Esoojidido-36M-MW-172 Phone-#: (760)489-5009 <br /> Escondido,CA 92029 Vernon-5688-MW-157 Phone#: (323)307-0519 <br /> Transporter I Arden g fit-- ----pt-- OfMateelais <br /> [Signature <br /> Print/Ty ped Name am— <br /> z <br /> T <br /> A:d gnetUre <br /> Printed Name <br /> 6 AILA)t e n acill inert n Pwqty AIC TrVatment Pacill!Y <br /> j' 2 n <br /> L <br /> wMMS 'I n WMHS eswricildo C*vanta Energy HESI Services Aemerge RedPak Hwlthwl-qq semoss <br /> 4280�ndlvd <br /> 4280 Randlill A 1996 Don Lee Place 5251 Tdana Blvd sw 1470 40th Street North SeM=S.C,LLC 4100 L Uncotn Av. <br /> Vernon,CA 90058 Suite C Huntsville,AL 33805 Fargo,ND 38102 96M U.Avenue Fowler,CA 93625 <br /> Phom(3Z3)307-0514 Esrnndldu,CA 92029 PNne(256)982-1019 Phone(701)282-7373 Hesperia CA,9 Ph (5'sq)�834.3333 <br /> Pfffiz�-' 7510ST91 phone(760)IV9-5009 Pent 9;709-1104 Permit t.1713-0203 (760)903- 009 P TS-69 <br /> penwt V:T5 73 <br /> Permit 4F:TSIOST 5 <br /> sIg -Signature Signature Signature 5ignatureDate Oa�P Dal® — <br /> at, <br /> Dats Date — Date;, <br /> Trd-afMe-RfVa—tUFr-y UME—alsEd—affica�Mpt Bra Qd§ft-C'U*—FK <br /> 'I caraly t"t Of contents or the aped cuntainer(s)have been fwi;eived,treated,and <br /> d1spo5M of at one or more of the fadHes Indirawd above In acrnrdance with all Loral,Mte, <br /> and liedem]regul3tIont- DEC 6 2018 <br /> ,Nm Healthcare Solutions <br /> Gancratces Certirmation:11 hereby declare that the content5 of t*5 carisivirnent are fully and accurstaly de5cftbecl above by the Proper shipping name and are dams1fled,package <br /> ma'ked and tabekWplamried,and are In all respecu in proper conditinA for transdart by filghWay aocordlAg to applicable Internaftnal and natlonal government re9UIA1110hS,IndudIn <br /> 30011ebble state r"t4aUoq;.- <br /> ignature Print a Ne Date <br /> 60 [/SZ 'd zS� I "N A d 9 6 �H '0 � '1dV <br />