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831-13530092 0002107656 <br /> T6 ®a�nnaewT� Medical Waste Tracking DOcurnent <br /> Route No. TP,207 <br /> LINCOLN POSTACUTE <br /> 1032 N Uncoln 5t 24-Hour Emergency Responae (800)424-9300 <br /> Stockton,CA 95203-2909 Customer SerfaCe (SW 608-0392 <br /> p <br /> 0esc�rwiOn of W�aste <br /> Container Type No.of or <br /> UN3291,Regulated Medical Waste,N— Cordalinersi Volume <br /> .0-5,6.2,PGU 17 GALLON(Regulated Medical Waste(Bio))17.000000 gal <br /> 17](300000000 gal UN3291,Regulated Me(flCal Waste,N-O.S.,6,2,pM <br /> 31 GALLON(Regulated m64cal Waste(S10))31.000000 go, <br /> .(Sl <br /> o)) <br /> N3291,Regulated ed c ' <br /> Waste,N.0.5-,6 1,PGMj41—GALLON(Re, 1a� <br /> Medical Waste(Bio))43-000000 gal <br /> Transporter <br /> Tot!!-5WM Healthcare SoluU n Int. Applicable Permits <br /> 1-06 Dan Lee Place Sw.C Escondido-5686-MW-172 Phone (760)409-5009 <br /> Escond1da,CA 92029 Vemon-5688-MW-157 <br /> Phone (323)307-0514 <br /> Transporter I AC Lv"Ae,�Iget�elpt�oF Ma�terlals <br /> Transporter <br /> P� <br /> T _P <br /> "j _ <br /> Signature Print/Typed Name —Ip <br /> L date 12 z=Lq--1 L <br /> ransp r <br /> Permit 4 <br /> Adair <br /> ddr. Signabuire Dal�-- <br /> Pdnfxd Name <br /> fAuWda risfer Fa Y�ta er Pacl <br /> WM S Es-ndrd. <br /> 'Bivd 19' Do.Lee Piece <br /> C <br /> _0_5 <br /> ��67 — —Indnera Incir4ration Fad] <br /> WmHsverrion WMIISESCondido gaz�-Cff�I n <br /> 4280 Bandin!Blvd 199f Don Lee Place covarita Enew HER Servfm AenrerVe Redpak' eali Servi <br /> Zi � <br /> Qo 1420 40th-Street North services S.C.,ILC Vernon,CA w5g SUIbEC 5251THana Blvd SW <br /> I .(3� Huntsville,A05805 Fargo,ND$6102 <br /> Phone(34 4800 E.Uncoln Av. <br /> -307-0514 'Esm dido,CA 92OZ� 9600 C.Avenue Fowler,CA 93625 <br /> C 9_5009 <br /> P�qe�M#; TS/cIST81. Pho C760)499-SOM Phone(25Q 8024019 Phone V01)ZaZ-7373 Hesperia 64 92345 Ph PA(559)834-33 <br /> Per ft V:TS-7-1 P <br /> Permit*;709-11(K Permit Phone C76o)9B3-aeoe peno"n V. <br /> sl <br /> Sigh ture Permit*,1510$7 135 <br /> Dan Signature— Signature Signature_ <br /> Date Data Date <br /> Date bats <br /> 1 uta?mra�nra arf Ate livt�wntaEna(sl have been rereiveQ,treated <br /> d <br /> 1,state, <br /> DEC 201 <br /> ire Healthicere SOIUtfans <br /> e6nerator's Cartliftatiorr'I hereby deda re thatthe contents of this coAsIgnmant are nilly and Booll,ately descrIbed above by the Pmoer shipping name and are diisstfied,packagE <br /> 11-IrkM and labele4/plaoiirded,and are.in all respell In proper conalon far tnWom by big"according to 0PUcubte International and riationBl 90vErnu'Enc regulations,IncludinE <br /> Pplicable Me regulations" <br /> gnatUre ®rant ed lft�-edate21 <br /> 6U/9Z 'd "N AdW � 61H '01 '1dV <br />