Laserfiche WebLink
10/16/2016 <br /> M-13530092 0002084001 <br /> Medical WaSW Trkking Document Route Na TR207 <br /> Customer; <br /> UNCOLN POST ACUTE <br /> 1032 N Lincoln St 24-Hour Emergency Response (BOO)424-9300 <br /> Stockton,CA 95203-2409 Customer Service <br /> (65$J 506-0392 <br /> Description of Waste <br /> -0 <br /> Container Type _--ilio,of Pb.o_r <br /> UN3291,Rtgutatecl Medical Waste,N.O.S.,6_2,pG11 _5�ontalners Volume <br /> 17 GALLON(Regulated Medical Waste(Blo))17.000000 gal j <br /> U291,Regulated <br /> Me"'ca'W <br /> TLO-S "-2'PG11 31 GALLON <br /> Waste MOD 31011000 gal <br /> UN32 MdlnWaste,N.05.,6.2, 43 GALLON(Regulated Mgdlcw <br /> (Bio))43.000000 gal <br /> Transporter 1; Totals <br /> WM Healthcam Solutions,Inc. Applicable Permits-- <br /> 1996 Don Lee Place Ste.C ESc0nd(d0-568a-MW-172 Phone (760)489-5009 <br /> Escondido,CAL 92029 Vernon-5688-MVV-157 Phone (323)307-0514 <br /> Transporter I Ac �edg, �Rem�ipt at Materials — <br /> ata"'aI5 <br /> Signature �Prlrvtf 11`�Vped Name Date <br /> Transp Permit 4 <br /> rr' 'P <br /> 5 Date <br /> Addr <br /> Signature <br /> PrInted Name <br /> AutodivefrransfEr Lad]& Transfer Fladilty <br /> Incineration F&06 Att Treatment Facility -'llrorP-;�Irl <br /> WMH Vernon 'WMHS E�5=ndldo covanta Energy HESI SerAce$ Aemerge RedPak Healthwise Seryl <br /> RedjPak <br /> 4260 11-and1ril Blvd V996 DQn Lee Place 52511 Triana FEV6 SW S LL <br /> Vem CA 90058 1420 49th Sheet North Services 5 S.C.,LL 4800 E.Lh2oln Av. <br /> Avenue <br /> _5 <br /> a 6 A'g 5 <br /> 0) <br /> on, sulte C Huntsville,AL 35605 Pargo,ND saioz 9600 F_Avenue Fbwler,CA 93625 <br /> Phone(32-3)307-0514 Escondido,CA 92029 Phone(251111882-1019 Phoria(701)282-7373 Hesperia CA,9 5 one($59)534-33 <br /> Permit TS/OST el Phone(760)489-5009 Permit 709-1104 Permit M-0203 Phone(760)9 808 Pe TES <br /> Perm It*:Tr2'-73 't.TS/0 <br /> Rtewrwmt 9.TS/0 135 <br /> Signature 151gnacurz Signature— signature -Tgnatu SI t <br /> ure <br /> Date Data Date Date Date <br /> r1rIumpency <br /> Yres tdie[if Fa-c—IRFcarti Son of Reccip and beftuigb6fi- <br /> "I certify'Mat the contents orthe listed writainer(s)have been receNrel,treated,and <br /> d[mDospd of atone or morn ar the Wflitles(ndicoted above In aewdance with all Iml,state, <br /> and Woral regulatjontl <br /> OCT 16 2018 <br /> WO Healthr.,are.solutim <br /> CBrtft1CRt1cn-'1 hereby declana that the contents of this conSlonment are fully and aalfratelY ddscilbed.4bove by the proper shipping name and are claisified,pacl®g <br /> marked d labeled/placarded,and aro in all respells In props condition for transport by highway according to 8PPlIca5le International and national government regulations, <br /> ipllcabie state feguladon%" atio,5,Inciuding <br /> Signature PrintfTyped Name 12 1 <br /> Date <br /> 60WH 'd lSEl "N NdLti : � 6 H '0 dV <br />