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d I <br /> II <br /> 10/02/2018 61-13530092 0002078477 <br /> MedicalWaste Tracking Document <br /> Route No. TR207 <br /> Customer. <br /> LINCOLN <br /> POSTACUTE <br /> 1032 N Uncoln St 24-Hour Emergency ReSponSe (800)424-9300 <br /> Stockton,CA 95703-2409 Customer S ervice 506-0392 <br /> Description'$aiption of Waste <br /> )e <br /> escriptlon of Waste Container Type of Ib,or <br /> F Regulated <br /> Medical Waste,N Containers Volume <br /> UN3291,Regulated Medical Waste,N.03.,6.2,P(GRII 17 GALLON(Regulated Medics[Waste(61o))17-000000 gal— <br /> UN3291,Regulated Medical Wade,N.O.S.,6.2,PGH 31 GALLON(Regulated Medical.Waste(Blo))31,000000 gal <br /> LJN329L Regulated Medical Waste,N.0,S,,6.2,PGM-- 43 GALLON(Regulated Medical Wsste'(Bio))43.0-00000 gal <br /> Transporter I.- Totall!5 <br /> WM Healthcare' Solutions,Inc. Applicable Permits. <br /> 1996 Don Lee Place Ste,C Escondido-5658-MW-172 Phone M, (760)489-5009 <br /> Escondido,CA 92029 Vemoa-5688-MW-157 Phone (323)307-0514 <br /> Transporter 1 Ac gem Of Pt of Materials <br /> signature <br /> Prfnt/Typed Name —4—0 Dabs <br /> Transpa r Permit 4 ®aha <br /> -'sp <br /> Address Signature <br /> Printed Name <br /> ,utocItygn'l-ansfer <br /> WMHS Vernon WNIHS EsconcildoHES[Servlcw large RedPaK flBalthwlse Servioas <br /> 1996 Don Lce Place Energy <br /> 4290 Bandint Slvil =3- BNd SN 14ZO 40th Street North 4600 F-Uncoln Av. <br /> Vernon,CA 90033 - sute C Muntriville,AL 35905 largo,ND M02 9 0 M Fowler,CA 9367,5 <br /> PhoneAvenue(323)307-051,1 Escondido,CA 92D29 Phone=6)882-1019 'Phone(701)28227373 Hesperia CA,95 Phone(SM 834-333 <br /> PermlL#: TS/OST Bi Phone(760)489-5009 Permit#:709,-1104 Permit#:rr--=3 PWPC(760)98 $09 F <br /> Permt*.Tg-73 Permit#,"TS/ 35 <br /> Signature— Signature Slj;naturg— Signature sgnawre— I na re. <br /> Date — t Date Date Date Date Date <br /> D. <br /> Tis—cr.p.nol L <br /> Treatinant P3tdlrty ca on Of pacalptanaDe u on <br /> "I cw*that the contents ome listed contalner(s)hav,4 bm recelved,MaW',and <br /> d4osed of at one or more of the f0cKe5 indicated above in accorclDncz with all local,=e, <br /> and rederal regulations," <br /> �omments <br /> OCT 0 2 2018 <br /> YVM Healthcare Solultlons <br /> Generator's 0ertlification:1 hereby declare that the oontents of this consignment are fully and ac=40/demlbed above bythe proper shipping name and are daWfled,package: <br /> ma*ecsand labeled/placarded,and are in all respects in propercondrUon for transport by highway according w applicable international and nadonalgayamment ulatforis cludIng <br /> -9 <br /> applicable Mte regLa&Uc)n5.1- M 1-21 <br /> Signature PrintlTviped Name <br /> 44 <br /> 6U/5� 'd ZSEl "N &9 : E 61H '0l '1dV <br />