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09/25/2018 <br /> 831-13530092 0002075336 <br /> AMCMedical W <br /> aste Tracking bowment Route No. TR207 <br /> Customer. <br /> LINCOLN POST ACUTE <br /> 1032 N Lincoln st 24,Hour Ernergenty Response (800 424-9300 <br /> Rocktan,CA 95203-2409 <br /> GuStOMell'Senfte Coss)50"392 <br /> Description of YjAste Container Type lb,or <br /> e"5 <br /> Contallnerg Volume <br /> c 1 .000 00 gal <br /> UN3291,Regulated Medical Waste:,N.O.s.,6.2,pGZ 17 GALLON(Regulated Mealcal Waste(51o)) 7 0 <br /> 31 - e0l <br /> UPJ-9291,Regulated Medical WwbA N.O.S-,6.2,PCIJ I eq, Cal <br /> UN3291,R291010ted Medical WastlE-,N.O.S,6.2,PC-Ij 31 GALLON(Regulated Medical Waste(ala))31.00000()gal <br /> UN3291,Regulated Medical Waste,N.O.S.,6.4,PGIr 43 GALLON(Regulated Medical Waste(Bio))43.000000 gal <br /> Transporter 1! <br /> Applicable Permits Healthcare soluaons,Inc. Tmls <br /> 1996 Don Lee Place Ste,C Escondido-55BB-MW-172 <br /> Escondido,CA 92029 Phone (760)489-5oo9 <br /> Vemon-5688-Mw-jv Phone (323)307-0514 <br /> Transporter I Acknova t of aeelpt of Materials <br /> Signature <br /> Print/Typed Name Date <br /> at <br /> Tran5porter 2: ermit# <br /> Address PbaCe <br /> Sqqnature <br /> Printed Name <br /> Awtoday ransfer ftcil* <br /> F, <br /> Pro <br /> PcMa M Tree MV Lacjik pro <br /> X"S;V <br /> WMI-Is Vernon WMHS Escondldo� <br /> I d Covanta Enew KESt Services <br /> F42BO B5andinj Sled 1999 Don Lee Place Aamerge kedPak lthvdse seryl <br /> Vernon,CA 90058 suite C 5251 Triana Blvd SW 1420 40th Street North services S.C.,LLC 001-UAwIn AV, <br /> Phone 023)3U-0514 Escondido,r Fargo,ND 58102 9600 E.Avenue or,CA 93625 <br /> PC 3 _A 92029 Huntsville,AL <br /> PC. <br /> rmito: T5jcl5791 Phone(7150)489-5009 Phase(256)882-1019 Phone(701)282-7373 Hesperla W234S Ph 559)8343#;T5-73 Permit V;709-1104 Permit#- Phom(760)983-2803 2.1t. <br /> Signatum— $Vn;ture_ Signature— Peanit#:TS/OST 135 <br /> -ate Date 15lgnature_ <br /> L��- Date Date <br /> Data Date <br /> Xscrewcy P DWI <br /> Date <br /> Fera sty t-,epti gbph <br /> I I,, lj'�'!F)nd DestmtUon <br /> ce that the contents of the listed cont'aine*' )have been reoekd,treated,and <br /> 41med of at one or More ohne fadlftks Indicated above in accordance wiM all incal,smote, <br /> 'ornments nd federal regulations.® <br /> . OCT 0 3201 <br /> W Healthcare SolUtIons ' <br /> by declare that the contents of this I <br /> -arked and labeleWpl fully and B=ral:aly described above by the proper Wipping name and are classified,Pa <br /> car, are in all respem in Proper owtifflon by highway according to applikable,International and national government regulations,Including <br /> a <br /> aPP[icableatatc reg for iransport <br /> Signature <br /> rink/Typed Name Date <br /> 60l/9� 'd zS�� 'ON AH : � 61R '0 'add <br />