Laserfiche WebLink
r <br />PAGE 03/25 <br />A 1 1 r 's. <br />VDriver <br />State: QA '7AP- <br />i r <br />I' '. <br />R_ <br />v + ' <br />STFANI S I,FIrll s ZF,D R11a)1t `.Ai. WASTE, 1`!;TOTAL <br />R=l, a, <br />UM <br />F+ <br />1 rc <br />h ION W \S'l'1: r to <br />Container Quantity <br />CoamltterQuetitity <br />Pu Dei <br />PIU Del <br />20CH <br />8CH <br />20PA <br />SPH <br />Z0PH <br />2.5C <br />16PH <br />WH <br />16CH <br />t`uat,­ <br />.w..., was "M uwr-r regeuau n properly clwKned, described, packaged, marked and tabckd, <br />and in proper condWon traaaQartatiou according to a le r tions or the DOT, <br />X7 <br />Print Namc Customer Si turn Date <br />9kCa forms Medksl Dispowd, inc. <br />4100E Avo. <br />Fresno, CA. <br />(559),834 <br />Reg.lbAm <br />461 <br />uthorized Signature Ante <br />Inc. <br />400 E Therese Ave. <br />Freaao, CA 93725 <br />(SS9)-834.Sti50 <br />Reg. Haulers k 4461 <br />P T'SJOB <br />u Signatar Da <br />Medical Dia;wsal, Inc. <br />w <br />J, <br />Fresno, CA 93725. <br />Authrorize. jDate <br />E <br />X <br />Authorized Signature Dace Reed <br />Authorized Signature Date Rec'd <br />