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U I I 1v1 �Uuj ri1.ori =IJUJO 'S2 <br />SERVICE ADDRESS <br />5155 DEUEL VOCATIONAL INSTITUTION <br />Trng Document <br />• e as <br />fiTR ill 5"I'l {21f.I�F,t) '�i► I)1C:�I. 1�'.1`l' <br />PAGE 11/25 <br />Container Quantity <br />Container quantity <br />•-r <br />Type P/U Del <br />Type P/LT Del <br />O <br />D 016 <br />CONTACT:DON <br />WILCOX <br />• e as <br />fiTR ill 5"I'l {21f.I�F,t) '�i► I)1C:�I. 1�'.1`l' <br />PAGE 11/25 <br />Container Quantity <br />Container quantity <br />Container uantity <br />Type P/U Del <br />Type P/LT Del <br />•lupe P/U- Del <br />4813 <br />32B <br />Transporter <br />44B <br />20B <br />S-14 <br />40B <br />Sharps <br />S-22 <br />38B <br />Sharps <br />S-32 <br />I ILMI �� fit.•/ �1(�:II Il <br />Container Quantity <br />Container Quantity <br />Container Quantity <br />T P/U Del <br />T) a P/U Del <br />i2e PIU Del <br />44PA <br />8CH <br />CCP. <br />20CH <br />8PH <br />CCPR <br />20PA <br />2.5C <br />S-14PH <br />16CH <br />2.5PH <br />S-22PH <br />.16PH <br />CCCH <br />S32 -PH <br />Customer t ertlrt tton: This is to certify that the above named regulated medical waste is properly classified, described, packaged, marked and lubeled, and <br />in proper condition for trans natio according to the applicable re ula ' sof the DO . <br />X x� <br />Frifit Name tust6&fr Signature Date <br />LyCalifornia Medical Disposal, Inc. <br />ese Av3725 <br />50 <br /># 6T <br />2Signature <br />A <br />Date <br />011 <br />Authorized Signature . Date <br />M <br />California Medkal Disposal, Inc. <br />4100 E Therese ave. <br />Fresno, CA 93725 <br />(559)-834.5850 <br />Reg. Haulers # 4461 <br />PERMIT # TS/OST32 <br />Authorized Signature <br />Date Ree -d <br />•T.California Medical Disposal, Inc. <br />4100 E Therese Ave. <br />Fresno, CA 93925 <br />(559)-834-5850 <br />Reg. haulers 0 4461 <br />P 417 # TS/US 132 <br />authorized igna *D, Authorized Signature Date <br />California Medica! Disposal, Inc. <br />4100 E Therese Ave. <br />Fresno, CA 93725 <br />(559)-834-5850 <br />Reg. Haulers 4 4461 <br />PERMIT # TS/OST32 <br />X x <br />Authorized Signature Date Authorized Signature Date Recd <br />UN3291, PG 11, 6.2 <br />