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MEDICAL WASTE PROGRAM <br /> Business Nam �X-11012! � —er. If) C. . PhoneZU ' 4-1-4 - *32- <br /> Business Address <br /> J <br /> i CK-+On Zip 9f1204- <br /> ontact Person Phone <br /> Owner Phone <br /> Owner Address <br /> ity Zip <br /> rogram Element Code <br /> Record ID # <br /> Onsite Treatment? Y N (Circle) if Yes,Treatment Unit Type <br /> QHE? Y N (Circle) <br /> MWMP in EHD file? Y N circle <br /> DELTA PATHOLOGY ASSOCIATES <br /> 17r� <br /> BONNIE J.NATIVIDAD <br /> Laboratory Administrator <br /> 2291 W.March Lane <br /> Suite 179E (209)477-4432 <br /> Stockton,CA 95207 FAX(209)320-6136 <br />