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MEDICAL WASTE GENERATOR <br /> FILE COVER SHEET <br /> FACILITY ID#: FA0012597 P/E: 4530 DATE: 06/14/2007 <br /> PROGRAM RECORD#: PR0516429 P/E: DATE: <br /> P/E: DATE: <br /> ADDRESS: 2291 W MARCH LN 145F CITY: STOCKTON <br /> FACILITY NAME (DBA): OUEST DIAGNOSTICS CLINICAL LAB <br /> FACILITY PHONE: FACILITY FAX: <br /> FACILITY CONTACT: I�(��,_� l 2� c ASA e-i PHONE: 9S —e-)4 7_72 <br /> OWNER NAME: OUEST DIAGNOSTICS CLINICAL LAE CITY: STOCKTON <br /> OWNER ADDRESS: 2291 W MARCH LN 145F PHONE: <br /> Water Service: ❑ Large PWS ❑ Small PWS ❑ Domestic Well <br /> Sewer Service: Public Sewer ❑ OnSite WWTX ❑ OnSite Septic System <br /> Stormwater: ❑ Street Drains ❑ Street Ditches ❑ OnSite Ponds ❑ Other <br /> Quest <br /> Diagn 'S` <br /> Kenneth T.llejay Jr,AHSM <br /> Sr.Environmental Health&Safety Specialist,Northern California <br /> C 6 o 930 <br /> c ''4! <br /> �.57 tl <br /> ' �at�Blvd. <br /> a rar7tentc,CA95834 <br /> Kenneto.T.liajay@D�es1Dlagnostic E; <br /> EH 00 18 rev 05/2007 <br /> rpt#: MWCS New Owner: Create a New Cover Sheet/Change Label of File <br />