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SAN�� ( ( ` ( I (� I Environmental Health Department <br /> S7 N 1u u N <br /> CC) t_1NT `14 <br /> i <br /> i <br /> Medical Waste Facility Registration <br /> Facility Name : 4111N' e. UeaACarv. <br /> Facility Address : � �� j ✓"lQi�/�l LXI /06) <br /> City , State , Zip Code : 5160 ( CA <br /> p51 !6j <br /> Mailing Address : �. <br /> City , State , Zip Code : <br /> Phone Number : <br /> Facility Contact and Title : <br /> Facility Registration Category : <br /> F1Small Quantity Generator ( < 200 pounds per month ) with Onsite Treatment . <br /> Large Quantity Generator ( > =200 pounds per month ) with Onsite Treatment . <br /> Large Quantity Generator ( > = 200 pounds per month ) without Onsite Treatment , <br /> Common Storage Facility ( 2 - 10 generators ) <br /> F1Common Storage Facility ( 11 -50 generators ) <br /> Common Storage Facility ( > 50 generators ) <br /> 1 <br /> i <br /> Version: 8-3 -23 Page 3 of 11 <br /> i <br />