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MEDICAL WASTE GENERATOR <br /> FILE COVER SHEET <br /> FACILITY ID#: FA0005035 P/E: 4557 DATE: 02/15/2011 <br /> PROGRAM RECORD#: PR0536047 P/E: DATE: <br /> P/E: DATE: <br /> DRESS: 75 N HAM LN CITY: LODI <br /> FACILITY NAME (DBA): WALGREENS 42961 <br /> ACILITY PHONE: (708) 317-5418 FACILITY FAX: <br /> FACILITY CONTACT: TAX DEPARTMENT PHONE: <br /> OWNER NAME: WALGREEN COMPANY CITY: DEERFIELD <br /> OWNER ADDRESS: 300 WILMOT RD PHONE: (847) 527-4669 <br /> Water Service: ❑ Large PWS ❑ Small PWS ❑ Domestic Well <br /> Sewer Service: Q Public Sewer ❑ OnSite WWTX ❑ OnSite Septic System <br /> Stormwater: ❑ Street Drains ❑ Street Ditches OnSite Ponds ❑ Other <br /> EH 00 18 rev 05/2007 <br /> rpt#: MWCS New Owner: Create a New Cover Sheet/Change Label of File <br />