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MEDICAL WASTE GENERATOR <br /> FILE COVER SHEET <br /> ACILITY ID#: FA0002974 P/E: 4557 DATE: 02/15/2011 <br /> PROGRAM RECORD#: PR0536051 P/E: DATE: <br /> P/E: DATE: <br /> ADDRESS: 1830 W 11TH ST CITY: TRACY <br /> FACILITY NAME (DBA): WALGREENS #2434 <br /> FACILITY PHONE: (708)317-5412 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: ❑ 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 />