Laserfiche WebLink
F alifomiat <br />Medilical <br />F Disposal <br />SERVICE ADDRESS <br />5W8 SUrTER TRACY COMM HOSP LAB <br />ly I M of <br />DRIVER: <br />ORDER# 15171 <br />SITE PHONE: 209-832-6032 <br />PO# <br />TRACY, CA 95376 T: PEDRO <br />DATE: 02/1712005 Ttusfty <br />I STEAM STERILIZED MEDICAL WASTE 11[41 Ign wol 31 rij . a = I <br />I Container Quantity <br />Container Quantity <br />Container Quantity <br />I Type P/U Del <br />Type P/U Del <br />Type Pfu Del <br />48ii; <br />8PH <br />Transporter <br />44B <br />20B <br />S-14 <br />116CH <br />2.5PH <br />111161� <br />r I <br />I LIJ Wj NILVA 01 LT]; I � <br />7� - <br />i-Container Quantity <br />Container— Quantity <br />-­ <br />Container Quantity <br />12e P/U Del <br />44PA <br />Type Ptu Del <br />8CH <br />Type P/U Del <br />CCPAjj <br />120CH <br />8PH <br />CCPH <br />20PA <br />2.5CH <br />S-14PH <br />116CH <br />2.5PH <br />S-22PH <br />r I <br />—CustomerC98 MO. —on: This is to certify that the above named regula medical waste is property classified, described, packaged, marked and labeled, and <br />station I I <br />in proper c'o'ad5jfor tra attion according to the applicable tions of the <br />17 <br />, L <br />X` <br />, ( x <br />Print Name momer ature Date <br />9101 <br />Medical Disposal, Inc. <br />'IT ST32 <br />Signature Date <br />California Medical Disposal, Inc. <br />4 100 E Therese Ave. <br />Fresno, CA 93725 <br />(559)-834-5850 <br />Reg. Haulers # 4461 <br />PERMIT # TSIOST32 <br />x <br />Authorized Signature Date <br />California Medical Disposal, Inc. <br />4100 E Therese Ave. <br />Fresno, CA 93725 <br />(559"34-5850 <br />Reg. Haulers# 4461 <br />PERMIT # TS/OST32 <br />x <br />X <br />Authorized Signature <br />M <br />Date <br />Authorized Signature Date <br />P <br />California Medical Disposal, Inc. <br />4100 E Therese Ave. <br />Fresno, CA 93725 <br />(559)-834-5850 <br />Reg. Haulers # 4461 <br />PERMIT # TS/OST32 <br />X <br />Authorized Signature Date Authorized Signature Date Rec'd <br />I UN -3291. PG IL 6.2 1 <br />