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®40 5tericycle' rl IN CASE OF EMERGE <br />� ® PrcSectiny Pegpte. Redvc4g Risi jjjj .- <br />RoUte O t.: 3 <br />1. Gignerator's Name, Address and Telephone' umber <br />ATTN: Bruce Cosby <br />SAN COAQUIN. PUB BIL`tR SYC <br />1601. EAST HAZELT N AVENUE <br />s` omTom, cA 95201 <br />.r <br />CUSTOMER NUMBER <br />2A: DESCRIPTION OF WASTE 2B. <br />ON3291, Regulated Medical Waste, n.o.s., <br />6.2, PGII <br />'p — 90 tai Tub <br />UN3291; Regulated Medical Waste, rl.o.s., <br />6.2, AliTB49 <br />— 37 fol Tub <br />UN3291; Regulated Medicaf.Waste, n.os,, <br />6.2: PGII . <br />T814 •- .44 Gal. Tub <br />UN3291, Regulated Medical Waste, n.o.s., <br />5.2, PGII <br />T621 20 .L33i 9't <br />UN3291, Regulated Medical Waste, mo.s., <br />62: PGII- <br />TRIS — .20. t9411 Tt <br />— 20 Qat. <br />Regulated Medical Waste, n.o.s., <br />Regulated Medical Waste, n.o.s:. <br />..7 <br />3. Generator's Certification: "i hereby declare that the contents.of this cc <br />described above by the proper shipping name, and are classified, packagr <br />are In all respects in proper condition for transport according to. applicable <br />— ZRVICE RECEIPT <br />ACCO�QIT 1: 6038109-002 { I <br />Sur Joaquin Pub IIIth Svc <br />SERVICE DATE: 819112 11:15:17 <br />DRIVER ID: Parra, Rene <br />MIPPI?is ,i: <br />TOTAL COLLECTED: 5 <br />TOTAL V1)LK: 21.200 CU FT <br />OMW RX12 0OA02LG 1849 0OA02LH 1849 <br />00=1 1849 DUAL TB49 <br />O LIVERY D1lClAfE `t: P R <br />TOTAL DEL VER511 , 4 <br />TYPE QTY <br />1849 37 Gal Tub (Blo), 10,7 LB 4 <br />ORHER: Parra, Rene <br />FREWM; Reekyy <br />MPICKUP: 8116112 <br />CUSTKR SERVICE: <br />:KING FORM NUMBEF <br />:ST Opt-40.O&•STD <br />