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11/12/2010 14:19 209239d&Lq BUSINESS 0FFIQF11k PAGE 27
<br /> 0 S AL WASTE Itll�i FQ A
<br /> IN CASE OF EMERQ@MCY CONTACT.CHEMIM 1 6TAN MANIF�$T Ont•t
<br /> " "ft`''° av haute f: 301 - 25
<br /> 1t�AFR009XQI
<br /> 1, S Name.A ®nd T—eiipM I
<br /> ATTK: CathY/Kaxlne I I I
<br /> 410 ZmWoon AVz
<br /> MWTISCA, CA 95336- 3167
<br /> (209) 239-1222 9/23/201(
<br /> art:ton 6059477-002 ® •
<br /> 2A.DESCRIPTION OF WASTE 2& COKMRERTTM 2C.N06 OF so VOLUME
<br /> UN3291, Medical WML n,oa. TDS7 - 90 Gal Tub (vio) (iZ eu tt> CONTAINBM
<br /> 62.PGa
<br /> UN3291.R Mddlpi WAft d,o.s., TD4 9 - 3'f ftl b ( O) (4.9 CU It)
<br /> 6.2.PGR
<br /> TUCu F6
<br /> Q6,2 11 RexWO MIdImlwalk ft'd.s_ T014 - 44 Gal igo-) (s.9 Cu ft)
<br /> ~4 6 23�u Rede4tW Medical Waste.n.o.s„ TM - Ua fu- Hio cu t �FL
<br /> WUN3291,Regulated MOda Waste,n.O1S., Cu Ft
<br /> I Z 6.z.poll T915 - 20 C_Al Tub (Path) (Z.I cu ft)
<br /> 3 UN n l RepaTaled(id l Wade,n n.5„ - Cu FR
<br /> 6.2.pGlt TY15 - 20 €dal, Tub (Chemo) 12.7 cu ft) Cu Ft.
<br /> UN3291,neguwad Med1cal Waite,n,o.^.,
<br /> 6.2.P611
<br /> UN3291,RP4bia(ed Medical Waste,nA.s. FI,
<br /> 6.2,P611
<br /> Cu 1`11-
<br /> Pharmaceutical Waste
<br /> 3.Gernxatvr'a Certitlealion:'I hem0y declarta lha t tho conterds of this coneignmeni errs fiCy and amurstaly AIS 1 Cut R.
<br /> d"-a6ltgtl abavP by Ine proper shipping name,and wo dRcsHi®d, .M.%*O t end I Itpyptecarded. n0
<br /> are in de rosoem In proper cone tlon for tran^pprt occ�np to ttppgco t'Ip imicenptional and national govo Ont, ro
<br /> Printetl!1Vptan NIimA — Signttttxa. C9t9
<br /> 4,TRAINSPORTEA 1 ADDRP-rjS; 7 - Fl n9 d. h -3 Z _ -
<br /> u�t 5f•*'T ic'Yole, Inc. A iesbi I`erntittVuruberM,
<br /> a S Went Shaft Ave.
<br /> Q [3 Th La in a Thcougtl Shipment
<br /> Fr-e- o,Ca 93722
<br /> chi TRA NSPORTE IFICAPON: Ir midi sa da-cri d r. -
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<br /> 16'r n/1yae V3mn SiGralurs Dalu
<br /> 99 S.INTERMEDIATE HANDIJ-*R 3!TRANSF't?HTL;R 3 ADDRC53; Phone e: -�
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<br /> INTERMEDIATE HANDLER f rSANSPOST'ER MM19CAT'0CN1: 4ne.,mp, -�t ?die.^!wnr.,lq n;deseribnd nbeun.
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<br /> 1 x i Pcm11?yoe Melte Sign lura w Datbt
<br /> I 17,UI'�t.HL� AMCY INDICATION
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<br /> u f 1 41351 VJ.SU+A4 T A\,E � --0 NORTH S I'm\N.-,---T � � 1345 IDONIttl4 0044"P4.aa C 277"E 26TH S'6hEET
<br /> !tit^ wl FRESNO,CA 93722 d WORTH SALT LAKE CITY,GT San Leandro.1CA X577 � VERNON,CA 9M?3'
<br /> !- (559)2,75-0994 i (80 1)93G- 1$55 (51 C)Z62•17651 (32313&--3-MG
<br /> W.i 5 jSOGA2 rz r9133 "`, � � t5
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<br /> TREATMENT FAcYL Ca th11'Pave be.!r nlrlhorized b;F 1ht" r'j%Cab --stat C tc^c.:cpt untrernter'r1^tI'C.gI-Aste's and lhat I hi.W,_
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