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SA N J a A Q U I N Environmental Health Department <br /> COUNTY <br /> Registration for Generators of Medical Waste <br /> Generator Name: CSL Plasma <br /> Generator Facility Address: 29 E. March Ln. <br /> Stockton CA 95207 <br /> City State Zip Code <br /> Phone Number: (303 ) 886-6721 <br /> Generator Mailing Address: 900 Broken Sound Parkway, Boca Raton, FL 33487 <br /> City State Zip Code <br /> Type of Business: Blood plasma collection facility <br /> Authorized Representative: Barbara Wunder <br /> Title: Director EHS <br /> Emergency Phone Number: (303 ) 886-6721 <br /> Registration for: <br /> ❑ Small Quantity Generator with Onsite Treatment (Generates less than 200 Ibs/month). <br /> ® Large Quantity Generator Only (Generates 200 Ibs or more/month). <br /> ❑ Large Quantity Generator with Onsite Treatment (Generates 200 Ibs or more/month). <br /> I declare under penalty of law that to the best of my knowledge and belief the statements <br /> made herein are correct and true. I hereby consent to all necessary inspections made <br /> pursuant to the California Medical Waste Management Act and incidental to the issuance of <br /> this registration and the operation of this business. <br /> l�t�� Director EHS 3/24/2021 <br /> Signature: Title: Date: <br />