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S�WAPS <br /> Inc.ram !F c� <br /> 191111I11111111111E <br /> 391319992 <br /> WASTE MANIFEST-TRACKING DOCUMENT <br /> Generator(Mailer)Certification <br /> L"[certify dint this container has beer approved for the mailing of(check one)(J'regulated medical waste"or( sharpswaste,", <br /> has been prepared for mailing <br /> in accordance-vith the directions for that purpose,and does not contain excess liquid or norm ulable <br /> material in violation of the applicable Postal Ser-ice regulations.I AM AWARE THAT FULL RESPONSIBILITY RESTS WITH <br /> THE GENERATOR(MAILER)FOR ANY VIOLATION OFI 8 USC 1716 WHICH MAY RESULT FROM PLACING <br /> IMPROPERLY PACKAGED ITEMS IN THE MAIL I also certify that the contents of this consignment are fully and accurately <br /> described above by proper shipping name and are classified,packed,marked,and labeled,and in proper condition for carriage by <br /> air accordinQ to the national governmental regulations <br /> -Generator's name,complete address and telephone. <br /> Fresher Nails <br /> 221 W Yokuts Ave, <br /> Stock-ton.CA 95207 <br /> I Product- 10 150 <br /> Printed Name Signature Date <br /> 2.Transporter Intermediate Handier Other Than USPS(If Different from Destination Facility <br /> Include:47c)mPa­Xame,Addrnss.and Pel Frit NFunih,­ <br /> I ccrtifj that the information provided is true and correct,and only untreated RMW waste are contained in this load.I am aware that <br /> falsification of this manifest may result in forfeiture of niv registration and/or the privelege of utilizing State-authorized facilities <br /> Authorized Ind. Signature Date <br /> Treatment Method: I]Autoclave DIncineration <br /> 3.Destination Facility Certification: <br /> 0 Sharps Environmental Services,Ine. ❑ HeattlakVise <br /> 1544 NE Loop 4800 F.Lincoln Ave <br /> Carthage,TX 75633 Fowler,CA 93625 <br /> Permit NO.40267 Permit NII.TS-89 <br /> 0 Alpha fflo-Med Services,LLC Other: <br /> 600 tridustriat Road <br /> IN"quela—ing,PA 18240 <br /> PemitNO.400696 <br /> "I certify that the contents of this container have been received,treated,and disposed of in accordance with all local,suite,and federal <br /> regulations" <br /> Authorized Ind. Signature Date <br /> 4.Coment and Discrepancies Area <br /> 5.Emergency Telephone Number <br /> EN CASE OF Erkl ERG01CY OR DISCOVERY OF DAr-LAGE OR LEAKAGE-CALL1.8011772.5657 <br /> White-File/yello-Generator'Pink-Treatirient Site Part#100163 REV I <br />