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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4500 - Medical Waste Program
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PR0450055
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COMPLIANCE INFO
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Entry Properties
Last modified
2/9/2023 12:05:38 PM
Creation date
7/3/2020 10:16:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0450055
PE
4520
FACILITY_ID
FA0000388
FACILITY_NAME
Lodi Outpatient Surgical Center
STREET_NUMBER
521
Direction
S
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
CURRENT_STATUS
02
SITE_LOCATION
521 S HAM LN STE F
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4520_PR0450055_521 S HAM_.tif
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EHD - Public
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FM GRAPHICS (916) 3612183 18001 621-7635 <br />IFA 1-5 IV <br />ENVIRONMENTAL MANAGEMENT CORP <br />11855 WHITE ROCK ROAD, RANCHO CORDOVA, CA 95742 <br />(916)985-6666 <br />BIOMEDICAL WASTE DISPOSAL SERVICE AGREEMENT <br />DATE _ 10-1-91 <br />IBill To <br />Customer Name <br />I <br />Lodi Outpatient Surgical Center _ <br />1 Billing Address <br />Sery;ce Address <br />" <br />521 South Ham Lane <br />I city. State ano ctr cny. Stare and ur i <br />Lodi, CA 95242 <br />Payment Contact -Name Service Contact -Name <br />Marklin Brown <br />rPhone Number —� <br />Phone Number <br />t <br />(209) 333-0905 <br />Collection containers with liners which meet State requirements for containment of biohazardous waste small, medium, and large ---- (sizes) <br />Collection of filled containers as needed/contingency (frequency) <br />I <br />Disposal according to the California Health and Safety Code. <br />Service to include collection and disposal at the following rates. <br />i <br />CONTINGENCY SERVICE RATES <br />Portal to portal rates: Lead technician @ $72,00 per hour <br />2nd technician @ $45.00 per hour <br />Container Rates: Small container (15" x 15" x 14") @ $6.00 each <br />Med. container (15" x 15" x 28") @ $8.00 each <br />Large container (18" x 18" x 38") @$10.00 each <br />Red Bag Liners: $1.00 each (2 required per container) <br />Disposal by Incineration: $1.00 per pound <br />Date Service To Commence <br />• Special emergency pick up service includes an hourly charge for one biomedical waste technician and truck at "book rates" per hour plus the above disposal charges. <br />72.00 <br />i• Consultation with customer's staff charged G, S per hour. Each session covers biomedical <br />i waste segregation, collection, and storage strategies, definitions and Health & Safety Code(s) and Statutes. <br />i <br />BY SIGNING THIS AGREEMENT. YOU ACKNOWLEDGE YOU HAVE READ AND UNDERSTAND THE TERMS A ONDITIONS ON TH REVERSE SIDE OF THIS AGREEMENT AND THE PRICES AND <br />SPECIFICATIONS ARE HEREBY ACCEPTED AND SERVICE SHALL BEGIN ON "DATE SERVICE TO COM NCE.' <br />�1�DATELl Al <br />– ---- DATE <br />AUTHORIZED SIGNAIURE CUSTOMER AEMC AUTHORIZED SIGNATURE <br />
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