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M <br />A <br />JAN h 4 2005 <br />f <br />�- <br />5E SIGN <br />•- AND CODE <br />Accounts Payaae <br />--------------------------------------------------------- <br />WASTE STREAM - <br />IN POUNDS <br />- ---------- <br />SALES TAX <br />----------- <br />- <br />--- - - , O <br />.Pathology .0 <br />Pharm - <br />Sharps <br />-_ .0 - - - <br />.0 TOTAL BILLING <br />32.85 <br />Red Bag/Bio 160.2 <br />Y <br />INVOICE <br />Page No. <br />1 <br />CALIFORNIA MEDICAL DISPOSAL <br />INVOICE # <br />103480 <br />P.O. Box 10250 <br />DATE 12 /31/04 <br />FRESNO, CA 93745 <br />1-866-288-2634 <br />SERVICE ADDRESS <br />Memorial Hospital Assoc <br />Sutter Tracy Eaton Ave <br />P.O. Box 942 <br />445 West Eaton Ave <br />Att: Accounts Payable <br />Tracy, <br />CA 95376 <br />Modesto,.CA.95353 <br />CUST.# 5509 PO# <br />TERMS <br />Net 30 <br />days <br />------ _____________------------------------------------------------------------- <br />Description <br />TARE WT <br />NET WT/QTY <br />Unit _- <br />Price <br />-- ___ <br />Extension <br />PICK UPDATE 12-23-04 <br />MANIFEST #11,493 <br />44 GALLON RED BAG ,BIO <br />15.4 <br />13.4 <br />LBS <br />.205 <br />2.75 <br />44 GALLON RED BAG BIO <br />15.4 <br />13.8 <br />LBS <br />.205 <br />2.83 <br />44 GALLON RED BAG BIO <br />15.4 <br />23:9 <br />LBS <br />.205 <br />4.90 <br />44 GALLON RED BAG BIO <br />15.4 <br />31.0 <br />LBS <br />.20.5 <br />6.36 <br />44 GALLON RED BAG BIO <br />15.4 <br />24.9 <br />LBS <br />.205 <br />5.10 <br />44 GALLON RED BAG BIO <br />15.4 <br />23.5 <br />LBS <br />.205 <br />4.82 <br />6.09 <br />44 GALLON RED BAG BIO <br />15.4 <br />29.7 <br />LBS <br />.205 <br />WEIGH MASTER CERTIFICATE <br />.0 <br />1.0 <br />EACH <br />.000 <br />.00 <br />This is to cerify that the following described commodity was weighed, <br />measured, or counted by a weighmaster, whose signature is on this <br />certificate, who is a recognized authority of accuracy, as prescribed by <br />Chapter 7 (commencing with Section 12700) of Division 5 of the California <br />Business and Professions Code, administered by the Division of Measurement <br />Standards of the California Department of Food and Agriculture. Principle <br />Weigh Master: Central Valley Medical Disposal / Deputy Weigh Master: Walter <br />Brumley, Jr. Address: 4100 E Therese,.Fresno, CA 93725 <br />Commodity: Medical Waste / Unit of Measure: Pounds <br />DOCUMENT OF DESTRUCTION .0 1.0 EACH .000 .00 <br />This is to certify that the above described medical waste was treated in <br />accordance with the requirements of Federal, State and Local regulations <br />governing the treatment of medical waste. A copy of this certificate, <br />tracking documents, and treatment logs are on file. The above invoice <br />number serves as your certifcation of destruction number. <br />SRA <br />JAN h 4 2005 <br />f <br />�- <br />5E SIGN <br />•- AND CODE <br />Accounts Payaae <br />--------------------------------------------------------- <br />WASTE STREAM - <br />IN POUNDS <br />- ---------- <br />SALES TAX <br />----------- <br />- <br />--- - - , O <br />.Pathology .0 <br />Pharm - <br />Sharps <br />-_ .0 - - - <br />.0 TOTAL BILLING <br />32.85 <br />Red Bag/Bio 160.2 <br />