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s <br />INVOICE . <br />Page No. 1 <br />CALIFORNIA MEDICAL DISPOSAL INVOICE # 103570 <br />P.O. Box 10250 DATE 12/31/04 <br />FRESNO, CA 93745 <br />1-866-288-2634 <br />SERVICE ADDRESS <br />MEMORIAL HOSPASSOCIATION Sutter Tracy Hospital <br />ATTN:ACCTS PAYABLE 1420 N. Tracy Blvd. <br />P.O:. BOX 942 <br />MODESTO, CA 95353 Tracy, CA 95376 <br />CUST.# 5234 PO# TERMS Net 30 days <br />Description - TARE WT NET WT/QTY Unit Price Extension <br />---------------------------------------------------------------------------- <br />PICK UPDATE 12-02-04 <br />MANIFEST #10047 <br />S14 SHARPSMART PHARM .0 16.0 CNT .000 .00 <br />S32 SHARPSMART PHARM .0 17.0 CNT .000 .00 <br />SHARPSMART PHARM PROCESS 16.2 263'.0 LBS 1.250 328.75 <br />WEIGH MASTER CERTIFICATE .0 1.0 EACH .000 .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." C <br />AND EvrGN _ i <br />COD, <br />Ia" L O E w <br />l <br />DECEIVED <br />r- JAN 2 7 2005 <br />ACCOUNTS <br />PAYABLE <br />------------------------------------------------- <br />WASTE STREAM IN POUNDS SALES TAX .00 <br />Pharm -263 0 <br />Pathology .0 Sharps .0 TOTAL BILLING 328.75 <br />Red Bag/Bio .0 <br />