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CALIFORNIA MEDICAL DISPOSAL <br />P.O. Box 10250 <br />FRESNO, CA 93745 <br />1-866-288-2634 <br />Memorial Hosp Assoc <br />P.O. Box.942 <br />Att: Accounts Payable <br />Modesto, CA 95353 <br />Page No. 1 <br />INVOICE #`104098 <br />DATE 02/28/05 <br />{BAR 2 1 ?009 1 <br />SERVICE ADDRESS <br />Sutter Tracy Diag Imaging <br />Accounts PayaUk-530 North Bessie Ave <br />Suite 108-109 <br />Tracy, CA 95376 <br />CUST.# '5510 PO# <br />TERMS <br />Net 30 <br />days <br />--------------------------------- <br />Description <br />TARE WT <br />NET WT/QTY <br />Unit <br />Price <br />Extension <br />PICK Up DATE 02-17-05 <br />MANIFEST #15173 <br />7.0 <br />7. <br />LBS <br />.205 <br />1.46 <br />20 GALLON RED BAG BIO <br />7.0 <br />8.44 <br />LBS <br />.205 <br />1.72 <br />20 GALLON RED BAG BIO <br />PICK UP DATE 02-24-05 <br />MANIFEST #15621 <br />7.0 <br />3.2 <br />LBS <br />.2A <br />.66 <br />20 GALLON RED BAG BIO <br />MINIMUM SERVICE FEE <br />.0 <br />2.0 <br />EACH <br />25.00? <br />50.00' <br />Red Bag/Bio.waste less than <br />contract <br />amount <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 />�-^ <br />PLEA�I%a <br />,AND GQDE <br />------- _---------------------------------------------------------------------- <br />SALES TAX 00 <br />WASTE STREAM - IN POUNDS <br />Chemo .0 Pharm •0 <br />Pathology .0 Sharps .0 TOTAL BILLING 53.84 <br />Red Bag/Bio 18.7 <br />