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COMPLIANCE INFO_1983-2005
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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PR0450005
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COMPLIANCE INFO_1983-2005
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Last modified
1/20/2023 2:39:39 PM
Creation date
7/3/2020 10:17:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
1983-2005
RECORD_ID
PR0450005
PE
4522
FACILITY_ID
FA0000086
FACILITY_NAME
San Joaquin General Hospital
STREET_NUMBER
500
Direction
W
STREET_NAME
HOSPITAL
STREET_TYPE
Rd
City
French Camp
Zip
95231
CURRENT_STATUS
01
SITE_LOCATION
500 W Hospital Rd
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4522_PR0450005_500 W HOSPITAL_1983-2005.tif
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EHD - Public
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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 />WASTE STREAM - IN POUNDS SALES TAX <br />Chemo 12.0 Pharm •0 <br />Pathology .0 Sharps .0 TOTAL BILLING <br />Red Bag/Bio .0 <br />X11 <br />FEB 11. 2005 <br />INVOICE <br />PAGE NO. <br />1 <br />INVOICE # <br />103819 <br />CALIFORNIA MEDICAL DISPOSAL <br />DATE <br />01/31/05 , <br />P.O. Box 10250 <br />FRESNO, CA 93745 <br />1-866-288-2634 <br />SERVICE ADDRESS <br />MEMORIAL HOSP ASSOCIATION <br />Sutter Tracy Hospital <br />ATTN:ACCTS PAYABLE <br />1420 N. Tracy Blvd. <br />P.O. BOX 942 <br />MODESTO, CA 95353 <br />Tracy, CA 95376 <br />COST.# 5234 PO# <br />TERMS <br />Net 30 days' <br />•--------------------------------------------- <br />Description <br />TARE WT <br />--------------------------------------- <br />NET WT/QTY <br />Unit Price <br />Extension. <br />---------------------------------------- <br />PICK UP DATE 01-06-05 <br />MANIFEST #12358 <br />7.0 <br />1.9 <br />LBS .650 <br />1.24 <br />20 GALLON CHEMO <br />PICK UP DATE 01-13-05 <br />MANIFEST #12818 <br />7.0 <br />6.9 <br />LBS .650 <br />4.49 <br />20 GALLON CHEMO <br />PICK UP DATE 01-27-05 <br />MANIFEST #13723 <br />7.0 <br />3.2 <br />LBS .650 <br />2.08 <br />20 GALLON CHEMO <br />MINIMUM SERVICE FEE <br />.0 <br />3.0 <br />EACH 25.000 <br />75.00 <br />Red Bag/Bio waste less than <br />contract <br />amount <br />WEIGH MASTER CERTIFICATE <br />.0 <br />1.0 <br />EACH .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 />WASTE STREAM - IN POUNDS SALES TAX <br />Chemo 12.0 Pharm •0 <br />Pathology .0 Sharps .0 TOTAL BILLING <br />Red Bag/Bio .0 <br />X11 <br />FEB 11. 2005 <br />
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