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INVOICE' <br />Page No. 1 <br />CALIFORNIA MEDICAL DISPOSAL , I DICE # 104794 <br />P.O. Box 10250 =:per r. P,; P•_: %DATE 05/31/05 <br />FRESNO, CA 93745 <br />1-866-288-2634 e <br />JUN 0, <br />.2005 <br />SERVICE ADDRESS <br />Memorial Hosp AssocSutter Tracy Diag Imaging <br />P.O. Box 942 t ` ° o ACC6UMS Payable 1530 -North Bessie Ave <br />Att: Accounts Payable ; , Suite 108-109 <br />'CA <br />Modesto, CA 95353 ' ,. Tracy, 95376 <br />a <br />CUST . # 5510 PO# TERMS Net' 30 day's <br />--- <br />--------- - -•�--- -- ---- <br />Description TARE WT NST - /QTY Unit Price Extension <br />Description <br />------------ <br />PICK UP DATE 05-05-05 <br />®T <br />MANIFEST #20428 <br />12.7 LBrS .205 2.60 <br />SHARPS .0 <br />20 GALLON RED BAG BIO 7.-0 9.4, LBS .205, 1.93 <br />PICK UP DATE 05-12-05 <br />MANIFEST #20905 <br />20 GALLON RED BAG BIO > 7.0 2.4 LBS. .20 .49 <br />, <br />20 GALLON RED BAG BIO 7.0 8,6 LBS '' X205 1.76 <br />PICK UP DATE 05-19-05 I ' <br />MANIFEST #21363 ° <br />20 GALLON RED BAG BIO 7101 2..7 LBS p .205 .55 <br />PICK UP DATE 05-26-05 <br />MANIFEST #21832 , <br />44 GALLON RED BAG BIO 15.4 10:4 LBS 205 2.13 <br />MINIMUM SERVICE FEE .0 4.0 EACH 25.000 100.00 <br />Red Bag/Bio waste less than contract amount <br />° <br />2.3% FUEL SURCHARGE .0 1!'0 EACP 2.520 2.52 <br />WEIGH MASTER CERTIFICATE .0 1.0 EACH .00� .00 <br />SU� <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 accuracyf as prescribed by <br />5 of the California <br />PLEnm: MIN <br />Chapter 7 (commencing with Section 12700) of Division <br />Business and Professions Code, administered by the Division of Measurement <br />, rNn� <br />A4G'�' <br />Standards of the California Department of Food and Agriculture. Principle <br />Weigh Master: Central Valley Medical Disposal / Deputy Weigh Master; Walter <br />° <br />Brumley, Jr. Address: 4100 E Therese, Fresno, CA 93725 <br />Commodity: Medical Waste / Unit of Measure: Pounds <br />1.0 EACH .00 <br />RFCENE <br />DOCUMENT OF DESTRUCTION .0 .000 <br />This is to certify that the above described medical waste was treated in <br />JUN1 20®5 <br />accordance with the requirements of Federal, State and Local regulations <br />governing the treatment of medical waste. A copy of this certificate, Y <br />file. The above invoice AE <br />tracking documents, and treatment logs are on <br />G <br />number serves as your certifcation of destruction number. <br />---------------------------------------------------- WASTE STREAM - IN POUNDS SALES TAX .00 <br />Chemo .0 Pharm .0 <br />Pathology .0 Sharps 12.7 TOTAL BILLING 111.98 <br />Red Bag/Bio 33.5 Incin <br />