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J14MV a3s=ii 7az � 44 . <br /> custoiwl&i <br /> #z cwAra lac-qui: a <br /> 1 21 RC ItiY E'131 Win+ I (900)4U-9300 <br /> (209).477-2664 <br /> Cotbiwqei ype irl a o Ib.at <br /> tJl!u 231, 11 ted Medca Wasti�,N El S.t .�,t IL £AtL{3b�''Ree tlt d'"4�f#c :+Ala 3it�))43 gab <br /> tai�Wners Volume I <br /> TOWS <br /> WP7 hTeallhe? A <br /> 1996 Don,�a S�iitltii3ns,211x: RAt�cabte Pet'rFls'ts,. <br /> I'face Ste.C Escclndtda MW-172; .p#dne#- (76't}" 50W: <br /> Ecco cltdtle 92029 Vetztiizt: $ MW-157 PPtrlCoe# ` .2Tj 307.014 <br /> Tra r <br /> porter x Acleiioui i�yn <br /> Qf; isle � <br /> • � � r <br /> Refit.0 Date <br /> Address <br /> SlWaWre � <br /> MOW ftkn,� <br /> AEAbcFaveJ fr,3 f2C PaGilty ttartsEer Psi�#t;'' 7: <br /> ira lnera ort t acldjty ty <br /> [Z7 <br /> PeciPtq Au ctAveJlYaztstEr FaolftyAle1r at Wecilinc "WM Healthcare sdubons,Inc ss I? r <br /> 4280.Band#nl Blvd te'Sobution5, 1tUh1 Seatt#e:t3:omeduaF #Healthwiseservices <br /> 1996 Don L Place Slate C : 3200}tawktns dad Ueaaon,-CA'90058 Cscondido OA X32029 Balt morE,MD 21226149,SW Kenyon Street.i 9800 LincolcAv; <br /> 33? Q5]4 Phone p6p 48 5008 Phone 910)3S4 3ZZ8 Seattle,WA 981"OS ler CA 93625TX 77ST4 Phone(206)505-9063 '� Phane(ST5S)834-3333 <br /> Perna@# TS/OST.81 Permit TOj Permit#:2011-YOU-00369)267 3913 Permit#:PR0080378, \ Pem t#,;T-t 852239 A �+',�i"Rure: 5 aFxxe Signature <br /> r2 <br /> Date .-- _ _ Date' T3ate: <br /> Vie. <br /> tYte DaW <br /> DlScrep�ncy <br /> Treaiiteret i^a1 tveion a1 Re�e?p d Destruction <br /> "I cerCiry that the coraYeriLs of the listed contafneF(s)have been recefyEd,treated,and <br /> tllsposed of at one or more of the facilitieslnrlicat6d above In accordance with all local„'s , <br /> arta federal regulations." <br /> comments; <br /> r s T alficarirded Pti Eisy t ecl ;tlt3t Che oc#nfiet s v€#tis consagnttienY: €e fy andacsalrate# above h}i tfie hippi iamE and am,ci ifrp, <br /> tararked avxC ia5e#ed(ptacarderl;;snd ars in ah m y Ind•, ng leo, <br /> propSP: ttdrho#j foC transpoit by.l hviay according to appCcable intern'atitnal and national government a0 -blestateregti#atwns 9 regulations,l1cw,ng <br /> ^�ignaitttre J � t3 3Y :� ti <br /> y ., date <br />