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gRio R017 3 11:z (!(f12 o0ox89 0 <br /> "C�� <br /> o <br /> �L JR Ci 24-i r Emen eftV ttespoes (SOOY 42"300. <br /> i Ft?SE MA ..t <br /> Stec rt, 5 k7' ;Ges ittt+ar (SSS)50392 <br /> rapt li'ehf'fiiYa. +�oftwii u`,Fy i5la: [b.or <br /> Containers volume <br /> UN3291, lediCat Mste,KoS,,0, ff. 411, LOb�1 RPg010lb tiE Medical iN6 .(Bia)),A3 c M <br /> �r nsporter Totals <br /> wM t ea*=re 5oht�ns 'it.� , A.ppbcabie#permits <br /> Ekin. .('lae sac6savva7a ohm* i60) sa <br /> E,,m q V29 3lern 5688-MW-16:7 Pr qm (323)307-fl534; <br /> Ad~edooir <br /> Signature -:� lanntJT Plume Data .�•- L 1 <br /> T aiissarte{r P'ehbit:# Date_ <br /> Address. Signature <br /> Printed Hanle .. <br /> Autod r2f7r nsfer.Far9lity T2[ ac{Tity F3ta r CaGllfy IIoi&,VbOn: acik Autbclave/'1r=(w' ParJllty JtltarnateTraaiment:factiiry <br /> wi h(eaiohe 5awons;lxc VM#lealktacare.Sdutions;tnc Curtis, !aer9Y Sutfv esGWa :Stiiutlorrs; 6VNf Seaktit, DFniadiEai Heaithwtse Services <br /> 4380;6andini Bled 1996 bon L€e.P{ece',S.ulte C 323 S.Hewkons Raad. LLC 149 SNi.lCeiiyorr st 4600E tlncoic.Av. <br /> Uem4n,C4 9085$ Escondido,".92029 Baltimore,Mp 2 26: 7505 5ttate savvy S5. SeatUe, <br /> .WA 9810$ Fowler,CA 93fx25 <br /> Phone.(3Z3)307(3514 Mori&(760)489=5004 Pfdne(91G),35+3-22$ AxWWa4�'X 77514 Phone(206);505-9.063. Phone(559).834-3333 <br /> P@rmlt:#; 75/057$1 Permit#:T$73 Permit#,2011 NIM(-0036; fttle:(409)26,7.-3913. Permit'#;RR00,80378 'Perrriit#,TS-89 <br /> Permi:4-2239-A <br /> Signature ... .. Sign burp. S{graattire S{gdiatiire` SlgraatuYa 5'ignanute <br /> Date'. (?ace Date, <br /> Date' Datd <br /> K <br /> D(screpaney T.re�#rneaat;Facitity Ce!'�fcatiiolt of ReterpE;Wred�restrud9op <br /> "i cern that4he:wnter s'af tfte listed;:containe.5)have been nmeived,heated,and <br /> dispgsed of at oneormore of the facilities indicated above.in accordante with:all local,state,. <br /> and federal regulations." <br /> ConirieiiE� <br /> { <br /> + eoaiatr�r' - e13kY atlo i,"7 heretsy'detlere that the coht h( of tfas:cans ntner t'ar #tilly,end attu;atE{y descx t etF abo 'by the proper shippirty r+arrre esti(are cfasslfied,packaged, <br /> rraar!eedanti ladtedJplatardezi,and are lii ail sespects M proper conditlonfnrtranspott by highway according to apphcabie intemat(�af and nadonar gavemment reguiaklons;.,including <br /> applicable'state.reg0)a5o <br /> $*afi re <br /> 1 <br /> i <br /> 1 <br /> I <br />