Laserfiche WebLink
Page: 1 of 1 <br /> Stericyclea <br /> Care & Rehab <br /> Experts in Infection Control and Healthcare Compliance Services Manteca MantecaAccountPayable <br /> ® 410 Eastwood Ave <br /> 9188 Glenoaks Blvd,Suite 300 ® ... <br /> Sun Valley CA 91352 IC <br /> Manteca CA 953363167 <br /> FOR CUSTOMER FOR'PICK-UP INVOICE DATE INVOICE NUMBER CUSTOMER NUMBER TERMS <br /> SERVICE INFORMATION <br /> CALL 800-953-9324 CALL 800-953-9324 07/01/2004 0002850304 6059477 Net 30 Days <br /> —MANIFEST <br /> DATE.- QT1` 17ESCRERI[O IGHT(l 8) PI9tGE UlM TOTAL: <br /> :NUMBER <br /> Site: 002 Manteca Care & Rehab <br /> 410 Eastwood Ave, Manteca, CA 95336-3167 <br /> WEIGHMASTER CERTIFICATE:This is to certify that the following described commodity was weighed,measured or counted by a weighmaster,whose signature is on this certificate, <br /> who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, <br /> administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> Commodity:Medical Waste;Weighed at:Stericycle,Inc.,4135 W Swift Ave,Fresno,CA 93722 Terry Shain Deputy Weighmaster <br /> 07/01/2004 1.00 Steri-Safe Standard-Monthly 0.00 825.000 EA 825.00 <br /> 07/01/2004 1.00 Monthly Fuel Charge 0.00 11.000 EA 11.00 <br /> SITE-SUBTOTAL-AMT: $836.00 <br /> SITE-TOTAL-TAX: $0.00 <br /> SITE-TOTAL-AMT: $836.00 <br /> Currtlftf 1 3c nays : 3 ,80 Da}aa fit 110 i)ays Gver 9Q Days <br /> _. _ . . .. <br /> 1,668.00 0.00 832.00 0.00 0.00 INVOICE TOTAL: $836.00 <br /> X. <br /> MESSAG£;CEft1TER ; <br /> FACILITY <br /> INVOICE# coo 7-1&05030 <br /> GL/MONTH c.1tl� Q i MEDICAL WASTE) HAS BEEN TREATED IN ACCORDANCE <br /> ACCT# AMOUNT THE TREATMENT OF SUCH WASTE. A COPY OF THIS <br /> o fH THE COMPANY. <br /> STE073.. 'H YOUR PAYMENT <br /> -- - - - -- - - - - - - - - - - - - -- - - - - -- - - - <br /> Express ❑ VISA ❑ MasterCard ❑ Discover <br /> TOTAL 6.DC's <br /> APPROVAL Credit Card Account Number Expiration Date <br /> ure <br /> ----- - <br /> [ROOMN07701 Please write Amount Paid below <br /> PLEASE STERICYCLE INC <br /> Manteca Care & Rehab SEND PO BOX 79145 <br /> Accounts Payable PAYMENT PHOENIX AZ 85062-9145 <br /> 410 Eastwood Ave TO <br /> Manteca CA 953363167 I'n'eelelelfunllnnlellelnnmlleluleleleo'ulele'null' <br /> Invoice Customer Date: Invoice Amount <br /> Number: 0002850304 Number: 6059477 07/01/2004 Amount: $836.00 Paid: $ <br />