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Page: i of 1 <br /> Stericycle" <br /> Sunbridge Manteca <br /> Experts in Infection Control and Healthcare Compliance Services Tabatha <br /> 9188 Glenoaks Blvd,Suite 300410 Eastwood Ave <br /> Sun Valley CA 91352ICF Manteca CA 95336-3167 <br /> FOR CUSTOMER FOR PICK-UP INyPtC9 DATE INVOICE NUMBER USTOMER NUMBER TERMS <br /> SERVICE INFORMATION <br /> CALL 800-953-9324 CALL 800-953-9324 12/01/2003 0002537154 6018848 Net 30 Days <br /> MANIFEST <br /> PATE QTY DESCRIPTION Wf ICa ) PRICE Ul '�"OTAL <br /> ::NUMBER <br /> Site: 002 Sunbridge Manteca <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 /> 11/10/2003 MDFROOOONT 1.00 1 44 Gal Tub Bio , CT 12.7 lb 0.00 1 0.000 EA0.00 <br /> 12/01/2003 1.00 Steri-Safe Standard-Monthly 1 0.00 711.940 EA 711.94 <br /> F"A,C!LITY a SITE-SUBTOTAL-AMT: $711.94 <br /> VENDOR a SITE-TOTAL-TAX: $0.00 <br /> SITE-TOTAL;AMT: $711.94 <br /> INVOICE <br /> DEPT ACCT AMOUNT <br /> q71 L l <br /> TOTALGyW <br /> Curtttt 1?313ays 31-60 Days f31 50<L3ays Z3ver 90 Days <br /> __ _ .. <br /> 71 .94 0.00 1 0.0 1 0.00 1 INVOICE TOTAL: $711.94 <br /> 'ESS E::GEW. ER:s <br /> CERTIFICATION: THE MATERIAL LISTED ON THE MANIFEST #'(S) DETAILED ABOVE (INFECTIOUS MEDICAL WASTE) HAS BEEN TREATED IN ACCORDANCE <br /> WITH THE REQUIREMENTS OF FEDERAL, STATE, AND LOCAL REGULATIONS GOVERNING THE TREATMENT OF SUCH WASTE. A COPY OF THIS <br /> CERTIFICATE,APPLICABLE MANIFESTS,AND THE APPROPRIATE LOGS WILL REMAIN ON FILE WITH THE COMPANY. <br /> STE073 STE001 STE00102.RTP 00000255 1 00000257 DETACH AT PERFORATION AND RETURN BOTTOM PORTION WITH YOUR PAYMENT <br /> - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ - - - - - - - - - - - - - - - - . <br /> ❑ American Express ❑ VISA ❑ MasterCard ❑ Discover <br /> Steric <br /> Experts in Infec on Control and Healthcare Compliance Services Credit Card Account Number Expiration Date <br /> Signature <br /> 9188 Glenoaks Blvd,Suite 300 <br /> Sun Valley CA 91352 <br /> 0006018848 0002537154 0000071194 3 030005 <br /> :0E M ITTANIIE-E-11 Please write Amount Paid below <br /> f`elnelelenllnellu�lneo'lease"e�lnleulne'llleeeelleel PLEASE STERICYCLE INC <br /> Sunbridge Manteca SEND PO BOX 79145 <br /> Tabatha PAYMENT PHOENIX AZ 85062-9145 <br /> 410 Eastwood Ave TO <br /> Manteca CA 95336-3167 Iln�ee+e'e'leeeellneelellelueu"e'u�elelnlnle'elnull� <br /> 00000255 41 8099 <br /> Invoice Customer Date: Invoice Amount <br /> Number: 0002537154 Number: 6018848 12/01/2003 Amount: $711.94 Paid: $ <br />