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DEC.18.2000 4:22PM NO.926 P.5 ;
<br /> O
<br /> ricPage; I of I SI, cyle
<br /> 610 The 11peciali4t in xana&g Mai i Waste TLC Withcare Inc
<br /> Oise lanout;Blvd,suits 31)0
<br /> Sunill i'l 11 Virg nia Milleii.
<br /> ey CA 01392 motengnmmm
<br /> 1120 $ lvla Dr
<br /> Lodi !c� 95240
<br /> FOR QUESTIONS ON NVOiOE ICE Urq INVOICE NUMBER
<br /> 800_9:
<br /> R� 53_0
<br /> C QMER NUMBER TERMS
<br /> CALL 800-953-E)32o 0000801865 1; 1
<br /> 60187)8
<br /> 'D TERMS
<br /> 0�Da Days
<br /> Site! 001 Lodi aTthcaro
<br /> Center
<br /> 1120 ylvia Dr, LOW, CA fi 4 0
<br /> This it to carilly that th 1IQWIr1Q1d%CrIhedQOnnrnodjty�A J111064.rpsaaur6d or counted byawslighmastor,whose sionw%4(s on this car
<br /> accuracy,ME Presci,lbod c4piRr 7(corrInnancing wit . 11ficav Who
<br /> starclarls or the callibill ser 1j,rill 2700)of Division 6 of the CAIIIOrnla BUtInsps and Profeqijori�0 recognized authority or
<br /> I Department of F60d and Aq-IQ III Oro. Oda,AdMinlotared,ay The tion of MsasureMan,
<br /> ComMocilly,,Msdlcml Wo 0;Weighed C4! I .
<br /> 4125 W.SwI It Avj,11 CA 23792 Osputy VVejghrnj�t;,i
<br /> 1-170272-6-65 MQ OOD01a2
<br /> ! Gal : 1, ii Irey TWO Disposal o.UU �O E
<br /> MQ O000jB2 2 0`�1. RE!r-d Retention Fm
<br /> ll/P2/20QQ 42.2 42.24
<br /> 11/02/2000 No 0000182 1.001 1 1 1-himum Pi'ck-qp Fee— 3.0�o E,�
<br /> 11/080000 MD 0000879 b.4 32.5 -0 EA. 32n-50 P, .1
<br /> 11/08/2000 MQ 000097a 1.00, SlUe-Gray Tub Dieposetj 15.6 42.2 0 EA
<br /> 1.00 F InOrd Retention Fee 42.24
<br /> 11/08/2000 M 0000979 1-00 IIiInill'11114M Pjak-LIP Fee 0.0 3.010 IZA:� 3.00
<br /> 11//j1S/2000 M 0002036 1,00 0.0 37-S 0 tA- 32,51
<br /> 11 5/2000 MD 002036 1.00 EOIG&I Blue Gray TWO Disposal 35.20' 0.2 0 EA
<br /> F porl Retention Fee 42.24
<br /> 7 rey TUOD'sP77 0
<br /> 'Or' IF 0.
<br /> L4P
<br /> r_, T b Djp ..I
<br /> 1,y F u
<br /> P n e" 9
<br /> Fee
<br /> r,." TU
<br /> �. 0
<br /> 11/15/2000 MD 002036 0.06 3,0�O EAI 3.00
<br /> 11/22/2000 ND 002g5p 1 1.00 1111'M'lhium PiCK-up Fee 0,06 62.5 0 EA 32.51
<br /> 1.00 jb�Q�:dl :.IW 32 49' 1 42.2 EAj 42,24
<br /> 11�22/2000 :,-Gray Tub Disposal I
<br /> MD 002953 1.00 41� tion Fee 0, 3.010 EAll 11/22/2000 MD 002953 1.0c) Nlkinnufln Pick-up Fee 3.00
<br /> 11/29/2000 MD 0:00�,l 12.5 Q EA,' 32.51
<br /> 003802 1.00 99 Gal Blue-Grey Tub 01sposal I 35.oq
<br /> 11/29/2000 MQ 003802 1100 R Or otention Fee 42.2,0 EA111 42,24
<br /> 11/29/2000 MD 001602 mi�lrnurr Pick-up Fee O.Oq 3.0 O ,EA 3.00
<br /> 0.0( 32.510 !EA 1 .92.51
<br /> I
<br /> I
<br /> $1TE-SURTOTAL-AMT: $3a8.71:5
<br /> II SITE-TQTAL-TAX- $0,00
<br /> SITE-TOTAL AMT; $388,75
<br /> it
<br /> ME, GRAND 71�A,:,
<br /> ;388.75
<br /> CEPITIFICATTOM THEM RRIAL LIE1TFD 0
<br /> E "IF' NTHE MAN F #'(S)DETAILED EWA,6TE)HAS 9 0 ABOVE(INFECTIOUS MEDICAL
<br /> C P
<br /> BEEN TI
<br /> L A R_8 :: TED IN ACCORDANCE W Th REQUIREMENTS OF FEDERAL,STATE,AND
<br /> OCA-�F!PiGULAI-IONql�12VC-RNINqTHFTRI&TM T -,81-1 W,1�5TP, tA COPY OF THI9_MK1lFLQ_ATE,
<br /> APPLICABLE MANIFEST q.AND THE APPROPRIATE I
<br /> LL REMAIN ON FILE WITH THE COMPANY.
<br /> DETACH AT
<br /> F=MFP IT AND RETURN T
<br /> 130TTOM PORTION WITH YOUR PA_ I -- ----- - -
<br /> Check Enclosecl
<br /> VISA ❑ Mfstar_:�
<br /> U Discover
<br /> Ste CreclWoor ccomn; ❑
<br /> Numliel 1� Expiration Date
<br /> .1cu le
<br /> Ste i yc
<br /> The SP@ alistinMAndgingUedi 17
<br /> 9188 Q14 oaks Blvd.91.11114 300 Signeture
<br /> 11 Sun Vail I CA 91852
<br /> 0006018708 000801865 0010I38875 3 030001
<br /> ti pleaso wet e Am) nt Paid below
<br /> it TLC Healthcare Inc PLEASE STrRICYCLE 14�
<br /> Virginia Miller PAYMESEND NT PO BOX 79145 1
<br /> 11 SY104 Or TO PNOENIX AZ 85062-9145
<br /> Lodi CA 95240,4619
<br /> Invoice I �i � ' '
<br /> Nurbbar; 0000801865 Tustonrier Data.-
<br /> Number. 6018708 11/3012000 Involc® amount
<br />
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