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,Feb.25.2016 11:51AM <br />Barnett Medical Se s, Inc, <br />® 3670 Enterprise Ave <br />Hayward Ca 94545 <br />14W EPA#CAL000404096 <br />Transporter IDM91 <br />r-`-erator: <br />Wine CountrV Care Center - Lodi <br />321 Mst Timer PDad <br />Lodi. CA x5240 <br />Contact: Pat <br />No, 8337n¢rP�21/56 <br />Date: ��G�� <br />Manifest #: 726;2 <br />Customer <br />Frequency of Service weekly <br />Pricing V455 per k1 rinth FLAT-RATG <br />WOM. (M) 33d -3i60 <br />0 Transfer FacilIV: <br />PQ Deslinalion Facility: <br />Alternate Transfer Facittty <br />0 A terrtate Destinadon Facility <br />0 Destination Facility <br />Daniels Sharpamarv6MS <br />Bmmett Medical Eetvlc4e,lhe <br />Daniela eherpatnart <br />Curtle Bay Energy <br />Photo Waste Recycling Inc <br />3670 Enterprlee Ave <br />2385 Amh Rd #200 <br />4144 E. Therese Ave <br />3200 HaWfts Fotnt Ad <br />2980 Kamer Blvd AC <br />Hayward CA 94545 <br />Stockton CA 95215 <br />reano CA 93725 <br />Baltimore MD 21226 <br />San Rafael CA 44901 <br />(510) 429-9911420,8811 <br />12 gal <br />$-834.OM <br />(410) 254-3228 <br />(415) 4598807 <br />MO TWOST 109 <br />rmit €I TWOST 66 <br />Permd d 2006-WMI,0030 <br />Permit i# PWR 122764 <br />Dateb <br />20 gal <br />8 gal <br />44gal <br />18 gal <br />Waste Collected: UN 3291 regulated Medical Waste n.o.s. 6.2 PG 11 <br />Shards Containers <br />fleeuiated Medical <br />Waste Pharmaceutical <br />MCC Ommotherany <br />Size Qty, <br />Size Qty: <br />Wt Size <br />Qty: Wt: <br />Size Qty: Wt <br />Up to: <br />3 gal <br />(1� <br />2 gal <br />20 gal <br />8 gal <br />12 gal <br />4 ga l <br />.38 gal <br />9 gal <br />18 gal <br />6gal <br />40 gal <br />=`-! 12 gal <br />20 gal <br />8 gal <br />44gal <br />18 gal <br />38 gal <br />12 gal <br />Weight <br />Size <br />Qty Weight <br />lltern4 <br />P <br />Weight: <br />Pathogen: <br />Description; Qt: <br />be.ntal Waste: <br />Amalgam: Size Qty Fixer. Size Qty Developer: Size QW <br />Lead; $1 ie Qt Other; $1x8 CQL__ <br />Ottiher: Type Size Qt <br />Notes: ea addl tub beAnd (6) u <br />Generator Certification: I herebycartlfy that thewntents of this oonsignmant -are full and wwratelydescribed above by proper shipping name <br />gnd tare classified, packed, marked, and labeled, and are in ell aspects In proper condition ffer transport ecoordfng to <br />applicable govemment regU1Wohs. <br />I further ded are that this shipmant of w Is tree hazardous and me waste as damned try The US code of federal <br />reP18tIOn$ and/or appropriate state rule and raga tions. <br />Generator (Customer) �:Ornvwm) A0 <br />Name of author; on (p t) Date <br />Route Driver .� 9LIS-- /1 Name o uthorized person (print) Signatu ace <br />e erdficate of Destruction <br />Incineration Name of authorized person (print) I tore Date <br />Brett Fsplcha 04/29/2015 <br />Certificate of Destruction <br />Autodaved Name of outhorizod person (print) Signature Date <br />Received Time Feb, 25, 2016 11:52AM No.1498 <br />