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Feb. 25. 2016 11:52AM <br />tsarnett Ivisdical Sa s, Inc <br />C <br />3670 Enterprise Avdw <br />Hayward Ca 94545 <br />EPAOCAL000404096 <br />Tran" <br />porterlD#4991 <br />�'�wrator: <br />Wins Catln" Care Center _ Lodi <br />321 VNk-qt TUrmer Rosd <br />Lodi, CA 9524 <br />�• <br />yjallY44Mi' <br />Contact: Pat <br />No.8337 P. 34/56 <br />Date: 87/28/2015 <br />Manifest; #: 70124 <br />Customer# 2560 <br />Frequency of Service weekly <br />Pricing $455 per ticH-v FLAT-RAIt <br />Work: PQ) .s4-3760 , <br />Cl Transfer Facility; <br />Daniels BhArii3aAv lBM3 <br />PO Deslination Facility. <br />Daniell Modlaal Avvio®m,ino <br />Alternate Trenafer Facility O Altsmate Deatlnetlon Facility <br />panlale 3h1l $Marl Curtis Bey Energy <br />D Deslinatian Foolity <br />Photo Waste Recycling Inc <br />$670 Enterprise Ave <br />Hayward CA 94545 <br />2385 Arch Rd 0200 <br />Stodctnn CA 95215 <br />4144 �, Therese Ave <br />Ftesno CA 93726 <br />8200 Nawklne Point fid <br />Baltimore MD x1226 <br />2650 Kamer Blvd #Q <br />San Rafael CA 94901 <br />(510) 429-9911429-0911 <br />Umlt <br />55@-83"252 <br />(410) 354-92ze <br />(415) 4630807 <br />Dale <br />0 TWOOT:108 Perrnft# TS/OST•55 <br />Dat%Sr <br />permit (P 2005-WMI.003e <br />pennit# PWR 172704 <br />,I.� <br />Waste Collected, UN 3291 Regulated Medical Waste n.o.s. 6.2 PGt II <br />Sharps Containers <br />Wulated Mgdlcal Waste <br />Pharmaceutical <br />Trace Chemotherapy <br />Size Qty: <br />Size Qty: Wt <br />Slae Qty: <br />Wt: Size Qty: <br />Wt <br />Up to: <br />3 gal 17— <br />'4O. <br />2gal <br />20gal <br />8gal <br />12 gal <br />4 gal <br />38 gal <br />9 gal <br />18 gal <br />6 gal <br />40 gal <br />12 gal <br />20 gal <br />S gal <br />44 gal <br />18 gal �'` <br />38 gal <br />12Weight g at <br />�® <br />mal <br />Size qty <br />Weight <br />product belivered: <br />bveight: <br />Pa o en: <br />Item # Description: Qtc <br />Amalgam: Size Qty Fixer; Size_ Qty DeveIOper:Size Qty <br />Lead: Size Qom_ Otn®r. Sizo %_, <br />Other: Type Size Qt <br />NOte5- upta(6)40's per MO.<)a $75 Hours: 8-5 <br />ee ®ddl tUb beyond (5) <br />Generator Cartification: <br />Generator (Customer} <br />Route Driver <br />c artiftrate of Destruction <br />Incineration <br />I hereby car%(y that the contents of this mnsignmentare fully and accurately described above by proper shipping name <br />and or® clesrlfled, packed, Iry�ffrfoed, end labeled, and ale In ail aspects in proper condition for transport according to <br />Applicable government regulatlorrs, <br />I further declare that this shipment of <br />regulatrons agnd�/w appropriate state i <br />dam Z) ' <br />Name of authorized person (print) <br />Name cfauthorized person (print) <br />Name of authorized person (print) <br />Brett Espiche <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) <br />Received Time Feb,25. 2016 11:52AM No,1498 <br />of hazardous and <br />signature <br />asdefi the US codeof federal <br />Date <br />Date <br />Date <br />07/29/2015 <br />Date <br />