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Feb. 25. 2016 11:52AM <br />Mcarne[[ Medical Se s, Inc <br />LOP).Oks3670 Enterprise Ave <br />Hayward Ca 94545 <br />EPOCAL000404056 <br />Transporter ID#4891 <br />(— )erator: <br />Wins' Cauntrd Carp Center - Lodi <br />321 WestTumetirRoad <br />Lr -,dl. CA 95240 <br />510-429-9911 Ph <br />510266-0945 Fax <br />Contact_ pn <br />No.8337 P. 35/56 <br />Date, QBrtr*If-U I -a <br />Manifest #: 70125 <br />Customer# 2560 <br />Frequency of Service Jveeltiy <br />Prioing $455 oer Mont! FLAT -RATE <br />VVOrX: (M) 334 -UD) <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2.PG II <br />Sharps containers <br />gegulated IV_ <br />adical Wash, Pharmaceutical <br />Trace Chemotherapy <br />Size Qty: <br />0 Transfer Fsclflty: <br />Daniel$ 9tuarp®merlll3MS <br />3670 Enterprise Ave <br />Hayward CA 99545 <br />(61 D) 429-9911 <br />Date <br />0 Destination FaclUty: <br />Barnett Medical 5ervices,Inc <br />238t3Arch fid 41200 <br />Stockton CA 05216 <br />(510)4z9-9911 <br />P11 # TS/OST-10'g 0/ <br />—Dato <br />Altamete Tnahsfer Feollity <br />enlels Sharp smart <br />144 E. Therese Ave <br />reano CA 9372` <br />$09.034-6262 <br />Permit TS/0$T55 <br />0 Att®mate Deadnetton Facility <br />Curtis Bay l'.hargy <br />3200 Hawkins Point Ra <br />Ballimore MD 31228 <br />(410) 854-3228 <br />petmltN 2006•WhU•0038 <br />O Destination Facility <br />Photo Waste Recycling Inc <br />2880 Kamer Blvd #C <br />San Rafael CA 94901 <br />(415) 459-6807 <br />Permit # PWR 12276a <br />Waste Collected: UN 3291 Regulated Medical Waste n.o.s. 6.2.PG II <br />Sharps containers <br />gegulated IV_ <br />adical Wash, Pharmaceutical <br />Trace Chemotherapy <br />Size Qty: <br />Size Qty: <br />Wt Size <br />Qty: <br />Wt: Size Qty: Wt <br />Up to: <br />3 gal <br />_ <br />2 gal <br />20gal <br />S gal <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 />.8 gal <br />44 gal <br />18 gal <br />38 gal <br />12 gal <br />Weight <br />mal <br />Size <br />Qty <br />Weight <br />Product Dellke 1 <br />iltem# <br />Vve(ght: <br />E <br />Description: Qt: <br />Dental Waste: <br />Amalgam: Size qty Fixer. Site Qty Developer: Size Qty <br />Lead: Slze Qom„ Other Size Qt <br />Other: Type Size Qt <br />Notes: u u.. . <br />ea adds tub beyond (R) <br />Generator Cert111cation: I hereby certify that thecontents of this consignment are fully and accurately described above by proper Shipping name <br />and are classified, packed, marked, and labeled, and are Fri all a5oecu In proper condition for tronspart oeeording to <br />applicable government regulatfons. <br />I further declare that this shipment of waste 13 free of hazardous and mercurywaste as defined by the us codeoffederal <br />regufatrons and/ propriate Stat rules and regulations, <br />Generator (Customer' , <br />'�ariWauthorized person (print) Slgnaturwn Date <br />Route Driver <br />Certificate of Destruction <br />Incineration <br />Name of 6uthorized person (print) <br />Name of autharized person (print) <br />Brett Espicha <br />Certificate of Destruction <br />Date <br />08/05/20:5 <br />Autoclaved Name of authorized person ())rint) Slgn$rtlre Date <br />Received Time Feb, 25. 2016 11:52AM No. 1498 <br />