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Feb, 25, 2016 11:55AM <br />No, 8337 P. 52/56r, <br />Barnett MedicalSes, Inc <br />51'®-429-9911 <br />Ph Date- <br />®844-12 <br />3670 Enterprise Ave <br />510-2660945 <br />Fax Manifest #: <br />Hayward Ca 94546 <br />Wt Size Wt-. <br />Customer# <br />EPA#CAL000404096 <br />Up to: <br />Transporter ID#4891 <br />Pat <br />Worx, k2w) M TM <br />lerator; <br />Contact: <br />8 gal <br />Wine Cauiitr`v Cabe Carter - Lodi <br />Y�rt=e:sly <br />3_1 West Turner Road <br />Frequency of Service <br />18gai <br />Lodl, GA 95240 <br />Pricing <br />40 gal ` <br />O Tramiler Fecllity J51 Daslinalian Fecility. <br />Alt.-.* TMr'o(- Faculty <br />O Alternate Dealinatlon Feollity O Destination Facility <br />DAnlets SharpsmarUBMS Darnel( Medical Servicea,inc <br />anletsSnarpsmert <br />Curtis Bay Energy. . Photo Male Recycling Inc <br />3070 En'a ise Ave 2365ArO Rd *200 <br />144 E- Therese Ave <br />8200 Hawidns Point Rd 2990 Kerner Blvd MC <br />Hayward t.A 84646 Stocktan CA 95218 <br />Eno GA 92725 <br />Belllmors MD 21226 San Rafael CA 94901 <br />(510) 429-9911 L51 0) 42"911 <br />939.634-6262 <br />(410) 364-3228 (415) 459.6007 <br />PerIt 0 T9rasT 10e <br />Permit 9 T9109T-69 <br />Permit # 2005-WMI-0038 PNrmlt o PWR 122764 <br />DateiDate// �I IJ <br />Might. <br />Waste Collected: UN 8291 Regulated Medical Waste n.o,s. 6.2PG II <br />Shat s Cai3talners <br />Realgitad Medicalto <br />PharmraceutlGal <br />Trace <br />the <br />Size Qty: <br />Size Qty: <br />Wt Size Wt-. <br />Size <br />Qty: ..Wt <br />Up to: <br />3 gal <br />2 gal <br />20 gal <br />8 gal <br />12 gal <br />4gal <br />38 gal <br />9gal <br />18gai <br />6 gal <br />40 gal ` <br />�p 12 gal �� <br />20 gal <br />8 gal <br />44 gal <br />1$ gal —� <br />38 gal <br />12 gal <br />Weight <br />mal <br />Size Qty Weight <br />' rered; <br />Might. <br />Pathet?en: <br />Item# <br />Description: Qt; <br />bg0til Zfaste: <br />AmaI9artl:S(2t3 Qty Fixer: Size Qty <br />Lead; Slze Qt Other: SI2e qt_ <br />other; Type Size <br />Notes: burs <br />Developer: Size Qty <br />Generator Certification: I hereby certify that the contents of this consignment ore Mly and accurately described above by proper nhlpping name <br />and etre e)aself)ed, packed, marked, and labeled, and are In all aspects In proper condition for transport according to <br />applicable government reguladons, <br />Generator (Customej <br />Route Driver <br />%`�. <br />~'Certificate of Deetrucv®n <br />Incineration <br />further declare that this shipment Of <br />mquIations and/or appropriate state i <br />Nama of authorized person (print) <br />Name of duthoriied person (print) <br />Name of authorized person (print) <br />Brett Fsplcha <br />of hazardous and mercury waste as defined by the U5 codeof federal <br />Date <br />12/01/2015 <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) Signature Date <br />Received Time Feb,25. 2016 11:52AM No,1498 <br />