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Feb, 25. 2016 11:49AM No, 8337 P, 7/56 <br />tsarne« Iviedical Se s, Inc 51.04-29-9911 Ph Dalt 0l/a.vrcu 10 <br />30620 San Antonlow 510-429-9914 Faxle Manifest #: 678 <br />I Hayward Ca 94544 San Joaquin County Customer# 7560 <br />G! U. l eportor 10(4488 <br />nvironmental• Health Department DIRECTOR t(~jf3FJr637t,Ci <br />nQ. �t g —! Care Cents -'1�8 t East aWtton Avenue Linda 44(Mle <br />�F@ p� PROGRAM COORDINATORS <br />er oad gtoc on, C f9 i 4 99 32 weekly Robert McClellon, REHS <br />L • •0 $465 per iiMQnth FLAT -FATE Jeff Carruesco, REHS, RDI <br />°q • ..... • ci�P Website:gjgov.Or91ehd Kasey Foley, REHS <br />F o R Adrienne Ellsaesser, REHS <br />Phone(209) 468-3420 - <br />0 Tranafer Facility: <br />� <br />Barnett Medical Services,in <br />30620 Son Antonio S1 <br />Ha and CA 94544 <br />(510) 428-0914 <br />ermft $ TS -97 <br />Date <br />Deatinat(on <br />Fax: (209) 464-0138 <br />Rndnpy E <br />will(y N9, <br />X Fedlity: <br />o Alternate Transfer Facility <br />o Deet nedon !'80Aty <br />0 AiternMe Dostlna(lon Fac <br />Barnett Medical Services,lnc <br />Heaithwlse Servloea <br />Photo Waste Repyoling Ino <br />Curtis Bay Enargy <br />2385 Arch Rd #200 <br />4800 E Lincoln Ave <br />2800 Kamer Blvd 4iC <br />3200 Hawkins Point Rd <br />StoDldon CA 06216 <br />Fowler CA 93625 <br />San Rafael CA 94901 <br />Baltimore MD 21226 <br />(510) 429-9911 <br />559-a34-3333 <br />(d15) 499-9807 <br />(410) 364-9229 <br />Permit 4 TSIOST--106 <br />Parmit ARTS -80 <br />Permll dl PWR 122784 <br />Nrmll S 2003 WMI-0036 <br />�- pHle�lJJS� <br />r Altsmale Transfer Facility <br />ba Ws; Sharp -smart <br />4144 E. Therese Ave <br />Fresno CA 93725 <br />869,934.6262 <br />Parmlt # TSIOST-5S <br />Waste Collected: UN 3291 Regulated Medical Waste rf.o,s. 6.2 PG II <br />T'`al <br />Sharps Containers <br />Regulated Medlcal Waste <br />Pharmaceutical <br />Trace Chemotherapy <br />Size On; <br />Size Qty; Wt <br />ELe <br />Qty. Wt: <br />Slze Qty: Wt <br />Up to: <br />3 gal <br />2gal <br />20 gal <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 />8 gal <br />44 gal <br />18 gal <br />38 gal <br />12 gal <br />Size <br />Qty Weight <br />Pathogen: <br />vveight: <br />Dental Waste: <br />Amalgann: Size Qty FIXar:SIza Qty Developer:Size Qty <br />Lead:Slze Qt Other:5lze Qt <br />Other: TvDe SIZE <br />Product Delivered: <br />Iters $1 Description: Qt: <br />Notes:—r--i—i -- — r --- • -- -. — <br />e a add[ tub beyond (6) <br />Generator Certification: I herthycertify that th econtents of this consignmentare fully and accurately described above by proper ahlpping name <br />and ars classified, packed, marled, and labeled, and are In s(I 6Spbcty In pro pereonditlon for tretaport occarding to <br />applicable gavernm en t regulogone. <br />I furrhBrd eclatE thatthls shipmentof T <br />free of hazardous and meratry ste as defined by the US code o (federal <br />regu/bi(ohs and/ora propriatestate leregulations- <br />Generator (Customer) _C.m_v�QYI — _ — T _ — I kD <br />Name ofsuthori;ed son(p rind ature Date <br />qI <br />Route Driver ----- — It �j� <br />CertiFrate of Destruction <br />Incineration <br />Name oTeuthorizcid parson (print) <br />Nate of authorized person (print{ <br />Brett Espicha <br />Certificate of Destruction <br />Autoclaved Name of authorized person (print) <br />Received Time Feb,25, 2016 11:52AM No.1498 <br />Signature <br />Date <br />01/21/2015 <br />Date <br />