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Feb. 25, 2016 11:50AM <br />No, 8337 P. 18/56 <br />8 gal <br />Barnett Medical Se s, Inc 51'4-4299911 Ph <br />3670 Enterprise Ave510-2 6-0945 Fax <br />Date: 041IM?-u,ta <br />Manifest #: 090 <br />38 gal <br />San Joaquin �ounty <br />2560 <br />6 gal <br />Hayward Ca 94545 <br />Customer# <br />Out AL00040409 <br />O <br />�..P - nor ID048A nvironmental Health Department <br />DIREtlTORLinPYA' <br />( ~ at . �--b <br />? 1868 Eas€-'4 Iton Ave ;Se <br />// <br />12 gal <br />r5tn, C Oen Y 5 232 weei!ly <br />Care Cent® olt n <br />PROGRAM COORDINATORS <br />Robert McClellon, REHS <br />• <br />�' Odd <br />Size Qty <br />WeightPro <br />Jeff Carruesco, REHS, RDI <br />gGiFp'Ft�� <br />Website: jgov.org e 5Cper (vlcrith FLAT -RATE Kasey Foley, REHS <br />Pathogen: <br />Phone: (209) 468-3420 <br />Adrienne Ellsaesser, REHS <br />Rodney Estrada, REHS <br />ax: <br />Willy Ng, REHS <br />O Transfer Facility: <br />N 0e411natl0h Feolllty: O Alternate Transfer Facility ❑ Allamate De6linaticn <br />Facility O DaBlinetion Facility <br />Daniela Sherpsman/BM9 Barnett Medical Services,lnc banlels Sharpemart Cunla Say Energy Photo Wosto Recycling Ino <br />3070 EnterpriseAve 2306 Arch Rd 1!200 4144 E. Therese Ave 3200 Hawkins Point Rd 2980 Kerner Blvd CC <br />Heyward CA 94545 <br />(610) 429-9811 <br />9looldon CA 95215 Froono CA P3729 Baltimore MD.71226 <br />(610)429-9911 55'9-934-6252 (410)3543228 <br />San Rafaet CA 94901 <br />(416)459-8807 <br />Perm1t(/*�TS/09T-106 Permit#TSrOST-55 Parmit92605-VYWO038 <br />Pennh9PWR1227ed <br />Date1�Dal <br />/ <br />S <br />Waste Collected; UN 3291 Regulated Medical Waste mo,s. 6.2 PG 11 <br />Sharps Containers Rgguliated Medlcal Waste Pharmaceutical Trace Chemotheraav <br />Size Qty: Size Qty: Wt Size Qty: Wt; Size Qty: Wt <br />Up to: 3 gal <br />2 gal <br />20 gal <br />8 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 />Welght <br />r"``el <br />Size Qty <br />WeightPro <br />bye(ght; <br />Pathogen: <br />Item <br />ntartal Waste: <br />AmaIgam:5ize Qty Fixe r: Size Qty D6V010pat.S(ka Qty <br />Lead:51za Qt Orh2r:Slze Qr <br />Other: Tvoe Size Qt <br />Descrlptlon- Qt: <br />Notes: j-- w "v. ,., .. , . — — <br />ea addl tut? Oeyond (9) <br />Generator Certification: 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, snd are In ell aspects In proper coneirlon for trencport aecording to <br />applicable government regulations. <br />Generator (Customer) <br />Route Driver <br />e:ertifica t e of Destruction <br />Incineration - <br />Certlfkat e of Dest ru ctl on <br />Autodeved <br />Received Time Fe'b,25. <br />I further declare that this Shipment of waste Is free of hawdous and mercurywaste as defined by hie US cod eof federal <br />r9xie lops and/or appropriate state rules and regulations. <br />Name of aut:horized parson (print) S <br />Name eut orizod pamon (print) 5 <br />Name of authorized person (print) /7 <br />Brett Espicha <br />Name of authorized parson (print) Signature <br />2016 11:52AM No,1498 <br />Date <br />tl? <br />, <br />ate <br />Date <br />04/09/2015 <br />Date <br />