Laserfiche WebLink
i ®®i SterBcytle <br />- ®® YrawN,�ry VvoYW. Nudut6y hli4: <br />1. Generator's Name, Address and Tele <br />rt: OF <br />.PERGENCY CONTACT: CHEMTREC 1-600.424 <br />(NN'°NN'AV <br />e Number <br />STANDARD MANIFEST =-16.06-$TD <br />6106 'C1 '2nyf,,,atull pania3a� <br />�19�liI��Yl�ilm�tl���dlm <br />CUST.oMER Numorin 60`3 f) 113 5. .4 ._ () 0 g <br />5. INTERMEDIATE HANDLER 2 / TRANSPOR•I'CR 2 ADDRESS: j" <br />GENERATORI� REGISTRATION # <br />2A. DE$CRtPTION OF WASTE <br />211. <br />- <br />CONTAINER TY091 <br />2C. NO. OF <br />21). VOLUME <br />n <br />UN3291, Regulated Medical Waste, .o.s., <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />d g'� <br />I <br />U <br />TREATMENT FACILITY; I certify <br />that I have been authorized by the applicable state agency to accept untreated medical wastes and that I have <br />- ' <br />eived the above indicated wastes in accordance with the requirement outlined inithat authorization, <br />I. 'Wrype Name <br />Signature <br />Date, <br />LEAVE AT GIElNiI:-.'F$A-KJIil <br />8T/9T SJdd NVO N3AVHW-13 NOSGNIM ZZSOLZV60Z TS:LT ZTOZ/96/80 <br />