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Medical W6 to Systems"' <br />FACILITY NO. <br />� I (lllii iiiwi iiiii iiiii ilii ilii iiiii ii <br />' <br />V310TRACK. BFI Medicair Tracking System <br />TICKET NO <br />/01 C4 <br />Regulated medical waste, 6.2, NA9275, PGII <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />This is to certify that the above named <br />materials are pro 6 <br />perly <br />classified, packaged, marked, and labeled and prelin proper.,�', <br />condition for transportation according to the 'U <br />apip icable: <br />regulations of the Department of Transp <br />ortation. <br />F -J BFI MEDICAL WASTE SYSTEMS OTHER <br />366-8 Greenville Road <br />Livermore, CA 94550 <br />(510)449-9323" <br />MWTS Permit #00122P-3 <br />X <br />F-] BFI MEDICAL WASTE SYSTEMS <br />11875 White Rock Road OTHER <br />Rancho Cordova, CA 95742 <br />(916) 364-8872 <br />MWTF Permit #99-00072-P x <br />El <br />I <br />t. eo- <br />#45432 TICKET, 4719754 <br />SINGH DIALYSIS INC <br />07/03/95 10:46 TAW <br />CONTAINERS COLLECTED: <br />1 63602 83173 B6031 B109 <br />2 86317 84626 B6320 <br />1 TOTAL COLLECTED: 7 <br />78 <br />TOTAL DELIVERED: <br />78 <br />Customer Signature (not required) Date <br />L <br />1st Transporter Date <br />initial Date received at Transfer Station <br />2nd Transporter (it applicable)— <br />Treatment by incineration Authorized Signature <br />This is to certify that the waste described herein has been treated in accordance with all applicable laws and regulations. <br />Date <br />