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. ® Page: I of 2 <br /> 00 Siericycle <br /> 1891660 <br /> Experts in Infection Co Gambro Health Care-San Joaquin <br /> Control and Healthcare Compliance Services <br /> m Accounts Payable <br /> 9788 Glenoaks Blvd,Suite 300 115 <br /> Columbia <br /> Sun V a <br /> valley Y <br /> CA <br /> 91 <br /> 3 <br /> 52 <br /> 4 Aliso Viejo CA 92656-1458 <br /> FOR CUSTOMER FOR PICK-UP INVOICE DATE INVOICENUMBER <br /> SERVICE INFORMATION CUSTOMER NUMBER TERMS <br /> CALL 800-953-9324 CALL 800-953-9324 <br /> Oti0��8fi2593� �t� <br /> Net 3 <br /> h <br /> O Days <br /> y <br /> >+�....... ...... roti:........:::.::.......::. <br /> ............ <br /> Site: 001 .Gambro Health Care <br /> 3115 W March Ln, Stockton, CA 95219 <br /> WEIGHMASTER CERTIFICATE:This is to certify that the following described commodity was weighed,measured or counted by a weighmaster,whose signature is on this certificate, <br /> Who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, <br /> administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> Commodity:Medical Waste;Weighed at:Stericycie,Inc.,1345 Doolittle or Ste C,San Leandro,CA 94577 Terry Sham Deputy Weighmaster <br /> 06 03 2004 MDRC002JUB 4.00 90 Gal Tub(Bio CT 27.2 LB <br /> 06/03/2004 MDRC002JUB 1.00 Energy.Charge 443.80 0.517 T <br /> 229.44 <br /> 06/07/2004 MDRC002K3J 6.00 En Gai Tub(Bio)CT 27.2 LB 0.00 2.750 7.3706/07/2004 MDRCO02K32.75 <br /> J 1.OD Energy Charge 536.50 0.517 2-75 <br /> 277.3706/10/2004 MDRC002KMG 6.00 90 Gal Tub(Bio)CT 2T:2 LB 0.00 2.750 2,75 <br /> 06/10/2004 MDRC002KMG 1.00 Energy Charge 553.90 0.517 286.3706/14/2004 MDRC002KUA 3.00 90 Gal Tub(Bio)CT 27.2 LB 0.00 2.750 2.75 <br /> 06/14/2004 MDRC002KUA 1.00 Energy Charge 407.10 0.517 LB 210,47 <br /> 06/17/2004 MDRC002LAI6.00 90 Gal Tub(Bio)CT 27.2 LB 0.00 2.750 EA 2.75 <br /> 06/17/2004 MDRC002LAI 1.00 Energy Charge 518.40 0.517 LB 268.01 <br /> 06/21/2004 MDRC002LLN 4.00 90 Gat Tub(Bio)CT 27.2 LB 0.00 2.750 EA 2.75 <br /> 06/21/2004 MDRC002LLN 1.00 Energy Charge 454.60 0.517 LB 235.03 <br /> 06/24/2004 MDRC002MIU 6.00 90 Gal Tub(Bio)CT 27.2 CB 0'00 2.750 EA 2.75 <br /> 06/24/2004 MDRC002MIU 1.00 Energy Charge 618.50 0.517 LB 319.76 <br /> 06/28/2004 MDRC002MCQ 6.00 90 Gal Tub(Bio)CT 27.2 LB0.00 2.750 EA 2.75 <br /> 06/28/2004 MDRC002MCQ 1.00 Energy Charge 450.90 0.517 LB 233.12 <br /> 0.00 2.750 EA 2.75 <br /> E1t3<f3�9.5;?;:a:a: <br /> � <br /> L: � 0 00 0.00 <br /> 0.00 <br /> :":`?``` f>tIESSAI `GE#R1T�R TOTAL:0 00 INVOICE TO <br /> CONTINUED <br /> JUL 15 2004 <br /> [CEERTION: THE MATERIAL LISTED ON THE MANIFEST #'(S) DETAILED ABOVE (INFECTIOUS MEDICAL WASTE) HAS BEEN TREATED IN ACCORDANCE <br /> REQUIREMENTS OF FEDERAL, STATE, AND LOCAL REGULATIONS GOVERNING THE TREATMENT OF SUCH WASTE. A COPY OF THIS <br /> TIFICATE,APPLICABLE MANIFESTS,AND THE APPROPRIATE LOGS WILL REMAIN ON FILE.WITH THE COMPANY. <br /> .2 11001 STEUOIDI.2TP 00002107 i 00002SS2 DETACH AT PERFORATION AND RETURN BOTTOM.PORTION WITH YOUR PAYMENT <br />