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Stericycle, Inc. PAGE: 1 of 2 <br /> Box 79145 <br /> ni <br /> Stericyclee enix,AZ 85062-9145 OICE DATE 04/30/2005 <br /> r o. <br /> NVOICE NUMBER 0003235879 <br /> CUSTOMER NUMBER 6050356 <br /> Experts in Infection Control and Healthcare Compliance Services <br /> C3 PREVIOUS BALANCE $4,792.41 <br /> FOR CUSTOMER SERVICE TOTAL ADJUSTMENTS . -$4,792.41 <br /> GAMBRO HEALTH CARE-SAN JOAQUIN 886-STERI-CALL TOTAL NEW CHARGES. $2,140.33 <br /> -.I ACCOUNTS PAYABLE 866-783-7422 <br /> C3 15253 BAKE PKWY <br /> ep IRVINE,CA 92618-2502 FOR PICK-UP INFORMATION TOTAL'..BALANCE DUE <br /> 800-MED-WASTE BY 05/30/2005 $2,140.33 <br /> 800-633-9278 <br /> 31111-U742"11KOX4UB0001733 612610A <br /> WEIGHMASTER CERTIFICATE: This is to certify that the foilow ing described commodity was weighed,measured,or counted by a weighmaster,whose signature <br /> is on this certificate,and who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the <br /> California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. <br /> MAY 1 6 2005 <br /> CERTIFICATION:The material listed on the manifest#(s)details below(infectious medical waste)has been treated in accordance with the requirements of federal,state,and local <br /> regulations governing the treatment of such waste.A copy of this certificate,applicable manifests,and the appropriate logs will remain on file with the company. <br /> MANIFEST/ QUANTrrY/ <br /> DATE ORDER NUMBER CONTAINERS DESCRIPTION WEIGHT PRICE TOTAL <br /> PREVIOUS BALANCE1011 $4,792.41 <br /> ADJUSTMENTS /�g t -$4,792.41 <br /> 95 9/2005 6 ; Payment -$2,352.42 <br /> ,:✓ <br /> �rL' v Payment -$2,439.99 <br /> A I=;•e 1- .9-M REMAINING PREVIOUS BALANCE $0.00 <br /> am 1 I�� 8 -NEW CHARGES $2,140.33 <br /> Site 001: Gambro Health Care,3915 W March Ln,Stockton,CA 95219 <br /> Commodity Medical Waste;Weighed of Stericycle,Inc.,1345 Doolittle Dr Ste C,Sen Leandro,CA 94577. Tom Staiberger,Deputy Weightmaster <br /> 04/04/2005 MDRC003EVZ 1.00 Energy Charge 0.00 LB $4.000 EA <br /> $4.00 <br /> 04/04/2005 MDRC003EVZ 4-00 90 Gal Tub(Bio)CT 27.2 LB 466.90 LB $0,517 LB $251.73 <br /> 04/07/2005 MDRC003FB7 1.00 Energy Charge 0.00 LB $4.000 EA $4.00 <br /> 04/07/2005 MDRC003FB7 6.00 90 Gel Tub(Bio)CT 27.2 LB 511.90 LB $0.517 LB $264.65 <br /> 04/11/2005 MDRC003FJB 1.00 Energy Charge 0.00 LB $4.000 EA $4.00 <br /> 04/11/2005 MDRC003FJB 6.00 90 Gel Tub(Bio)CT 27.2 LB 541.80 LB $0.517 LB $280.11 <br /> 04/14/2005 MDRC003GOO 1.00 Energy Charge 0.00 LB $4.000 EA $4.00 <br /> 04/14/2005 MDRC003GOO 5.00 90 Gel Tub(Bio)CT 27.2 LB 506.80 LB $0.517 LB $262.02 <br /> 04/18/2005 MDRC003G7A 1.00 Energy Charge 0.00 LB $4.000 EA $4.00 <br /> 04/18/2005 MDRC003G7A 4.00 90 Gal Tub(Bio)CT 27.2 LB 437.50 LB $0.517 LB $226.19 <br /> 04/21/2005 MDRC003GM2 1.00 Energy Charge 0.00 LB $4.000 EA $4.00 <br /> PLEASE DETACH AND RETURN BOTTOM PORTION WITH YOUR PAYMENT IN THE ENCLOSED ENVELOPE <br /> AMOUNT ENCLOSED TOTAL BALANCE DUE BY 05/30/2005 <br /> $ $2,140.33 <br /> ® CUSTOMER NUMBER INVOICE DATE INVOICE NUMBER <br /> V 6050356 04/30/2005 0003235879 <br /> 00 Sterids clesCHECK CARD USING FOR PAYMENT <br /> 0® Stericycle, Inc. PC <br /> ECUR;yP.O. BOX 79145 ❑MASTERCARD ODISCOVERISA AMERICAN EXP.I CODE <br /> Phoenix, AZ 85062-9145 CARD NUMBER EXP.DATE <br /> RETURN SERVICE REQUESTED SIGNATURE PRIPITED NAME <br /> 0006050356 0003235879 0000214033 3 030005 <br /> ADDRESSEE: REMIT TO: <br /> �leleoee�ele�leun0�fee�nelele�elellinn�ell�elnel0e�ne�� (�e1�te�eOl�IeIeelLeellelle�Iene�le�n0e'e�n�ee�e�elenev'I� <br /> GAMBRO HEALTH CARE-SAN JOAQUIN STERICYCLE, INC. <br /> ACCOUNTS PAYABLE P.O. BOX 79145 <br /> 15253 BAKE PKWY <br /> IRVINE,CA 92618-2502 PHOENIX,AZ 85062-9145 <br /> 11.11 tfllee1Hid 111.1leeM11.1t1.11.1n111.11letIll.11 <br /> 31111-U742'11KOX4UB0001733 11K0X9GFD:1.2 IBIUI ���tql IMlld��il9 011t �9� <br />