Laserfiche WebLink
Admoobb� Barnett Medical Services, Inc 510-429-9911 Ph Date: 01120)-'2016 <br /> 1fp L nA �!� 3670 Enterprise Ave 510-266-0945 Fax Manifest M L178-77 <br /> Hayward Ca 94545 Customer# 223-2 <br /> EPA#CAL000403598 <br /> ierator: Transporter IM4891 Contact: 0,03)4E:5-2M <br /> Stocktoiii Hematol aqv Onocoloov -SWEN ency of Service weekl) <br /> IA-7PA�E <br /> Pricing F <br /> o Transfer Facility: N Destination Facility. to Transfer Facility e on Facility tj Destination Facility <br /> to-. —'s Destination <br /> a Photo Waste Recycling Inc <br /> Daniels Sharpsmart/BMS Barnett Medical SerVICSS,InG P�D—IVls Sharpsmad rU. y Energy <br /> 3670 Enterprise Ave 2385 Arch Rd 0200 4144 E.Therese Ave 32 0 Mtki..Point Rd 2980 Kerner Blvd#C <br /> Hayward CA 94545 Stockton CA 95215 Fresno CA93725 Baltimore MD 21226 San Rafael CA 94901 <br /> (510)429-9911 (510)429-9911 559-834-6252 (410)354.3228 (415)469-8807 <br /> Permit#TS-125 Permit#TS/OST-106 Permit#TS/OST-55 Permit#2005-WMI-0036 Permi(l)PWR 122764 <br /> Date KP— Date ) lao 16 <br /> Waste Collected: UN 3291 Regulated Medical Waste n.o.s.6.2 PG 11 <br /> Sharps Containers Regulated Medical Waste Pharmaceutical Trace Chemotherapy <br /> Size Qty: Size Qty: Wt Size Qty: Wt: Size Qty: wt <br /> Up to: 3 gal <br /> 2 gal 20 gal 8gal 12 gal <br /> 4 gal 38 gal 9 gal 18 gal <br /> 6 gal 40 gal 12 gal 20 gal <br /> 8gal 44 gal 18gal 38 gal <br /> 12 gal Weight <br /> I al Size Qty Weight Product Delivered: <br /> Welgk Pathogen: Item# Description: Qt: <br /> Dental Waste: <br /> Amalgam:Size_Qty—Fixer:Size Qty_Developer:Size Qty <br /> Lead:Slze_QtOther:Size_Qt�__ <br /> Other:Type SizeQt <br /> Notes- Pours f-di-T'i Fr', 0,304 <br /> Generator Certification: I herebycertify that the contents of this consignment are fully and accurately described above by proper shipping name <br /> and are classified,packed,marked,and labeled,and are In all aspects in proper condition for transport according to <br /> applicable government regulations. <br /> I further declare thatthis shipmentof waste isfree of hazy q obs and mercury waste as d ided by the US code of federal <br /> regulations ancl/o�appropylatest te rule,and let, <br /> �,,, <br /> Generator(Customer) -A ao '0 <br /> Name of authorized person(prin,* Signature Date <br /> Route Driver qrI/ "6Z /-9:9 6) -114 <br /> Name of autlzecl person(prino Signature Date <br /> -Certificate of Destruction <br /> Incineration Name of authorized person(print) Signature Date <br /> Certificate of Destruction,\ fi����Ot ate• ) � � {a I f btu <br /> Autodaved Name of authorized person(print) Signature r Date <br />