Laserfiche WebLink
Barnett Medical Services; Inc 510-429-9911 Ph Date: 07/30i2013 <br /> A 6- 30620 San Antonio St Manifest 375'15 <br /> 51®-429-9914 Fax Customer# 2232 <br /> 61,k no 4W Hayward Ca 94544 <br /> EPA#CAL000331285 <br /> aerator: <br /> Transporter ID#4891 contact: Sally Solanki wolx:Cm)466-2525 <br /> Stockton Hem atollow-Onocoloav .YL'rgkly <br /> 2026 N California 8t,Ste#3 Frequency of Service <br /> Stockton.CA 95204 Pricing $950 a mo. <br /> ❑ Transfer Facility: X Destination Facility: ❑ Alternate Transfer Facility ❑ Destination Facility ❑ Alternate Destination Faciii Alternate Transfer Facility <br /> Barnett Medical Services.lnc Barnetl Medical Services,inc Healthwlse Services Photo Waste Recycling Inc Curtis Bay Energy anWs Sharpsmart <br /> 30620 San Antonio St 2385 Arch Rd#200 4800 E.Lincoln Ave 2980 Kerner Blvd#C 3200 Hawkins Point Rd 4144 E.Therese Ave <br /> Hayward CA 94544 Stockl9nCA95215 Fowler CA 93625 San Rafael CA 94 got Baltimore MD 21226 Fresno CA 93726 <br /> (510)429.9911 (510)429.9911 559.834-3333 (415)459.8807 (410)354.3228 559.834.6252 <br /> Permit#TS-87 Per it TSIOST-106 Permit#TS-89 Permit#PWR 122764 Permit#2005.WMI-0036 Permit#TS/OST-55 <br /> Date Date /f 3 <br /> Waste Collected: UN 3291 Regulated Medical Waste n.o.s.6,2 PG II <br /> Sharps Containers_ Begulated Mesal Waste Pharmaceutical Trade Chemotherapy <br /> Size Qty: Size Qty: Wt Size Qty: Wt: am Qty: Wt <br /> Up to: 3 gal <br /> 2 gal 20 gal 8 gal 12 gal <br /> 4 gal 38 gal 9 gal 18 gal <br /> 6 gal 40 gal 12 gal 20 gal <br /> 8 gal 44 gal 18 gal 38 gal <br /> 12 gal Weight <br /> Igal Size Qty Weight Prod uptD_elivered: <br /> •►.night: Pathoggns Item 4 Description: Qt: <br /> Dental Waste; <br /> Amalgam:Size Qty Fixer:Size Qty Developer:Size QtY <br /> Lead:Size Qt Other:Slze Qt <br /> Other:Type Size <br /> Qt ou s: <br /> :30-4 <br /> Notes: <br /> Generator Cer0ficatlon: I herebyoertify that the contents of this consignment are fully and accudatelydescdbed 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 /> further declare that this shipment of waste Is free of hazardous and mercurywaste asdefined by the US code of federal <br /> regulations and/or appropriate state rules an egulations. <br /> 2 <br /> Generator(Customer, �d�t�lt�t ��2�' CtnC�LZ 0:1. <br /> Name of authorized person(print) Sig a ure .77Date <br /> Route Driver �L `" 13 <br /> Name ofauth ized person(print) a pate f <br /> --%:ertificate of Destructions <br /> Incineration Nameo'authoriz dperson(p►int} n turp1_p Date <br /> Brett Espicha Ai 8/3/2013 <br /> Certificate of Destruction <br /> Autoclaved Name of authorized person(print) Signature Date <br />