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lapBarnett Medical Services, inc 510429-99-11 Ph Date: 07/08/2015 <br /> 3670 Enterprise Ave 510-266-0945 Fax Manifest#: 77349 <br /> Hayward Ca 94545 Customer# 2232 <br /> EPA#CAL000404096 <br /> Transporter IM4891 <br /> If lerator: Contact: Saif� Solanki Work:(209)465-2528 <br /> Stockton Hematoiopv O>i oc olotpi-S-toc'ki <br /> 2020 NGailtomla Sit,ste#3 <br /> Frequency of Service weekly <br /> Stockton,CA 95204 Pricing $950 a rrFo. <br /> O Transfer FaaTity.. X Destination Facflk)r O Alternate Transfer Facility O ARemale Destination FeaGty O Destination Faclry <br /> Daniels SharpsmartfBhfS Barnett Medical SerAces,tnc Duels Sharpsmart Curtis Bay Energy Photo Waste Recycling Inc <br /> 3670 Enterprise Ave 2385 Arch Rd#200 4144 E.Therese Ave 3200 Hawkins Podnt Rd 2080 Kamer Blvd#C <br /> Hayward CA 94545 Stockton CA 95215 Froano CA 03725 Baltimore MD 21226 San Rafael CA 94001 <br /> (510)42941811 (510)429.9911 550-834-6252 (410)9543228 (415)4593807 <br /> Perrnh#TSlOST-106 Permit#TSIOST 55 Permit#2006-WMIM36 PermR#PWR 122764 <br /> Daae Dato ,— <br /> Waste Collected: UN 3291 Regulated Medical Waste n.o.s.6,2 PG II <br /> Sharps Containers Regulated Medical Waste Pharmaceutical Trade Chemotherapy <br /> Size qty: Size Qty: Wt Size Qty: Wt: Size Qty: Wt <br /> Up to: 3 gal <br /> 2 gal 20 gal 8 gal 12 gal <br /> 4gal 38 gal te::— _ 9gal 18gal <br /> 6 gal 40 gal 12 gal 20 gal <br /> 8 gal 44 gal 18 gal 38 gal <br /> 12 gal Weight <br /> al Size Qty Weight Product Dellyered: <br /> Weight: Pathogen item It Description: Qt: <br /> pinta Waste- <br /> Amalgam:5lze Qty Fixer:Size Qty Developer:Size Qty <br /> Lea d:Size Qt Other:Size Qt <br /> Other:Type Size Qt <br /> Notes: ours: - , ri 8:304 <br /> Generator Certification: I herebycortify that thecontents 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 is In proper condition transport according to <br /> applicable government regulations, <br /> furthe declare that this shipment of waste Is free zardous ast fined by the US codeof federal <br /> regula ons a or opriate state rule and reg tions. / <br /> Generator(Customer) <br /> authorized perso prin gra re Date <br /> + q 1 <br /> Route Driver c.at ~�---- '—/-C <br /> Name of authorized rson(print) OlgripMV.1 Date <br /> `�fxate of Destru coon <br /> Inclneratlon Name of authorized person(print) r SJgn lure DF11 <br /> Certificate of Destruction Brett Espicha Y)t�� � T- <br /> AutOdaved Name of authorized person(print) Signature Date <br />