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San Joaquin County Operations <br /> ® Medical Waste Tracking Form <br /> Date: x'=23' <br /> Pick Location <br /> ,4 1709 S. Stockton Street, Lodi, CA ❑455 W. Beverly Place,Tracy, CA <br /> ❑400 S. Fresno Avenue, Stockton, CA ® 730 N. Union Street, Stockton, CA <br /> ❑2060 E. Main Street, Stockton, CA ❑ Other: <br /> Drop-Off Location <br /> ❑1709 S. Stockton Street, Lodi, CA ❑455 W. Beverly Place, Tracy, CA <br /> . 400 S. Fresno Avenue, Stockton, CA ❑ 730 N. Union Street,Stockton, CA <br /> ❑2060 E. Main Street, Stockton, CA ❑ Other: <br /> Medical Waste Description <br /> Quantity Container Type <br /> 40 gal- Bio Hazard Bag <br /> Sharps Container <br /> Other: <br /> Other: <br /> Transport Personnel <br /> Print Name Sin --- -------- <br /> Medical Waste Transportation form <br /> Revised,5-23-12 <br />