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mocKton, tA'UXMIIf <br />REGULATORY 1: <br />Phone 1: (209) 451-9031 <br />Contact : <br />SERVICE DATE: 214114 11:58:39 AN <br />UN3291, REGULATED MEDICAL WASTE, N.O.S., <br />6.2, PGI I <br />For OOT HOAT Emergency Response Call: <br />CHENTREC 1-800-424-9300 <br />Customer No. 21132 <br />TOTAL CONTAINERS COLLECTED: 1 <br />TOTAL VOLUME COLLECTED: 5.900 CU FT <br />SUMMARY(Cont Type) QTY CF <br />TB14 44 Gal Tub(Bio), CT 12.7 1 5.900 <br />00AOOM TB14 <br />I hereby declare that the contents of this <br />consignment are fully and accurately <br />described above by the proper shipping <br />name, and are classified, packaged, marked <br />and labelled/placarded, and are in all <br />respects in proper condition for transport <br />according to applicable international and <br />national governmental regulations. <br />H <br />Gmrator Signature <br />Transporter Certification: Blythe, Russell <br />Transporter Signature <br />(_J THIS IS A THROUGH SHIPMENT. <br />(XJ LOCAL TRANS CENTER <br />S ter i cyc I e -Fresno, CA <br />DESTINATION FACILITY: <br />Incinerate Only <br />Stericycle-North Salt Lake,UT <br />3A-4481JA-35 <br />Dental Waste <br />Ster icycle-Hol I ister,CA <br />Pharmaceutical <br />Stericycle-North Salt Lake,UT <br />3A-4481JA-36 <br />Standard <br />X Stericycle-Freua,CA <br />DATE ME RECE I PT AT <br />TREATMENT FACILITY: <br />DELIVERY DOCUMENT 1: PDFROOEOYJ <br />TOTAL DELISE t : 1 <br />