Laserfiche WebLink
24-Hour Emergency Phone Tracking Document Number: <br /> 111111. .`=a, Number: 888-785-7225 <br /> irkd � <br /> • <br /> ACTMedical Waste Tracking Document <br /> environmental services <br /> a s Facility Name: Manteca UNffed School Dist mega HEJO)act Name: 6Qmbedey Wdgtht <br /> 450 E.Yosemite Ave <br /> �o Address: r Phone: <br /> Mariteea <br /> GA 963-36— <br /> Shipping Descriptionont. Estimated Actual s) #of Cont.Cant. Type Size Weight Weight "Treatment <br /> UN 3291, Regulated Medical Waste, N.O.S. <br /> 6.2, PG 11 <br /> UN 3291, Regulated Medical Waste, N.O.S. 3 /„ <br /> o 6.2, PG 11 (Pathological Waste) <br /> a <br /> s UN 3291, Regulated Medical Waste, N.O.S. <br /> rc <br /> a 6.2,PG 11 (Chemotherapy Waste) <br /> LL <br /> z <br /> Z Non-Hazardous Pharmaceutical Waste <br /> a <br /> a_ <br /> 2 _ <br /> N <br /> Non-Regulated <br /> r - <br /> Other(specify}: <br /> A=Autoclave, l=Incineration,M=Microwave <br /> Advanced Chemical Transport,Inc. CA Hazardous Waste Registration:4026 <br /> 1210 Elko Drive,Sunnyvale,CA 94089 EPA ID#:CAR000070540 <br /> W= , Motor Carrier Permit:0194741 <br /> 0 <br /> ❑ 1210 Elko Drive ❑ 2010 Mission Ave. 265 Riggs Avenue ❑ 13722 Carmenita Road <br /> y 2 Sunnyvale, CA 94089 Escondido,CA 92029 r Merced,CA 95341 Santa Fe Springs,CA 90670 <br /> U. 408-548-5050 760-489-5600 209-7224228 714-545-2191 <br /> ~ MWTS Permit#TS42 MWTS Permit#,TS,;100 MWTS Permit#TS-8 <br /> `I ! Signature: Z Y—1Print Name: <br /> LU <br /> q P Name: DOT#: <br /> 0 Z g Address: State Transporter#or Permit: <br /> Z <br /> a <br /> U4Z4 <br /> rn K <br /> Print Name: Signature: Date: <br /> z I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, <br /> ix o marked and labeled,and are in all respects in proper condition for transport according to applicable governmental regulations. I certify that this shipment does <br /> q not contain regulated hazardous and or radioactive waste. I am aware that there are significant penalties for submitting false information including the possibility <br /> wLL <br /> of fines and imprisonment. <br /> wz _ <br /> Signature: k( ,_ f r. P �_ Print Name: `, P r� r, f t 7tJf, }Date: <br /> - _ <br /> Advanced Chemical Transport ACT Medical Advanced Chemical Transport Advanced Chemical Transport <br /> 1210 Elko Drive 2010 Misslon Ave. 265 Riggs Avenue 13722 Carmenita Road, <br /> LU z Sunnyvale,CA 94089 Escondido,CA 92029 Merced,CA 95341 8p8¢W� S�pqg� 90670 <br /> LL 408-54&5050 760-089.5600 209-722-4228 '-aL'7'1�-59'W� <br /> U3 q MWTS Permit#TS-42 Permit#TSIOST-66 mwT$Permit#TS-i= MWTS Permit 9 7S-8 <br /> 9r <br /> H N <br /> THIS IS TO CERTIFY THAT THE WASTE IDENTIFIED ABOVE WAS <br /> RECEIVED AT THE TRANSFER FACILITY CHECKED ABOVE. Signature&Date: <br /> ❑ ACT Medica! ❑ Healthwise Services Medical ❑ Waste Management Healthcare ❑ Other <br /> Z 2010 Mission Road Waste Disposal Solutions <br /> O y Escondido,CA 92029 4800 E.Lincoln Ave Fowler 4280 Bandini Blvd <br /> � 760-489-5600 Caiifomia 93625 Vernon,CA 90058 <br /> Z d Permit 11TS705T-6fi 559-634-3333 323-307-0514 <br /> w Q I Permit 9 TS-39 Permit#TSfOST-61 <br /> ww <br /> THIS$TO CERTIFY THAT THE WASTE IDENTIFIED ABOVE WAS <br /> RECEIVED AT THE DESTINATION FACILITY CHECKED ABOVE- Signature&Date: <br />