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+ o Tracicin Document Number: <br /> ► � �,�4 r,ir <br /> ACT' 0 1527 70 <br /> environmental services <br /> Medical Waste Tracking Document <br /> Manteca Unified School? Dist(Manca I iqh} Kimberley 1Nng <br /> o Facility N E Yo&erriite t9ntact Name: <br /> tt <br /> WOf <br /> W Of <br /> I Address: Manteca, CA 95336 Phone: 0g-$58-0860 <br /> Vf Shipping DescriptionCont <br /> Description(s) #of Cont. Type 5¢ Estimated Actual e Weight Weight Treatment <br /> UN 3291,Regulated Medical Waste,6.2,PG II <br /> ! UN 3291, Regulated Medica!Waste,6.2,PG 11 <br /> o (Pathological Waste) Irl <br /> a <br /> x <br /> UN 3291, Regulated Medical Waste,6.2,PG 11 <br /> o (Chemotherapy Waste) <br /> u. <br /> Z <br /> c� <br /> a Expired Pharmaceuticals <br /> a <br /> x <br /> N <br /> Nan-Regulated <br /> Other(specify): <br /> I A =Autociave, l=Incineration, M=Microwave <br /> Advanced Chemical Transport,Inc. <br /> a Motor Carrier Permit:0194741 <br /> CA Hazardous Waste Registration:4026 <br /> o EPA ID#:CAR000070540 <br /> z 1210 Elko Drive ❑ 2010 Mission Ave. © 265 Riggs Avenue 13722 Carmenita Road,Santa Fe <br /> Sunnyvale, CA 94089 Escondido,CA 92029 Merced,CA 95341 Springs,CA 90670 <br /> LU <br /> 0 408-548-5050 760-489-5600 209-722-4228 714-545-2191 <br /> Z MWTS Permit#TS-42 MWTS Permit#TS-66 MWTS Permit#TS-100 MWTS Permit#TS-8 <br /> Signature:_.—, Date: <br /> >W <br /> a Name: <br /> za <br /> °,i <br /> U Address: <br /> wa <br /> N rY <br /> Phone#: Signature: Date: <br /> This is to certify that the materials described above are properly classified,packaged, marked and labeled and are in proper <br /> o a condition for transportation in accordance with the applicable regulations of the United States Department of Transportation and <br /> a the State of California: <br /> LU_ <br /> LU� 1-889-7F.4_7225 <br /> 0 Lu <br /> I 24-hr Emergency <br /> Signature: Print Name: <br /> .t I Phone# 858.785-7225 Date: <br /> Healthwise Services Waste Management Healthcare E] Curbs Bay Energy Qther <br /> Medical Waste Disposal solutions 3200 Hawkins Road, <br /> 4600 E.Lincoln Ave 4280 Bardini Blvd Baltimcre,MD 21226 <br /> F <br /> Fowler California 93625 Vernon,CA 9005a 410-354-3228 <br /> :i 559-634-3333 323-307-0514 Permit#:2011-WMI-0036 <br /> F 4Permit#TS-39 Permit#TS/DST-61 <br /> a u THIS IS TO CERTIFY THAT THE WASTE IDENTIFIED ABOVE WAS <br /> RECEIVED AT THE DESTINATION FACILITY CHECKED ABOVE. Signature 8 Date: <br />