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17-7:1774 <br />linfigkiEgrleW teseF% . <br />DRIVER <br />Print Name: <br />Date: / <br />• <br />• <br />• • • SteriCYCle® <br />0.0 Protecting People. Reducing Risk: <br />NON-HAZARDOUS WASTE SHIPPING DOCUMENT <br />Phone: 866.783.7422 <br />Website: www.stericycle.com <br />Generator's Name, Address & Telephone Njokber <br />Customer # <br />1o07 . <br />c--ps c>1 <br />PAPF---fe,oc2f1—Z-Z.Aci <br />Waste Description <br />Non-RCRA Waste . <br />(photochemical/photoprocessIng waste) <br />Number of Containers <br />DW I I <br />Total Cubic Feet <br />.::::9 C9. i L---- <br />Weight Type <br />Gallon <br />Universal Waste (containing Mercury & <br />Aqueous Solution) (DentalAmalgam) DW2 I Gallon <br />Universal Waste From Dental X-Ray <br />Unit (Scrap Metal Lead Foil) DWO3 LBS <br /> <br />77V-- -111 . <br />r • s. .^ • , <br /> <br />GENERATOR <br /> <br />Print Name: çfl cL "Roi0,00 <br /> <br />Signature: <br /> <br />Date: <br /> - <br /> <br />RETAIN COPY FOR THREEYEARS <br />001-93-VN (REV 1/18)