Laserfiche WebLink
;; • _ I <br />'4lt <br />SUTTER TRACY MAGING CTR <br />949-630002. <br />1530 Bessie Ave #109 <br />Tracy. CA 96376-3080 <br />MEDICAL WASTE TRACKING DOCUMENT <br />SERVICE DATE: 11/2912011 <br />TRUCK NUMBER <br />24 -Hour Emergency Response <br />(800) 424-9300 <br />Slate Generator's ID No. <br />Generator's US EPA 10 No. <br />2a. Description of Waste 2b. Container Type <br />Regulated NedlcalWasl N.O.S., 6.2 SHARPS (Regulated Medical Waste (Blo)) 0 gal <br />UN M. PGII <br />Regulated MedicalWaste, N.0 -S.. 6.2 SHARPS (Pharmaceutical Waste) 0 gal <br />Uhl 3M, PGJl <br />Regulated Medical WaW UO -S, 6.2 SHARPS (Regulated Medical Waste (Slo)) Ot <br />Ung a�31,12GA <br />ON %Al. pGll <br />rV.+v#1t,�a,eu �r <br />um T251, PG11 <br />0114,32M, 1201 <br />n.,..., ,. ; ., <br />UN 3291, Prill <br />Qn r. ila9�ar1 Ritts <br />U,4a23t. €dill <br />2c. No of <br />lb. or <br />Volume <br />�J Transporter 1 Is to check box If this Is a through shipment a TOTALS ID=J I I <br />Transporter 1 Address: WM Healthcare Solutions, Inc. Applicable permit numbers: Escondido- 5688— MW -172 <br />1996 Don Lee Place Ste. C Phone #: (780) 489.5009 <br />Escondido, CA 92029 Vernon- 5688 — MW -157 <br />Transporter 1 Acknowledgement of Receipt of Materials _ e --Phone #A23) 307-0514 <br />Signature <br />Print/ Typed Name/ 1"7 <br />5, I Transporter 2 Address: Phone #: { ) <br />wg <br />F.E� <br />C <br />_ Signature Penna number: <br />Print/ Typed Name Data <br />8, <br />Discrepancy <br />EE <br />E Comments <br />c8 <br />aTO terminated New TD # <br />Date ///Iq 9-j <br />7Treatment Facility Printed Certification of Receipt and Treatment <br />J1 certify that the contents of the listed contalner/s have been received, treated <br />and disposed of in accordance with all local, state, and federal regulations." <br />Print Name <br />Signature <br />Date <br />�ar <br />a� <br />c <br />A� <br />o <br />1 <br />It <br />F- <br />Q <br />we <br />i� <br />Q � <br />d <br />8�Q � <br />5� <br />