|
11/12/2010 14:19 209239dQlq BUSINESS OFFIC
<br /> PAGE
<br /> �
<br /> 14
<br /> WASTE �pO
<br /> Stwicpdo-
<br /> 4110.6.4IN CASE -
<br /> - E
<br /> STANDARDMAWEST001.1M"TO
<br /> "inFR 062(s'Y
<br /> i.twooraWrIs N �� and Tale aru T-
<br /> Ate:
<br /> Cathy/Maxine
<br /> i 410 MLSTI= AVE
<br /> MA , CSA 9S_336- 3161
<br /> I -Rna) 23Q-1222 5,�22j2 8
<br /> i
<br /> cve"NeR mumm 6059477-002 GraleMtdteReiGret7rAt�va
<br /> 2A.DESCRIFTpN OF WASTE 29. C mTmmERTVpR RC.NO OP 2D. VOLUME
<br /> REGMATM MEDICAL WASTE,n.ox®.2, 'Pt3•S7 ^ 90 Gja Tub M0 (La cu ttl CONT 9
<br /> uh 3281.FII 11 Cu FL
<br /> REGULATED MEDICAL WASTE.iws.,8.1. ^- - -�• �`i 14.9
<br /> UA!32e1 Pq fl (,'.t.t'r,
<br /> p ��t MEDICAL WASTE.mos.6.2. - . ® CUo T ® d Gu Ft.
<br /> REGULATED MEDICAL WAS o,o.s-6.21
<br /> r.Nl S701.?G rl
<br /> ILI REGULATED MMICAL WAVE,n,0.942, a • C'N C
<br /> PNJ 3291,PG 11 Cu FL
<br /> RGULATEeMEDICALWASTE.,).o.s_6.2. r7 , - 2 Qa TNh (C'be=) 42.7 Cu Ft?
<br /> Iqt x191,pE q I Ctr R.
<br /> RMLATE'D MEDICAL WASTE,0.o.&A",
<br /> LIN 3291,PC 11 Cu R.
<br /> Y J K-UULAIEu MEDICAL WAS ic,n.n...,fi.2,
<br /> Oil r,
<br /> p cu FI
<br /> z t o s C s+k�!1re^:M e...t.,L.y,1at 1n a.thAr n�.r <•r.I,„e�Aese.e..,.W.t Ar"6411,.A.M a,: r"14rV Tt TALS I-
<br /> A I ! Cv F
<br /> i 6avt:nbas abovo by the proper 9hlpprng name.and are dasalflad.podcagod.rneftad turd latsellodWwa ded,and
<br /> arc in all raSl7eCtS it.15:utxtr C9nd llon' r tmdaeg to applical.k. and stat vemrnenler r ulalwtte,-
<br /> l i t'i:'Ee2/T}pCCNdlttr� / w natzrm
<br /> .t TRAMGnnRTF9A M aM. w• .'. �rJ 0"4
<br /> �� D� C�w=e �1lC. -
<br /> W I Ar.throR,l®P--It M RM%OM:
<br /> Fresno,Ca 3332 TR{.e t+� ,o '!9+ gdsP"1• "
<br /> 172 TION:pacwrot re a,,-AkW.41A AA d"rrllueN,mmvo. F 1
<br /> i I '
<br /> Prinu7ype Nanta
<br /> E.INTEAAQ-D1ATE HANDLER 2/TRANSPORTER 2 ADDRESS:c 9:
<br /> r AppficMo Parmlt Nuabera:
<br /> w
<br /> '� � TE DI.ER d 7!RAW Cfw IATiQN:Receipt tel ttwtdipu wr�to as d eAow.
<br /> prsrl(fi!vp�le�mo C.rt^,wrh,s. �. t�nu+
<br /> 6.INTEFOIEOIATE HANCKER 3;TPAN!3Ff)FtTCF13 ADDF1ES;: Hurls a: (�
<br /> av Apvrv,-.ebb)PAimil NimitAm,
<br /> MTEMEDIATE HANDLER iTHANSROffii"M CERTIF'I,CA :Recm of r,=adiIe
<br /> eal wase ao Us Decl aAwv�e,
<br /> �� PdrMTtT^
<br /> !� rte,A isr:Uity: � BC. F�11Ay-
<br /> e a It G i44. CLE INC STMcYcLE INC
<br /> ! > ca.� a�� .1 sera v,^k %j"
<br /> 'e:A
<br /> U. ( 277- 1 9 -t 3 eI;10)�- i �
<br /> , 1
<br /> a 1 I i
<br /> p TREATMENTY:1 comy chat I have been authonxed by ttto ap®lioabfo a a+rte adapt unlreate4 medical wWos and IhM I have
<br /> re
<br /> .t
<br /> ^ ceived L;ta above it ur , ;in aCCprdancG aiFl};lip requi:t3nzon din ih MAY 2 2 ?n a
<br /> •e ,C•v
<br /> s`ttnt/�?o Nzrc1A,„ 'Q� Qia�z.,ra ✓ aa:ra --
<br /> ORIGIWA9„
<br />
|