Laserfiche WebLink
4 <br />1[7 - <br />SERVICE DATE: <br />Ez <br />ROUTETRUCK NUMBER <br />�j qg <br />Seq <br />Generator No. <br />24 -Hour Emergency Response <br />Ox N <br />uENT*:': <br />DocM <br />(800) 424-9300 <br />WIA Healthcare solutions, Inc. <br />3670 Enterprise Ave. <br />Transporter 1 Address: WM Healthcare Solutions, Inc. <br />1996 Don Lee Place Ste. C <br />Escondido, CA 92029 <br />Transporter I Acknowledgement of Receipt of Materials <br />Signature <br />5. I Transporter 2 Address: <br />V <br />1, 129 Signature <br />Print /Typed Name — <br />6. Discrepancy <br />Comments <br />0 TO terminated New TD # <br />Applicable permit numbeds: <br />Escondido- 5688 — MW -172 <br />Phone #: (760) 489-5009 <br />Vernon- 5688 — MW -157 <br />Phone M. (323) 307-0514 <br />Print/ Typed Name Date <br />Phone #: ( ) <br />Permit number: <br />Date <br />Darvels Sharpsmad. Mo. <br />4144 E Therese Ave. <br />Fresno, CA 93726 <br />Phone (659) 8M-6252 <br />Permit 0: TS/OST 55 <br />Signature_ <br />Date_ <br />7. Treatment Facility Printed Certification of Receipt and Treatment <br />"I certify that the contents of the listed containeds 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 />Seq <br />Generator No. <br />24 -Hour Emergency Response <br />®7A. Transfer Facility: <br />(800) 424-9300 <br />WIA Healthcare solutions, Inc. <br />3670 Enterprise Ave. <br />9 <br />•j "'i, t oi I -k <br />Hapatd, CA 94545 <br />Phone (512) 356-8901 <br />Permit fi: TS -96 <br />State Generator's ID No. <br />- <br />Signalure <br />- <br />W1, <br />r <br />Generator's US EPA ID No. <br />Datq_ <br />99 <br />2a. Description of Waste2c. <br />2b. Container Typo <br />No of <br />--Containers <br />2d. lb. or <br />Volume <br />[:1-78. Transfer Facility: <br />WM Healthcare Solutions. Inc. <br />w] <br />5337 Luce Avenue, BLDG 243G <br />McClellan, CA 95652 <br />Phone (612) 356-8907 <br />I j;, <br />Permit #: TS -98 <br />Signature <br />Date <br />41, 1 ?2 <br />E] 7C. Incineration Facility: <br />77� E�7, I I.,,v, ;7j) �1 <br />WMFIRRC <br />0� —WAi =.AtfV,+ WA k, 1(,AMWJ, <br />7505 State Hwy 65 <br />Anahuac, TX 77514 <br />—i;i <br />O <br />14 <br />Phone (409) 267-3913 <br />Permit 0; MSW 2239-A <br />Alternate Facility: <br />V, 14 <br />V <br />Transporter I Is to check box If this Is a through shipmentEl <br />TOTALS <br />I <br />7E. Destination Facility: <br />Transporter 1 Address: WM Healthcare Solutions, Inc. <br />1996 Don Lee Place Ste. C <br />Escondido, CA 92029 <br />Transporter I Acknowledgement of Receipt of Materials <br />Signature <br />5. I Transporter 2 Address: <br />V <br />1, 129 Signature <br />Print /Typed Name — <br />6. Discrepancy <br />Comments <br />0 TO terminated New TD # <br />Applicable permit numbeds: <br />Escondido- 5688 — MW -172 <br />Phone #: (760) 489-5009 <br />Vernon- 5688 — MW -157 <br />Phone M. (323) 307-0514 <br />Print/ Typed Name Date <br />Phone #: ( ) <br />Permit number: <br />Date <br />Darvels Sharpsmad. Mo. <br />4144 E Therese Ave. <br />Fresno, CA 93726 <br />Phone (659) 8M-6252 <br />Permit 0: TS/OST 55 <br />Signature_ <br />Date_ <br />7. Treatment Facility Printed Certification of Receipt and Treatment <br />"I certify that the contents of the listed containeds 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 />