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C <br />Sort <br />I Ii 'P, - �� fiv,�-' <br />Generator Na. <br />24 -Hour Emergency Response <br />[]-/A. Transfer Facility: <br />(800) 424-9300 <br />WM Healthcare Solutions, Inc. <br />x;a <br />3670 Enterprise Ave. <br />Hayward, CA 94545 <br />State Generator's ID No. <br />Phone (512)356-8901 <br />Permit #: TS -96 <br />U; <br />Signature_ <br />YI <br />Generator's US EPA ID No. <br />Date_ <br />2a. Description of Waste <br />2b. Container Type <br />2c. No of <br />2d. lb. or <br />El"71211. Transfer Facility: <br />Containers <br />Volume <br />WM Healthcare Solutions. Inc. <br />iAI,E* ,��t„'ir<,iti <br />k, f i rj -j(:,')t i5337 <br />Luce Avenue, SLOG 243G <br />McClellan, CA 95652 <br />Phone 356-8907 <br />0 <br />(512) <br />Permit 0: TS -98 <br />Signature_ <br />Date <br />13 <br />7C. Incineration Faci[ity: <br />WMRRRC <br />7505 State Hwy 65 <br />Anahuac, TX 77514 <br />iPhone <br />(409) 267-3913 <br />Permit #: MSW 2239-A <br />E] 7D, Alternate Facility: <br />!'1,;4 -1 -,J 1rs)) <br />I 1V fcd <br />Transporter I Is to check box if this Is a through shipment❑ <br />- <br />iE. Destination Facility: <br />!1 <br />U) <br />E <br />E <br />0 <br />0() <br />is <br />Transporter 1 Address: WM Healthcare Solutions, Inc. <br />1996 Don Lee Place Ste. C <br />Escondido, CA 92029 <br />Transporter 1 Acknowledgement of Receipt of Materials <br />Signature <br />5. j Transporter 2 Address: <br />Signature <br />Print/ Typed Name <br />6] Discrepancy <br />Comments <br />r-1 To terminated New To # <br />Daniais Sharpsminc. <br />Applicable permit numbeds: Escondido- 5688— MW -172 4144 E Therese Ave. <br />Phone #: (760) 489-5009 Fresno, CA 93725 <br />Vernon- 5688 — MW -157 Phone (559) 834-6252 <br />Phone If: (323) 307-0514 Permit #: TSIOST 65 <br />Signature <br />Print / Typed Name Date Date <br />Phone #: 7. Treatment Facility Printed Certification of Receipt and Treatment <br />"I certify that the contents of the listed container/s have been received, treated <br />and disposed of in accordance with all local, state, and federal regulations.” I <br />Permit number: <br />Data — <br />Print Name <br />Signature <br />Date <br />E <br />K <br />CL <br />0 W <br />t3 <br />4) CL <br />r <br />8 <br />e <br />E cL Vt di <br />co: E <br />m <br />Z 0 <br />0 m & <br />11 am <br />0) CL <br />10 <br />r- CL <br />0 <br />4) <br />W <br />ar can 00 <br />0 <br />02 <br />z._ <br />A <br />c <br />7- <br />E <br />0 W E <br />E m <br />> IV, <br />-so <br />cr) cri a <br />mo .a IT <br />'. 120 in, <br />rq 0o <br />W C <br />v® .2) <br />Q) <br />X <br />